Abstract
We reviewed university-based outbreaks of meningococcal disease caused by serogroup B and vaccination responses in the United States in the years following serogroup B meningococcal (MenB) vaccine availability. Ten university-based outbreaks occurred in 7 states during 2013–2018, causing a total of 39 cases and 2 deaths. Outbreaks occurred at universities with 3,600–35,000 undergraduates. Outbreak case counts ranged from 2 to 9 cases; outbreak duration ranged from 0 to 376 days. All 10 universities implemented MenB vaccination: 3 primarily used MenB-FHbp and 7 used MenB-4C. Estimated first-dose vaccination coverage ranged from 14% to 98%. In 5 outbreaks, additional cases occurred 6–259 days following MenB vaccination initiation. Although it is difficult to predict outbreak trajectories and evaluate the effects of public health response measures, achieving high MenB vaccination coverage is crucial to help protect at-risk persons during outbreaks of meningococcal disease caused by this serogroup.
Highlights
Vaccination is the primary strategy for prevention of meningococcal disease
We summarize university-based outbreaks of meningococcal disease caused by serogroup B in the United States in the years following MenB vaccine availability (2013–2018) and describe the resulting MenB vaccination responses
We reviewed cases of meningococcal disease reported through the National Notifiable Diseases Surveillance System, supplemented since 2015 with data collected through enhanced meningococcal disease surveillance activities to improve completion of key variables, including association with an outbreak
Summary
§One additional suspected case with inconclusive lab results occurred in February 2016 in a student previously vaccinated with 2 doses of MenB vaccine and who received antimicrobial chemoprophylaxis the day before symptom onset. Chemoprophylaxis was provided to close contacts of case-patients; in some cases, chemoprophylaxis recommendations were expanded to include those in common social networks, such as athletic teams or social organizations. Some universities made additional efforts to target specific subpopulations of students for MenB vaccination, because of either the epidemiology of the cases or increased social mixing and close contact among specific student organizations, such as athletic teams or social organizations. Even with mass vaccination campaigns, MenB vaccination coverage in response to university-based outbreaks was highly variable, ranging from an estimated 14% to 98% coverage for the first dose (median 67%) (Figure 2). Several universities were able to track only vaccine doses administered on campus; because additional students received MenB vaccine from external providers and pharmacies, reported coverages are considered minimum estimates
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