PDF(Pubmed)
Abstract：
BACKGROUND: Invasive meningococcal disease (IMD) causes significant mortality and long-term sequelae. This study assesses the potential public health impact of adolescent vaccination strategies employing MenACWY and MenC vaccines in Germany, where the existing meningococcal immunisation programme predominantly involves MenC administration in toddlers.
METHODS: A dynamic transmission model was developed to simulate the carriage of five meningococcal serogroup compartments (AY/B/C/W/Other) from 2019 until 2060 within 1-year age groups from 0 to 99 years of age. IMD cases were estimated based on case-carrier ratios. The model considered vaccine effectiveness against carriage acquisition and IMD.
RESULTS: The model predicts that introducing MenACWY adolescent vaccination could lead to a considerable reduction in IMD incidence, with the potential to prevent up to 65 cases per year and a cumulative total of 1467 cases by 2060. This decrease, mainly driven by herd effects, would result in a reduction of IMD incidence across all age groups, regardless of vaccination age. Furthermore, implementing MenACWY vaccination in adolescents is projected to decrease annual MenACWY-related IMD mortality by up to 64%, equating to an overall prevention of 156 IMD deaths by 2060. These protective outcomes are expected to culminate in approximately 2250 life years gained (LYG) throughout the model\'s projected time horizon. In contrast, the adoption of MenC vaccination in adolescents is predicted to have minimal influence on both IMD incidence and mortality, as well as on LYG.
CONCLUSIONS: The results of this study demonstrate that implementing MenACWY vaccination for adolescents in Germany is likely to notably reduce IMD incidence and mortality across age groups. However, the introduction of MenC adolescent vaccination shows only limited impact. Considering the extensive healthcare resources typically required for IMD management, these findings suggest the potential for economic benefits associated with the adoption of MenACWY adolescent vaccination, warranting further cost-effectiveness analysis.
METHODS: A dynamic transmission model was developed to simulate the carriage of five meningococcal serogroup compartments (AY/B/C/W/Other) from 2019 until 2060 within 1-year age groups from 0 to 99 years of age. IMD cases were estimated based on case-carrier ratios. The model considered vaccine effectiveness against carriage acquisition and IMD.
RESULTS: The model predicts that introducing MenACWY adolescent vaccination could lead to a considerable reduction in IMD incidence, with the potential to prevent up to 65 cases per year and a cumulative total of 1467 cases by 2060. This decrease, mainly driven by herd effects, would result in a reduction of IMD incidence across all age groups, regardless of vaccination age. Furthermore, implementing MenACWY vaccination in adolescents is projected to decrease annual MenACWY-related IMD mortality by up to 64%, equating to an overall prevention of 156 IMD deaths by 2060. These protective outcomes are expected to culminate in approximately 2250 life years gained (LYG) throughout the model\'s projected time horizon. In contrast, the adoption of MenC vaccination in adolescents is predicted to have minimal influence on both IMD incidence and mortality, as well as on LYG.
CONCLUSIONS: The results of this study demonstrate that implementing MenACWY vaccination for adolescents in Germany is likely to notably reduce IMD incidence and mortality across age groups. However, the introduction of MenC adolescent vaccination shows only limited impact. Considering the extensive healthcare resources typically required for IMD management, these findings suggest the potential for economic benefits associated with the adoption of MenACWY adolescent vaccination, warranting further cost-effectiveness analysis.
摘要：
背景：侵袭性脑膜炎球菌病（IMD）导致显著的死亡率和长期后遗症。这项研究评估了在德国使用MenACWY和MenC疫苗的青少年疫苗接种策略的潜在公共卫生影响。现有的脑膜炎球菌免疫计划主要涉及幼儿的MenC管理。
方法：开发了一种动态传播模型，以模拟从2019年到2060年的5个脑膜炎球菌血清群（AY/B/C/W/Other）在1岁年龄组（0至99岁）的携带。IMD病例是根据病例载波比率估计的。该模型考虑了疫苗对运输获取和IMD的有效性。
结果：该模型预测，引入MenACWY青少年疫苗接种可能导致IMD发病率大幅降低，有可能每年预防多达65例病例，到2060年累积总数为1467例。这种减少,主要由羊群效应驱动，将导致所有年龄组的IMD发病率降低，无论接种疫苗的年龄。此外，在青少年中实施MenACWY疫苗接种预计将使与MenACWY相关的IMD死亡率降低多达64%，相当于到2060年全面预防156例IMD死亡。这些保护性结果预计将在整个模型的预计时间范围内达到大约2250寿命年（LYG）。相比之下,预计在青少年中采用MenC疫苗接种对IMD发病率和死亡率的影响最小，以及LYG。
结论：这项研究的结果表明，在德国对青少年实施MenACWY疫苗接种可能会显著降低各年龄组的IMD发病率和死亡率。然而,MenC青少年疫苗接种的引入仅显示出有限的影响。考虑到IMD管理通常需要的广泛医疗保健资源，这些发现表明，与采用MenACWY青少年疫苗接种相关的潜在经济利益，保证进一步的成本效益分析。
方法：开发了一种动态传播模型，以模拟从2019年到2060年的5个脑膜炎球菌血清群（AY/B/C/W/Other）在1岁年龄组（0至99岁）的携带。IMD病例是根据病例载波比率估计的。该模型考虑了疫苗对运输获取和IMD的有效性。
结果：该模型预测，引入MenACWY青少年疫苗接种可能导致IMD发病率大幅降低，有可能每年预防多达65例病例，到2060年累积总数为1467例。这种减少,主要由羊群效应驱动，将导致所有年龄组的IMD发病率降低，无论接种疫苗的年龄。此外，在青少年中实施MenACWY疫苗接种预计将使与MenACWY相关的IMD死亡率降低多达64%，相当于到2060年全面预防156例IMD死亡。这些保护性结果预计将在整个模型的预计时间范围内达到大约2250寿命年（LYG）。相比之下,预计在青少年中采用MenC疫苗接种对IMD发病率和死亡率的影响最小，以及LYG。
结论：这项研究的结果表明，在德国对青少年实施MenACWY疫苗接种可能会显著降低各年龄组的IMD发病率和死亡率。然而,MenC青少年疫苗接种的引入仅显示出有限的影响。考虑到IMD管理通常需要的广泛医疗保健资源，这些发现表明，与采用MenACWY青少年疫苗接种相关的潜在经济利益，保证进一步的成本效益分析。
