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Meningococcal ACWY Vaccination Has its Limitations
J Infect Dis; ePub Nov 15; Oldfield, et al
Among teenagers who have received vaccination against Neisseria meningitidis with the conjugate MenACWY vaccine, expansion of capsule-expressing isolates of the 2013 strain of Neisseria meningitidis serogroup W clonal complex ST-11 (MenW:cc11) indicates different susceptibilities to immunity induced by vaccine.
- Investigators performed whole genome sequencing to determine strains of Neisseria meningitidis.
- The genomic fingerprints of carried and invasive MenW:cc11 were then compared.
- W: P1.5,2: F1-1: ST-11 (cc11) isolates that belonged to the 2013 strain of the South American-United Kingdom MenW:cc11 sub-lineage were responsible for increased carriage of group W Neisseria meningitidis among university students.
Citation:
Oldfield NJ, Green LR, Parkhill J, et al. Limited impact of adolescent meningococcal ACWY vaccination on group W carriage in university students. [Published online ahead of print November 15, 2017]. J Infect Dis. doi:10.1093/infdis/jix596.
This study looked at the effects of vaccination on the carriage of Neisseria species in a young adult university population. Despite a 70% vaccination rate, carriage of a hypervirulent clonal South American-United Kingdom menW:cc11 strain increased over time. In comparison menY carriage remained the same. The conclusion is that vaccination did not prevent the spread of this particular clonal isolate, and that the vaccine works better at preventing disease with some circulating strains than others. Timing of vaccination in relation to entering university and increasing the vaccination rate may improve the vaccine effectiveness.
-Sarah Rawstron, MB, BS, FAAP, FIDSA
Pediatric Residency Program Director, The Brooklyn Hospital Center, NY
Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY