Seroprevalence of Antibodies against Serogroup C Meningococci in England in the Postvaccination Era

Author:

Trotter Caroline L.1234,Borrow Ray1234,Findlow Jamie1234,Holland Ann1234,Frankland Sarah1234,Andrews Nick J.1234,Miller Elizabeth1234

Affiliation:

1. Department of Social Medicine, University of Bristol, Bristol, United Kingdom

2. Vaccine Evaluation Unit, Health Protection Agency North West, Manchester Royal Infirmary, Manchester, United Kingdom

3. Statistics Unit, Centre for Infections, Health Protection Agency, Colindale, London, United Kingdom

4. Immunisation Department, Centre for Infections, Health Protection Agency, Colindale, London, United Kingdom

Abstract

ABSTRACT The United Kingdom introduced meningococcal serogroup C conjugate (MCC) vaccines in 1999, resulting in substantial declines in serogroup C disease and carriage. Here, we measured the age-specific prevalence of serum bactericidal antibodies (SBA) to Neisseria meningitidis serogroup C and immunoglobulin G (IgG) concentrations to serogroups A, C, W-135, and Y in 2,673 serum samples collected in England between 2000 and 2004. We compared the seroprevalence of SBA titers of ≥8 in the postvaccination era with results from an earlier prevaccination study conducted using the same methods. We found that the percentages of individuals with protective SBA titers were higher in 2000 to 2004 in all of the age groups targeted for MCC vaccination. In the postvaccine era, the prevalence of protective titers was high (75%) in children who had recently been offered routine immunization, but this fell to 36% more than 18 months after scheduled immunization. In the cohorts targeted in the catch-up campaign, the percentage achieving SBA titers of ≥8 was higher in children offered the vaccine at ages 5 to 17 years than in children offered the vaccine at ages 1 to 4 years. The geometric mean concentration (GMC) IgG for serogroup C followed a similar pattern, corresponding to the age at and time since scheduled MCC vaccination. Serogroup-specific IgG GMCs for W-135 and Y were low and showed little variation by age. Serogroup A IgG GMCs were higher, possibly reflecting exposure to cross-reacting antigens. Although the incidence of serogroup C disease remains low due to persisting herd effects, population antibody levels to serogroup C meningococci should be monitored so that potentially susceptible age groups can be identified should herd immunity wane.

Publisher

American Society for Microbiology

Subject

Microbiology (medical),Clinical Biochemistry,Immunology,Immunology and Allergy

Reference34 articles.

1. Andrews, N., R. Borrow, and E. Miller. 2003. Validation of serological correlate of protection for meningococcal C conjugate vaccine by using efficacy estimates from postlicensure surveillance in England. Clin. Diagn. Lab. Immunol.10:780-786.

2. Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection

3. Borrow, R., P. Balmer, and E. Miller. 2005. Meningococcal surrogates of protection-serum bactericidal antibody activity. Vaccine23:2222-2227.

4. Borrow, R., and E. Miller. 2006. Long-term protection in children with meningococcal C conjugate vaccination: lessons learned. Expert Rev. Vaccines5:851-857.

5. Department of Health. 8 February 2006. Planned changes to the routine childhood immunisation schedule. Department of Health London United Kingdom. http://www.dh.gov.uk/assetRoot/04/12/81/21/04128121.pdf/ .

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