Planning, registration, and implementation of an immunisation campaign against meningococcal serogroup C disease in the UK: a success story

The introduction of meningococcal C conjugate (MCC) vaccine in the UK in No vember 1999 as a routine 3 dose infant immunisation course, with a single c atch-up dose for all children aged between 12 months and 17 years, was the result of an intensive 5 year collaborative research programme funded by th e Department of Health for England and involving public bodies, academia an d vaccine manufacturers. The research programme established the safety and immunogenicity of MCC vaccines in infants, toddlers, pre-school and school- aged children. The nature and frequency of common adverse events in school- aged children was similar to that after a booster dose of diphtheria and te tanus vaccine given to the same age groups. The recommendation that a singl e dose was adequate for children aged 12 months and above was based on anti body levels measured by serum bactericidal assay and evidence of induction of immunological memory as shown by maturation of antibody avidity. Licensu re by the Medicines Control Agency was based on serological criteria alone without direct evidence of efficacy and has set a precedent for other menin gococcal conjugate polysaccharide vaccines, Vaccine coverage of around 85% was achieved in the targeted age groups and has resulted in a drop in the i ncidence of serogroup C disease in these groups of over 80% within 18 month s of the start of the vaccination programme. Early post-licensure efficacy estimates for toddlers and teenagers (88 and 96%, respectively, in the firs t 16 months after vaccination) validate the serological criteria used for l icensure. Surveillance of the prevalent serogroups and serosubtypes among i nvasive case isolates has shown no evidence of any capsular switching to se rogroup B during the first 18 months of the MCC vaccination programme. (C) 2001 Elsevier Science Ltd. All rights reserved.