Adolescents need a booster of serogroup C meningococcal vaccine to protect them and maintain population control of the disease

Department of Paediatrics, University of Oxford, Level 2, Children's Hospital, Oxford OX3 9DU, UK
Archives of Disease in Childhood (Impact Factor: 2.9). 04/2013; 98(4):248-251. DOI: 10.1136/archdischild-2012-303103
Source: PubMed
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    • "The current World Health Organization program on immunization is estimated to prevent more than 2 million childhood deaths each year [53]. However, these vaccines also seem to have effects beyond the intended reduction of disease caused by the relevant pathogen. "
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    ABSTRACT: The success of the immune response is finely balanced between, on the one hand, the need to engage vigorously with, and clear, certain pathogens; and, on the other, the requirement to minimize immunopathology and autoimmunity. Distinct immune strategies to achieve this balance have evolved in females and males and also in infancy through to adulthood. Sex differences in outcome from a range of infectious diseases can be identified from as early as fetal life, such as in congenital cytomegalovirus infection. The impact of sex hormones on the T-helper 1/T-helper 2 cytokine balance has been proposed to explain the higher severity of most infectious diseases in males. In the minority where greater morbidity and mortality is observed in females, this is hypothesized to arise because of greater immunopathology and/or autoimmunity. However, a number of unexplained exceptions to this rule are described. Studies that have actually measured the sex differences in children in the immune responses to infectious diseases and that would further test these hypotheses, are relatively scarce.
    The Journal of Infectious Diseases 07/2014; 209 Suppl 3(Suppl 3):S120-6. DOI:10.1093/infdis/jiu232 · 6.00 Impact Factor
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    ABSTRACT: Recent data have shown that the immune protection evoked by vaccines given in the first years of life progressively weakens, and that this is associated with a higher than expected incidence of vaccine-preventable diseases in adolescents and young adults. Furthermore, the greater circulation of pathogens among adolescents and young adults leads to a high risk of infection in unvaccinated or not fully vaccinated younger children. These findings, together with the availability of vaccines specifically developed to prevent infections that typically occur during adolescence, have induced a number of experts to suggest radical changes in the immunisation schedules usually recommended by health authorities. The most important of these relate pertussis, meningococcal and human papillomavirus vaccines but, although they are based on unexceptionable scientific premises, the suggestions have been only slowly and partially received in most countries, even in those in which vaccination programmes are usually adequately implemented and monitored. Adolescence is a particular period of life characterised by changes in intellectual, moral, physical, emotional and psychological development. All of these can have a considerable impact on compliance with immunisation schedules because the approach to any preventive method no longer entirely depends on parents' and pediatricians' judgements as in the first years of life but is the consequence of a more complex process involving the adolescents' thoughts and opinions, their relationships with their parents, friends and physicians, and the information they receive from the mass media. Every effort should be made to overcome the barriers to adolescent immunisation, including those arising from the adolescents themselves.
    Vaccine 09/2013; 31(46). DOI:10.1016/j.vaccine.2013.08.092 · 3.62 Impact Factor
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    ABSTRACT: The European licensure of 4CMenB, the first vaccine licensed to prevent non-epidemic meningococcal B (MenB) disease, marked an important milestone in the fight against meningococcal disease. However, the potential introduction of 4CMenB into the routine infant schedule is complicated by a number of factors. The recent decline in the number of cases of invasive MenB disease in the UK has important implications for cost effectiveness, though the unpredictable nature of meningococcal disease epidemiology (as evidenced by a recent outbreak in MenB disease at Princeton University) means that it is not clear whether this decline will be sustained. The variable waning of antibody levels against each of the four key vaccine components also complicates the assessment of the likely duration and breadth of protection. After considering these factors, the UK Joint Committee on Vaccination and Immunisation (JCVI) released an interim statement in July 2013 indicating that the introduction of 4CMenB to the routine infant schedule was unlikely to be cost effective but highlighted the need for further data on strain coverage and persistence of immunity. This brief editorial discusses the possible role that booster doses of 4CMenB may have in prolonging persistence of immunity.
    Expert Review of Vaccines 01/2014; 13(3). DOI:10.1586/14760584.2014.878654 · 4.21 Impact Factor
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