Effect of Quadrivalent Conjugate and Serogroup B Meningococcal Vaccines on Pharyngeal Carriage
Mary E. Wilson, MD
Both preparations reduced meningococcal carriage during follow-up — the quadrivalent vaccine against vaccine serogroups, and the serogroup B vaccine more broadly.
Meningococcal conjugate vaccines protect those vaccinated; they can also prevent carriage and thereby provide herd immunity. In a manufacturer-supported, phase 3, randomized trial, investigators assessed the effects of a quadrivalent glycoconjugate vaccine targeting serogroups A, C, Y, and W (MenACWY-CRM) and a multicomponent serogroup B meningococcal vaccine (4CMenB) on meningococcal carriage rates.
Healthy students aged 18 to 24 in England were randomized in a 1:1:1 ratio to receive two doses of 4CMenB, one dose of MenACWY-CRM followed by one dose of placebo, or — as a control — two doses of Japanese encephalitis vaccine. Doses were given 1 month apart. Oropharyngeal cultures were obtained before vaccination and for 12 months after the first dose. Before vaccination, the 2946 enrollees' meningococcal carriage was found in 33% of the 2946 enrollees.
One month after the second vaccination, carriage of disease-associated capsular group B strains was similar between the 4CMenB and control groups. Three months postvaccination, the 4CMenB group had significantly lower carriage rates than the control group for all Neisseria meningitidis, as well as for capsular groups BCWY, capsular groups CWY, and serogroups CWY. Two months postvaccination, the MenACWY-CRM group had a 39% lower carriage rate for serogroup Y and a 36% lower rate for serogroups CWY than the control group.
Local reactions were more common in the 4CMenB group than in the other groups, but the incidence of severe reactions was low in all groups.
Citation(s):
Read RC et al. Effect of a quadrivalent meningococcal ACWY glycoconjugate or a serogroup B meningococcal vaccine on meningococcal carriage: An observer-blind, phase 3 randomised clinical trial. Lancet 2014 Aug 19; [e-pub ahead of print].
Taha M-K and Deghmane A-E.Meningococcal carriage: The dilemma of 4CMenB vaccine. Lancet 2014 Aug 19; [e-pub ahead of print].
