Meningococcal C conjugate vaccination campaign: the Dutch experience

In 2001 The Netherlands experienced an increase in notifications of group C meningococcal disease. By the end of 2001 serogroup C caused 38% of all meningococcal infections (incidence of 1,7/100.000), while in previous years about 14–20% of all meningococci belonged to serogroup C. During the first 3 months of 2002, serogroup C was found in 45% of the cases (data from The Netherlands Reference Laboratory for Bacterial Meningitis). In August 2001 a cluster of menC requested immunization of 5000 children with conjugated vaccine. The increase in menC and the occurrence of clusters prompted the Ministry of Health (MOH) to ask the Health Council to advise on universal vaccination with newly licensed conjugated menC vaccines. In January 2002 the Health Council advised to start with universal vaccination and to implement a catch up programme for children aged up to 18 years [1]. In March 2002 the MOH decided favourably upon introduction of the menC-conjugated vaccine within the National Vaccination Programme, as a unique dose at the age of 14 months. Furthermore, in March 2002, the decision was taken to implement a catch up vaccination programme targeting children aged 1–18. The age groups 14 months- 5 years and 15–18 years were scheduled to be vaccinated before summer holidays, to be followed in September by the remaining birth cohorts (6–14 years). During the period June-December 2002, 3.5 million children and adolescents were vaccinated with a conjugated menC vaccine. The programme was carried out outside the regular health care and required commitment of all municipal/ regional health services. The results show an overall vaccination coverage of 94% (83% within the campaign, 11% prior to the campaign) while a target of 90% was set by the MOH. Meanwhile the Netherlands experienced a sharp decrease (fig. 1) in the number of patients with group C meningococcal disease following the vaccination campaign. In the period november 2002-january 2003 a 89% decrease in the overall incidence of menC infections was seen, as compared to the same period the year before [3]. The reported adverse effects show a good safety profile of this vaccine. Fig: 1 Incidence of meningococcal disease: 1999–2003; Netherlands Reference Laboratory for Bacterial Meningitis AMC-RIVM. Literature Neppelenbroek SE, Vries M, Greeff SC, Timen A. Implementatie en evaluatie vaccinatiecampagne meningokokken. Juni 2003 Health Council of the Netherlands: Universal vaccination against meningococcal serogroup C and pneumococcal disease. The Hague;2001/27E. Timen A; Steenbergen JE. Meningitis group C vaccination campaign in the Netherlands. Eur J Public Health 2002; supp 12: 22. De Greeff SC, de Melker HE, Spanjaard L, van den Hof S, Dankert J. The first effect of the national vaccination campaign against meningococcal C-disease: a rapid and sharp decrease in the number of patients. NTVG 2003; 7 juni: no 23: 1132–35