Impact on disease incidence of a routine universal and catch-up vaccination strategy against Neisseria meningitidis C in Tuscany, Italy

Abstract

BackgroundInvasive infections due to Neisseria meningitidis are still an important public health issue worldwide. In Europe, meningococcal meningitis is differently distributed in the EU countries, but most cases of meningococcal diseases are caused by serogroups B and C. In Italy, each year about 900 cases of bacterial meningitis occur, of whom one third are caused by N. meningitidis. In March 2005, the Regional Health Authority of Tuscany approved a policy of active offer of conjugate meningococcus C (MCC) vaccination with three doses to all newborns at 3, 5 and 13months of age (subsequently turning to a single dose at 13months as of 2008) and a catch-up until age 6years with a single dose. ObjectiveThe aim of the present study was to evaluate the effectiveness of the vaccination strategy adopted by Tuscany in preventing cases of invasive meningococcal C disease. MethodsSurveillance data for the calculation of disease incidence, immunization coverage with MCC vaccine and vaccination status of meningitis cases were collected from 2005 to 2011. ResultsIncidence rates of meningococcal meningitis and septicemia decreased in all age groups involved in the immunization campaign, as a result of the progressively increasing vaccination coverage. Since 2006, no cases of invasive meningococcal C infection in vaccinated subjects were observed in Tuscany. A herd immunity effect was measured in unvaccinated age groups. ConclusionMCC vaccination implementation in Tuscany was successful in the prevention of meningococcal C disease. Our results should prompt all Italian Regions to consider introducing MCC vaccination in order to protect their population.