Outbreaks of invasive meningococcal disease (IMD) are unpredictable, can be sudden and have devastating consequences. We conducted a non-systematic review of the literature in PubMed (1997-2020) to assess outbreak response strategies and the impact of vaccine interventions. Since 1997, IMD outbreaks due to serogroups A, B, C, W, Y and X have occurred globally. Reactive emergency mass vaccination campaigns have encompassed single institutions (schools, universities) through to whole sections of the population at regional/national levels (e.g. serogroup B outbreaks in Saguenay-Lac-Saint-Jean region, Canada and New Zealand). Emergency vaccination responses to IMD outbreaks consistently incurred substantial costs (expenditure on vaccine supplies, personnel costs and interruption of other programmes). Impediments included the limited pace of transmission of information to parents/communities/healthcare workers; issues around collection of informed consents; poor vaccine uptake by older adolescents/young adults, often a target age group; issues of reimbursement, particularly in the USA; and difficulties in swift supply of large quantities of vaccines. For serogroup B outbreaks, the need for two doses was a significant issue that contributed substantially to costs, delayed onset of protection and non-compliance with dose 2. Real-world descriptions of outbreak control strategies and the associated challenges systematically show that reactive outbreak management is administratively, logistically and financially costly, and that its impact can be difficult to measure. In view of the unpredictability, fast pace and potential lethality of outbreak-associated IMD, prevention through routine vaccination appears the most effective mitigation tool. Highly effective vaccines covering five of six disease-causing serogroups are available. Preparedness through routine vaccination programmes will enhance the speed and effectiveness of outbreak responses, should they be needed (ready access to vaccines and need for a single booster dose rather than a primary series).

中文翻译：

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脑膜炎球菌病爆发：​​移动目标和常规预防性疫苗接种的案例。

侵袭性脑膜炎球菌病 (IMD) 的爆发是不可预测的、可能是突然的并会造成灾难性后果。我们对 PubMed (1997-2020) 中的文献进行了非系统回顾，以评估疫情应对策略和疫苗干预措施的影响。自1997年以来，由A、B、C、W、Y和X血清群引起的IMD疫情在全球范围内发生。反应性紧急大规模疫苗接种运动涵盖了单个机构（学校、大学）以及区域/国家层面的整个人群（例如加拿大和新西兰萨格奈湖圣让地区 B 群血清群爆发）。针对 IMD 疫情的紧急疫苗接种反应持续产生大量成本（疫苗供应支出、人员成本和其他计划的中断）。障碍包括向家长/社区/医护人员传递信息的速度有限；与收集知情同意有关的问题；年龄较大的青少年/年轻人（通常是目标年龄组）疫苗接种率低；报销问题，特别是在美国；以及快速供应大量疫苗的困难。对于 B 群疫情暴发，需要两剂疫苗是一个重大问题，它会极大地增加成本、延迟起效以及不遵守第 2 剂疫苗的规定。对疫情控制策略和相关挑战的真实描述系统地表明，反应性疫情管理行政、后勤和财务成本高昂，而且其影响难以衡量。鉴于与疫情相关的 IMD 的不可预测性、快速发展和潜在致命性，通过常规疫苗接种进行预防似乎是最有效的缓解工具。高效疫苗涵盖六种致病血清群中的五种。如果需要的话，通过常规疫苗接种计划做好准备将提高疫情应对的速度和有效性（随时获得疫苗并需要单次加强剂量而不是初级系列）。