The UK Joint Committee on Vaccination and Immunisation has advised that immunisation for meningococcal group W disease be offered to 14-18 year olds, following a Public Health England report showing a rise in cases since 2009.
Prof. Adam Finn, Professor of Paediatrics, University of Bristol, said:
“The accelerating rise in cases of group W clonal complex 11 meningococcal disease is an alarming problem for which, fortunately there is already a solution in the form of a licensed vaccine. The UK is in a good position to exploit its world leading experience with the group C meningococcal vaccine programme to design an effective programme to bring this epidemic under control by immunising teenagers who are at risk of disease and also the commonest carriers of the bug. Immunising this age group should reduce group W infection and disease in all age groups.
“The available vaccine protects against four groups of meningococci- groups A C W & Y and could replace the group C vaccine already offered to teenagers. The group B meningococcal vaccine which may be introduced in the near future for young children in the UK is designed differently from the W and C vaccines and may provide some cross-protection against disease not caused by group B including group W.”
Dr Tarit Mukhopadhyay, Lecturer in Vaccine Bioprocess Development, UCL, said:
“The MenB vaccine was not designed to protect against MenW, and while there is discussion as to its effectiveness against MenW, this would require far more testing. However, a licensed MenW vaccine already exists which is based on a polysaccharide or sugar component of the disease and that is enough to provide protection. This is the same technology used for the other strains of Meningitis except for MenB. This is because the polysaccharide from MenB provides almost no protection. This is why there has been much investment into a MenB vaccine, which is based on proteins from the bug, not polysaccharides.”
Dr Matthew Snape, Consultant in General Paediatrics and Vaccinology at the Oxford Vaccine Group, University of Oxford, said:
“The rapid rise in serogroup W meningococcal disease highlights the unpredictable nature of meningococcal disease and the importance of ongoing surveillance against this potentially fatal infection. Fortunately we have a licensed vaccine against 4 types of meningococcus (Men A, C, W and Y) available for use. A vaccine against another type of meningococcus, MenB, is being considered for introduction into the routine infant immunisation schedule. The MenB vaccine may well also provide some protection against a proportion of MenW cases, although this has not yet been shown conclusively. For the adolescent immunisation programme the MenACWY vaccine is the preferred choice as it is expected that this vaccine would be highly effective at not only providing direct protection to immunised adolescents, but also protecting other age groups by reducing circulation of this bacteria.”
Dr David Turner, Associate professor of Clinical Microbiology, University of Nottingham, said:
“The JCVI recommendation to introduce the combined ACWY vaccine to adolescents aged 14-18 years in response to the current outbreak of serogroup W meningococcal disease in UK is welcome news. The rise in serogroup W cases probably relates to the low levels of immunity in the population to this strain. Cases have included both serious and atypical infections. The MenB vaccine, which has previously been recommended by JCVI for infants in UK, is also expected to provide protection against the W strain.”
Prof. Adam Finn is a member of the JCVI. He has previously carried out research and consultancy for multiple vaccine manufacturers, including those that manufacture meningococcal vaccines.
Dr Matthew Snape acts as an investigator for clinical studies from for both non-commercial funding bodies and commercial sponsors (Novartis Vaccines, GlaxoSmithKline, Sanofi-Pasteur, Sanofi-PasteurMSD, Pfizer Vaccines and Johnson and Johnson) conducted on behalf of the University of Oxford.
He also undertakes consultancy and advisory work for Novartis Vaccines and Diagnostics, Pfizer and Sanofi-Pasteur; Speaking honoraria and travel and accommodation reimbursements from these organisations are paid to the University of Oxford Department of Paediatrics. Matthew Snape does not receive any personal financial support from vaccine manufacturers.
Dr David Turner has received support from Novartis Vaccines, SanofiPasteur and GSK, including honoraria, grants and travel assistance for conferences. David was an external advisor on the guidelines development group for the NICE guidelines on ‘Meningococcal disease and meningitis in children and young people’ (http://www.ncbi.nlm.nih.gov/books/NBK83080/).