2012 Antigen Review for the New Zealand National Immunisation Schedule: Meningococcal B and C

Abstract

Neisseria meningitidis is the causative agent of meningococcal disease. The organism is only found in humans and is a commensal carried in the nasopharynx of approximately 10% of the population although this is agedependent. The meningococcal population is highly diverse and isolates from invasive meningococcal disease represent only a small sub-set of this overall population. The polysaccharide capsule of invasive meningococci is the major virulence factor and is used both to serotype the organism and as a vaccine antigen. The traditional polysaccharide vaccines are poor immunogens in infants under two years old, which stimulated the development of conjugate vaccines in the 1990s. Conjugate vaccines have been developed for four (A, C, W135 and Y) of the five major serogroups. Group B vaccines based on outer membrane surface proteins are currently in development and being trialled with one under approval processes in a number of countries as of early 2013. The objectives for this review have been informed by the general specifications and the specific specification for the 2012 antigen review. Information about the epidemiology in NZ is derived from annual reports from ESR. This report summarises the some of the key data for meningococcal vaccines and vaccination published between 2009 and 2012.