Effectiveness and Duration of Protection of One Dose of a Meningococcal Conjugate Vaccine
Effectiveness and Duration of Protection of One Dose of a Meningococcal Conjugate Vaccine
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DOI：
10.1542/peds.2016-2193
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发表时间：
2017-02-01
期刊：
影响因子：
8
通讯作者：
Messonnier, Nancy E.
中科院分区：
文献类型：
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作者：
Cohn, Amanda C.;MacNeil, Jessica R.;Messonnier, Nancy E.
背景技术：脑膜炎球菌结合疫苗于2005年开始根据血清学终点获得许可，并推荐用于青少年。在11至12岁时服用一剂，预计可在青春期后期提供保护。我们进行了一项病例对照研究，评估脑膜炎球菌疫苗的有效性（VE）和保护期。（A、C、W和Y组）白喉类毒素多糖结合疫苗方法：从1月1日起，美国通过脑膜炎球菌病监测点在青少年中发现了经培养或聚合酶链反应证实的血清群A、C、W和Y脑膜炎球菌病病例，2006年至2013年8月31日。尝试每例病例入组4名朋友和学校对照。VE计算使用广义估计方程，控制潜在的医疗条件和吸烟。结果：血清型C占88（49%），血清型Y 80（44%），血清型W 13（7%）的登记病例。36例（20%）病例和87例（44%）对照接受了MenACWY-D。疫苗接种后0 - 8年的总体VE估计值为69%（51%-80%）;< 1年的VE为79%（49%-91%），1 - 3年为69%（44%-83%），3 - 8年为61%（25%-79%）。VE对血清群C为77%（57%至88%），对血清群Y为51%（1%至76%）。结论：MenACWY-D在接种后第一年有效，但在接种后3至< 8年有效性减弱。该评价的VE估计值告知免疫实践咨询委员会决定增加MenACWY的加强剂量。
BACKGROUND: Meningococcal conjugate vaccines were licensed beginning in 2005 on the basis of serologic end points and recommended for use in adolescents. A single dose at age 11 to 12 years was expected to provide protection through late adolescence. We conducted a case-control evaluation of vaccine effectiveness (VE) and duration of protection of a meningococcal (groups A, C, W, and Y) polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D).METHODS: Cases of culture-or polymerase chain reaction-confirmed serogroup A, C, W, and Y meningococcal disease among adolescents were identified through meningococcal disease surveillance sites in the United States from January 1, 2006, through August 31, 2013. Attempts were made to enroll 4 friend and school controls per case. VE was calculated using the generalized estimating equation, controlling for underlying medical conditions and smoking.RESULTS: Serogroup C accounted for 88 (49%), serogroup Y 80 (44%), and serogroup W 13 (7%) of enrolled cases. Thirty-six (20%) cases and 87 (44%) controls received MenACWY-D. The overall VE estimate 0 to 8 years postvaccination was 69% (51% to 80%); VE was 79% (49% to 91%) at < 1 year, 69% (44% to 83%) at 1 to < 3 years, and 61% (25% to 79%) at 3 to < 8 years. VE was 77% (57% to 88%) against serogroup C and 51% (1% to 76%) against serogroup Y.CONCLUSIONS: MenACWY-D was effective in the first year after vaccination but effectiveness waned 3 to < 8 years postvaccination. The estimates of VE from this evaluation informed the Advisory Committee on Immunization Practices in its decision to add a booster dose of MenACWY.