BACKGROUND In September 2015, the United Kingdom introduced the multicomponent meningococcal group B vaccine (4CMenB, Bexsero) into its publicly funded national immunization program at a reduced two-dose priming schedule for infants, with a 12-month booster. METHODS Using data from enhanced national surveillance of invasive meningococcal disease in England, we evaluated the effect of vaccination on the incidence of meningococcal group B disease during the first 3 years of the program. The effect of vaccination was assessed by comparing the observed incidence of disease with the expected incidence based on the incidence during the 4-year prevaccination period in equivalent cohorts and with the use of disease trends in cohorts of children younger than 5 years of age who were not eligible to receive the vaccine. Vaccine effectiveness was estimated with the use of the indirect screening method. RESULTS 4CMenB uptake in England remained consistently high; data from the first 3 months of 2018 showed that 92.5% of children had completed the primary immunizations by their first birthday and 87.9% had received all three doses by 2 years. From September 2015 through August 2018, the incidence of meningococcal group B disease in England (average annual birth cohort, approximately 650,000 infants) was significantly lower in vaccine-eligible cohorts than the expected incidence (63 observed cases as compared with 253 expected cases; incidence rate ratio, 0.25; 95% confidence interval [CI], 0.19 to 0.36), with a 75% reduction in age groups that were fully eligible for vaccination. The adjusted vaccine effectiveness against meningococcal group B disease was 52.7% (95% CI, -33.5 to 83.2) with a two-dose priming schedule for infants and 59.1% (95% CI, -31.1 to 87.2) with a two-dose priming schedule plus a booster at 1 year). Over the 3-year period, there were 169 cases of meningococcal group B disease in the vaccine-eligible cohorts, and an estimated 277 cases (95% CI, 236 to 323) were prevented. CONCLUSIONS The 4CMenB program was associated with continued positive effect against meningococcal group B disease in children in England, and protection after three doses of the vaccine was sustained for at least 2 years. (Funded by Public Health England.).

中文翻译：

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在英格兰给婴儿接种脑膜炎球菌B组疫苗（4CMenB）。

背景技术2015年9月，英国将多组分B型脑膜炎球菌疫苗（4CMenB，Bexsero）引入其国家资助的国家免疫计划中，以减少的婴儿两剂初免时间表进行了加强，为期12个月。方法使用来自英格兰的全国性侵袭性脑膜炎球菌疾病加强监测的数据，我们评估了该计划最初3年中疫苗接种对B型脑膜炎球菌疾病发病率的影响。通过将观察到的疾病发生率与预期发生率进行比较，从而评估疫苗接种的效果，该预期发生率是基于相同人群中4年预疫苗接种期间的发病率，以及对5岁以下儿童队列中疾病趋势的利用不符合接受疫苗的条件。使用间接筛选方法评估疫苗的有效性。结果英格兰的4CMenB摄入量一直保持较高水平；2018年前3个月的数据显示，有92.5％的孩子在他们的第一个生日之前已经完成了初次免疫，而87.9％的孩子在2岁之前已经接受了全部三剂。从2015年9月至2018年8月，符合疫苗资格的人群在英格兰的B型脑膜炎球菌群疾病（平均每年出生队列，约65万婴儿）的发病率明显低于预期发病率（观察到63例病例，而预期为253例;发病率比率为0.25； 95％的置信区间[CI]为0.19至0.36），而完全有资格接种疫苗的年龄组减少了75％。调整后的针对B型脑膜炎球菌的疫苗效力为52。7％（95％CI，-33.5至83.2）的婴儿采用了两剂启动方案，而59.1％（95％CI，-31.1至87.2）的婴儿采用了两剂启动方案，并在1岁时加强了剂量。在三年的时间里，符合疫苗资格的人群中有169例B型脑膜炎球菌病，估计预防了277例（95％CI，236至323）。结论4CMenB计划与针对英国儿童的B型脑膜炎球菌持续持续的积极作用相关联，在三剂疫苗接种后至少要持续2年才能获得保护。（由英国公共卫生部资助。）。在符合疫苗条件的人群中，有169例B型脑膜炎球菌病，估计有277例（95％CI，236至323）被预防。结论4CMenB计划与针对英国儿童的B型脑膜炎球菌持续持续的积极作用相关联，在三剂疫苗接种后至少要持续2年才能获得保护。（由英国公共卫生部资助。）。在符合疫苗条件的人群中，有169例B型脑膜炎球菌病，估计有277例（95％CI，236至323）被预防。结论4CMenB计划与针对英国儿童的B型脑膜炎球菌持续持续的积极作用相关联，在三剂疫苗接种后至少要持续2年才能获得保护。（由英国公共卫生部资助。）。