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MenB vaccination campaign effectively stopped Princeton outbreak

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Success story: public health response, immunization coverage

The study by Dr. McNamara and her associates evaluating the public health response to the meningitis B outbreak at Princeton University reveals that the vaccination campaign was highly effective in stamping out the mini-epidemic. It confirms that the vaccine, two-dose Bexsero, is highly efficacious and can be used in outbreak situations.

Dr. Stanley Block

These types of studies are important because they provide a real-time, in vivo opportunity to assess the effectiveness of the vaccine as well as public health officials’ success in communicating the risk of the disease to the target population. This study tells us that public health experts did a superb job of getting almost every candidate on this school campus – over 90% of all undergraduates – vaccinated and revaccinated with an additional booster dose over two 3-day intervals.

These results show what can be done in terrifying situations when we have to contain a horrific contagious bacteria like meningococcus. The public health response was incredible, especially since college students aged 18-22 years are typically resistant to receiving any vaccinations. The students must have been well informed about the alarming disease process that could maim them, cause brain damage, or even kill them.

It was quite a remarkable feat that the Food and Drug Administration and the Centers for Disease Control and Prevention, two large bureaucratic organizations, came together in such a timely matter to ensure that a non–FDA approved meningococcal B vaccine was quickly acquired from Europe to be used for an entire at-risk population of individuals in an epidemic situation. Thus, this paper also suggests that the new manufacturing process using “reverse lipoproteins” in vaccines will protect extremely well not only the recipients, but also that small percentage of the exposed population who did not receive the vaccine (i.e., providing some herd protection).

These comments were made during a phone interview by Dr. Stanley Block, a pediatrician in private practice in Bardstown, Ky. Dr. Block has received research grants from Novartis, Pfizer, and Sanofi Pasteur with regard to meningococcal vaccines. He has received other research grants from GlaxoSmithKline and has been on the speaker’s bureau for Novartis Vaccines meningococcal vaccine.


 

FROM PEDIATRICS

References

A targeted MenB vaccination campaign during a university outbreak of serogroup B meningococcal disease effectively prevented additional cases in those who received the vaccine, according to a recent study.

“The outbreak investigation and highly successful vaccination campaign described here can serve as a model for how to approach similar outbreaks in the future,” reported Lucy A. McNamara, Ph.D., of the Centers for Disease Control and Prevention, and her associates (Pediatrics 2015 April 27 [doi: 10.1542/peds.2014-4015]). Dr. McNamara’s team used a compilation of data sources for their report: case and population data, laboratory typing of meningococcal isolates, university staff interviews, and vaccination coverage data from the Investigational New Drug protocol.

The outbreak investigation and highly successful vaccination campaign described here can serve as a model for how to approach similar outbreaks in the future, Dr. McNamara remarked. ©BVDC/Fotolia.com

"The outbreak investigation and highly successful vaccination campaign described here can serve as a model for how to approach similar outbreaks in the future," Dr. McNamara remarked.

Seven cases of the same strain of serogroup B meningococcal disease occurred among undergraduate students at Princeton (N.J.) University, between March and November 2013, plus an eighth case during that time in a high school student who stayed in the Princeton dorms. The subsequent vaccination campaign with a two-dose series of the 4CMenB vaccine Bexsero targeted the 5,241 undergraduates and 541 graduate students living in the dorms, plus 6 caregivers or spouses of these students living in the dorms and 11 other individuals at the university with a medical condition putting them at high risk.

The first vaccine dose was administered between Dec. 9 and 12, 2013, followed by the second between Feb. 17 and 20, 2014. By May 14, 94.9% of the target population had received at least one dose of the vaccine, and 89.1% had received both doses. Among undergraduates, 96.6% received the first dose and 91.4% received both. The only serious adverse event considered a possible effect of the vaccine was a single case of rhabdomyolysis occurring a day after the second dose. Since Feb. 1, 2015, no vaccinated individuals developed serogroup B meningococcal disease, but a ninth ultimately fatal case occurred in March 2014 in a student from a different university who had close contact with several mostly vaccinated Princeton undergraduates, indicating that carriage of serogroup B Neisseria meningitidis among vaccinated persons was not eliminated, the authors wrote.

The research was funded by the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists. Dr. Johnsen spoke at Pfizer conferences and at a National Meningitis Association conference; travel expenses were covered, but he received no honorarium or other reimbursement. No other authors reported any relevant financial disclosures.

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