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Helen Campbell @ MRF's Meningitis & Septicaemia in Children & Adults 2017

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Impact and challenges of the MenACWY programme and catch up campaign in England
https://www.meningitis.org/mrf-conference-2017

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Helen Campbell @ MRF's Meningitis & Septicaemia in Children & Adults 2017

  1. 1. Impact and challenges of the MenACWY vaccination programme in England MRF conference November 2017 Helen Campbell Shamez Ladhani, Sonia Ribeiro, Sydel Parikh, Ray Borrow, Steve Gray, Jay Lucidarme, Nick Andrews, Mary Ramsay, Michael Edelstein, Joanne Yarwood, Angela Edwards, Louise Letley Helen.campbell@phe.gov.uk Public Health England, Immunisation Team
  2. 2. 1. Context of the programme 2. Programme challenges 3. Acceptance of the programme 4. Impact of the programme MenACWY vaccination in England
  3. 3. Group W invasive meningococcal disease by epidemiological year, England 3 Group W IMD 0 20 40 60 80 100 120 140 160 180 200 Totalconfirmedcasenumbers Epidemiological year
  4. 4. JCVI recommendations: February 2015 • Strategy in Chile of vaccinating children <5y, only impacted on vaccinated age group (Abad et al Epidemiol. Infect, 2014) • Evidence that Bexsero (new infant programme) protects against the circulating W strain* • Strategy was to target carriers with conjugate ACWY vaccine – 14-18 year olds plus new university freshers *Ladhani et al. Emerging Infectious Diseases www.cdc.gov/eid • Vol. 22, No. 2, Feb 2016
  5. 5. MenACWY vaccination programme roll-out Birth cohort 2014/15 year - age Academic year 2014/15 2015/16 2016/17 2017/18 2018/19 01/09/2003-31/08/2004 Y6 – 10/11 Y9 ACWY Y9 ACWY 01/09/2002-31/08/2003 Y7 - 11/12 Y9 ACWY 01/09/2001-31/08/2002 Y8 - 12/13 Y9 ACWY Y10 ACWY 01/09/2000-31/08/2001 Y9 - 13/14 Y10 ACWY Y11 ACWY 01/09/1999-31/08/2000 Y10 - 14/15 Y10 MenC Y11 ACWY 01/09/1998-31/08/1999 Y11 - 15/16 Y13 ACWY 01/09/1997-31/08/1998 Y12 - 16/17 Y13 ACWY 01/09/1996-31/08/1997 Y13 – 17/18 Y13 ACWY Routine schedule MenC Routine schedule ACWY School based catch-up ACWY Primary care catch-up cohorts Key 5
  6. 6. 1. Context of the programme 2. Programme Challenges 3. Acceptance of the programme 4. Impact of the programme MenACWY vaccination in England
  7. 7. Programme challenges 1. Short interval from decision to implementation 2. Getting MenACWY vaccine into school leavers a) The immunisers b) The immunised
  8. 8. 1. Context of the programme 2. Programme challenges 3. Acceptance of the programme 4. Impact of the programme MenACWY vaccination in England
  9. 9. MenACWY vaccine coverage General practice, 17-18Y Coverage (end Aug 17) 2015 school leaver 39.7% 2016 school leaver 35.5% 2017 school leaver 29.5% At school, 13-15Y 77-84% At school 16Y 71.8%
  10. 10. 11 Campbell et al. EID 2016
  11. 11. 1. Context of the programme 2. Programme Challenges 3. Acceptance of the programme 4. Impact of the programme MenACWY vaccination in England
  12. 12. 0 50 100 150 200 250 0% 5% 10% 15% 20% 25% 30% 35% Totalcasesoflaboratory confirmedIMD %ofallIMDcases W cases % W of all IMD MenW IMD by epidemiological year, England only 13 Vaccine Update
  13. 13. Confirmed MenW cases by age and epidemiological year, England 14 MenB disease and vaccination programme in England14 MenB disease and vaccination programme in England14 invasive meningococcal disease
  14. 14. Observed cases and projected MenW cases based on trend lines fitted to the pre-vaccination period and extrapolated to2015/16 for the school-leaver cohort 15 Meningococcal disease Type IRR (95% CI) W 0.31 (0.12-0.82) Y 0.40 (0.05-3.35) B 1.67 (0.93-2.99) 15 Campbell et al EID 2016 >20 MenW cases in vaccine eligible cohorts and none of these have been vaccinated under the MenACWY programme.
  15. 15. Summary • Increase in MenW cases from 2009 in England. • Introduction of a MenACWY vaccination programme from Aug 2015 targeting teenagers. • Roll out of the programme has caused some confusion and older teenagers can be difficult to motivate but they clearly recognise the importance of vaccination. • MenW cases continued to increase overall in 2016/17 with falls in in those aged 15-24 years and <1year. • Early data suggested a 69% reduction in the first year in the first targeted vaccination group • There have been falls in university associated cases • MenW levels are lower at the beginning of 2017/18 than the previous 3 years – across all age groups

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