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Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)

Background: A few years after the introduction in Italy of a four-component anti-meningococcal B vaccine (4CMenB), we evaluated the effectiveness and impact of vaccination in two regions using different schedules (2, 4, 6, 12 months in Tuscany vs. 7, 9, 15 months in Veneto) through an observational...

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Autores principales: Azzari, Chiara, Moriondo, Maria, Nieddu, Francesco, Guarnieri, Valentina, Lodi, Lorenzo, Canessa, Clementina, Indolfi, Giuseppe, Giovannini, Mattia, Napoletano, Giuseppina, Russo, Francesca, Baldovin, Tatjana, Cocchio, Silvia, Ricci, Silvia, Baldo, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563708/
https://www.ncbi.nlm.nih.gov/pubmed/32842669
http://dx.doi.org/10.3390/vaccines8030469
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author Azzari, Chiara
Moriondo, Maria
Nieddu, Francesco
Guarnieri, Valentina
Lodi, Lorenzo
Canessa, Clementina
Indolfi, Giuseppe
Giovannini, Mattia
Napoletano, Giuseppina
Russo, Francesca
Baldovin, Tatjana
Cocchio, Silvia
Ricci, Silvia
Baldo, Vincenzo
author_facet Azzari, Chiara
Moriondo, Maria
Nieddu, Francesco
Guarnieri, Valentina
Lodi, Lorenzo
Canessa, Clementina
Indolfi, Giuseppe
Giovannini, Mattia
Napoletano, Giuseppina
Russo, Francesca
Baldovin, Tatjana
Cocchio, Silvia
Ricci, Silvia
Baldo, Vincenzo
author_sort Azzari, Chiara
collection PubMed
description Background: A few years after the introduction in Italy of a four-component anti-meningococcal B vaccine (4CMenB), we evaluated the effectiveness and impact of vaccination in two regions using different schedules (2, 4, 6, 12 months in Tuscany vs. 7, 9, 15 months in Veneto) through an observational retrospective study. Methods: Vaccination started in 2014 in Tuscany and in 2015 in Veneto; the data collected referred to the period 2006–2018 for Tuscany and 2007–2018 for Veneto. Cases of invasive meningococcal disease due to N. Meningitidis B were identified by culture and/or real-time PCR. Results: In Tuscany, pre-vaccine incidence was 1.96 (95% CL 1.52; 2.40) and dropped to 0.62 (95% CL 0.60; 0.64) in the post-4CMenB era. Evaluating only vaccinated children, post-4CMenB incidence was 0.12 (95% CL 0.08; 0.15). In Veneto pre-vaccine incidence was 1.94 (95% CL 1.92; 1.96) and dropped to 1.34 (95% CL 1.31; 1.38) in the post-4CMenB era. In the vaccinated population, MenB incidence was 0.53 (95% CL 0.50; 0.56). Vaccine effectiveness was 93.6% (95% CL 55.4; 99.1) in Tuscany and 91.0% (95% CL 59.9; 97.9) in Veneto, with mean vaccine coverages of 83.9% and 81.7%, respectively. The overall impact (evaluating both vaccinated and unvaccinated children) was 0.68 (95% CL 0.10; 0.89) in Tuscany and 0.31 (95% CL −0.56; 0.69) in Veneto; the total impact (evaluating only vaccinated children) was 0.94 (95% CL 0.56; 0.99) and 0.90 (95% CL 0.57; 0.97), respectively. The relative case reduction (RCR) was 65% in Tuscany and 31% in Veneto. Considering the vaccinated population, the RCR was equal to 91% and 80%, respectively. Conclusion: In conclusion, 4CMenB appears to have a very high effectiveness in Italy; the impact of vaccination appears greater where the immunization program is started early.
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spelling pubmed-75637082020-10-27 Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018) Azzari, Chiara Moriondo, Maria Nieddu, Francesco Guarnieri, Valentina Lodi, Lorenzo Canessa, Clementina Indolfi, Giuseppe Giovannini, Mattia Napoletano, Giuseppina Russo, Francesca Baldovin, Tatjana Cocchio, Silvia Ricci, Silvia Baldo, Vincenzo Vaccines (Basel) Article Background: A few years after the introduction in Italy of a four-component anti-meningococcal B vaccine (4CMenB), we evaluated the effectiveness and impact of vaccination in two regions using different schedules (2, 4, 6, 12 months in Tuscany vs. 7, 9, 15 months in Veneto) through an observational retrospective study. Methods: Vaccination started in 2014 in Tuscany and in 2015 in Veneto; the data collected referred to the period 2006–2018 for Tuscany and 2007–2018 for Veneto. Cases of invasive meningococcal disease due to N. Meningitidis B were identified by culture and/or real-time PCR. Results: In Tuscany, pre-vaccine incidence was 1.96 (95% CL 1.52; 2.40) and dropped to 0.62 (95% CL 0.60; 0.64) in the post-4CMenB era. Evaluating only vaccinated children, post-4CMenB incidence was 0.12 (95% CL 0.08; 0.15). In Veneto pre-vaccine incidence was 1.94 (95% CL 1.92; 1.96) and dropped to 1.34 (95% CL 1.31; 1.38) in the post-4CMenB era. In the vaccinated population, MenB incidence was 0.53 (95% CL 0.50; 0.56). Vaccine effectiveness was 93.6% (95% CL 55.4; 99.1) in Tuscany and 91.0% (95% CL 59.9; 97.9) in Veneto, with mean vaccine coverages of 83.9% and 81.7%, respectively. The overall impact (evaluating both vaccinated and unvaccinated children) was 0.68 (95% CL 0.10; 0.89) in Tuscany and 0.31 (95% CL −0.56; 0.69) in Veneto; the total impact (evaluating only vaccinated children) was 0.94 (95% CL 0.56; 0.99) and 0.90 (95% CL 0.57; 0.97), respectively. The relative case reduction (RCR) was 65% in Tuscany and 31% in Veneto. Considering the vaccinated population, the RCR was equal to 91% and 80%, respectively. Conclusion: In conclusion, 4CMenB appears to have a very high effectiveness in Italy; the impact of vaccination appears greater where the immunization program is started early. MDPI 2020-08-22 /pmc/articles/PMC7563708/ /pubmed/32842669 http://dx.doi.org/10.3390/vaccines8030469 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Azzari, Chiara
Moriondo, Maria
Nieddu, Francesco
Guarnieri, Valentina
Lodi, Lorenzo
Canessa, Clementina
Indolfi, Giuseppe
Giovannini, Mattia
Napoletano, Giuseppina
Russo, Francesca
Baldovin, Tatjana
Cocchio, Silvia
Ricci, Silvia
Baldo, Vincenzo
Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title_full Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title_fullStr Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title_full_unstemmed Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title_short Effectiveness and Impact of the 4CMenB Vaccine against Group B Meningococcal Disease in Two Italian Regions Using Different Vaccination Schedules: A Five-Year Retrospective Observational Study (2014–2018)
title_sort effectiveness and impact of the 4cmenb vaccine against group b meningococcal disease in two italian regions using different vaccination schedules: a five-year retrospective observational study (2014–2018)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563708/
https://www.ncbi.nlm.nih.gov/pubmed/32842669
http://dx.doi.org/10.3390/vaccines8030469
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