Volume 40 Supplement 1

70th Congress of the Italian Society of Pediatrics

Open Access

A new meningococcal B vaccine

Italian Journal of Pediatrics201440(Suppl 1):A2

https://doi.org/10.1186/1824-7288-40-S1-A2

Published: 11 August 2014

Neisseria meningitidis is an important cause of invasive bacterial infection in children worldwide, and is a rare example of a bacterium that has evolved to become an obligate human commensal which commonly colonizes the oropharyngeal mucosa. Carriage is age-dependent and appears to be very common in young adults. The relationships between carriage and invasive disease are not completely understood [1].

Each year approximately 1.2 million cases of invasive meningococcal disease (sepsis or meningitis) with 135,000 deaths are estimated to occur worldwide [2].

Epidemiology and serogroup distribution differs geographically, as the example in Figure 1 shows, with invasive disease mainly affecting young children, older children and young adults. In addition to age, another individual risk factor includes underlying immune deficiencies; the deficiency of complement components is a known risk factor for invasive infection. Crowding and concurrent upper respiratory tract infections might also contribute to the disease.
Figure 1

Variations in the proportion of strains of serogroup B, C and Y circulating in Italy

In early 2013, a new vaccine developed specifically to prevent disease caused by group B meningococci (MenB) was licensed in Europe (4CMenB, Bexsero©, Novartis Vaccines, Italy). This vaccine is protein-based and, therefore, compared to meningococcal conjugate vaccines , has a different mechanism of action, along with different safety, reactogenicity and immunogenicity profiles in the various age groups.

The vaccine, developed by reverse vaccinology, contains three surface-exposed recombinant proteins (fHbp, NadA, and NHBA) and outer membrane vesicles derived from the NZ98/254 strain and has the potential to reduce mortality and morbidity associated with serogroup B meningococci infections, but uncertainty remains about the breadth of protection the vaccine might induce against the diverse serogroup B meningococci strains that cause disease: Meningococcal Antigen Typing System predicted that 78% of all MenB strains would be killed by postvaccination [3].

In Italy (updated April 2014) the Basilicata Region [4] recommend Bexsero for the routine vaccination of infants and will have an active call to parents that includes providing the vaccine free of charge. The Board of Calendario per la Vita, comprising of the country’s foremost scientific societies, has recommended Bexsero for all infants with three doses in the first year of life and one dose at 13 months of age [5].

For parents and clinicians, the predicted benefits of 4-component meningococcal group B vaccine (4CMenB) outweigh existing uncertainties about the potential impact of the MenB vaccine against invasive disease, but future introduction of the vaccine must be followed by rigorous post-implementation surveillance to assess its value to health systems.

Authors’ Affiliations

(1)
Maternity and Pediatrics Services, Local Health Units Benevento
(2)
Maternity and Pediatrics Services – Local Health Units Naples1

References

  1. Gasparini R, Comanducci M, Amicizia D, Ansaldi F, Canepa P, Orsi A, Icardi G, Rizzitelli E, De Angelis G, Bambini S, Moschioni M, Comandi S, Simmini I, Boccadifuoco G, Brunelli B, Giuliani MM, Pizza M, Panatto D: Molecular and serological diversity of neisseria meningitidis carrier strains isolated from italian students aged 14-22 years. J Clin Microbiol. 2014, 52: 1901-10. 10.1128/JCM.03584-13.PubMed CentralView ArticlePubMedGoogle Scholar
  2. Jafri RZ, Ali A, Messonnier NE, Tevi-Benissan C, Durrheim D, Eskola J, Fermon F, Klugman KP, Ramsay M, Sow S, Zhujun S, Bhutta ZA, Abramson J: Global epidemiology of invasive meningococcal disease. Popul Health Metr. 2013, 11: 17-10.1186/1478-7954-11-17.PubMed CentralView ArticlePubMedGoogle Scholar
  3. Vogel U, Taha MK, Vazquez JA, Findlow J, Claus H, Stefanelli P, Caugant DA, Kriz P, Abad R, Bambini S, Carannante A, Deghmane AE, Fazio C, Frosch M, Frosi G, Gilchrist S, Giuliani MM, Hong E, Ledroit M, Lovaglio PG, Lucidarme J, Musilek M, Muzzi A, Oksnes J, Rigat F, Orlandi L, Stella M, Thompson D, Pizza M, Rappuoli R, Serruto D, Comanducci M, Boccadifuoco G, Donnelly JJ, Medini D, Borrow R: Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: a qualitative and quantitative assessment. Lancet Infect Dis. 2013, 13: 416-25. 10.1016/S1473-3099(13)70006-9.View ArticlePubMedGoogle Scholar
  4. Approval of scientific and technical document entitled "schedule of vaccination campaign for primary prevention of disease, invasive group b meningococcal. [http://opendata.regione.basilicata.it/opendata/home.jsp?tile=DELIBERE.delibere.jsp&numAtto=&oggetto=meningococco&year=2014]
  5. Proposal of the Board of “Calendar for Life” (SITI-SIP-FIMP-FIMMG) on the inclusion of anti-meningococcal B vaccine in the childhood vaccination schedule. Available at: http://sip.it/wp-content/uploads/2013/12/Documento-congiunto-SItI-SIP-FIMP-FIMMG.docx

Copyright

© Russo; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Advertisement