Thatiana Pinto

Invasive meningococcal disease (IMD) is an uncommon but serious infectious disease caused by Neisseria meningitidis that may result in death or long-term sequelae.1,2 In the overall population of t...

1. Invasive meningococcal disease (IMD) is a severe infectious disease that can result in extreme acute morbidity and case fatality rates as high as 15–20%, even with appropriate treatment [1,2]. O...

Invasive meningococcal disease (IMD) is a vaccine-preventable, serious disease. In 2023-2024, the United States (US) Advisory Committee on Immunization Practices (ACIP) proposed revisions to the adolescent meningococcal vaccine schedule. This survey aimed to understand healthcare professionals' (HCPs') perspectives on these revisions and the potential role of the meningococcal serogroups A, B, C, W, Y (MenABCWY) vaccine. An online survey was conducted in May - June 2025 among US HCPs who regularly recommend meningococcal vaccines for 16-23-year-old patients. Responses were analyzed descriptively. Of 302 HCPs, 73.2% felt the MenABCWY vaccine provides significant value to the meningococcal vaccination program, and almost half preferred a two-dose MenABCWY schedule over the ACIP recommendation, wherein a MenABCWY dose is followed by a MenB dose. Most HCPs indicated concern with removing MenACWY vaccination for 11-12-year-olds (84.8%). Comparatively, fewer were concerned about changing the MenB vaccine recommendation from shared clinical decision-making to risk-based (60.6%) and administering the second MenB dose closer to college entry (48.7%). While HCPs were receptive to revisions that simplify the vaccine schedule, this was not without concerns. The adolescent vaccination platform is essential to ensure continued protection against IMD; any changes will require clear, evidence-based guidance.

Introduction Invasive meningococcal disease (IMD) caused by meningococcal serogroup B (MenB) is a rare but serious illness with potentially life-threatening outcomes, particularly in infants. In Brazil, IMD is endemic, with the highest incidence in infants and most cases being due to MenB. The four-component MenB vaccine (4CMenB), with potential cross-protection against other meningococcal serogroups, is approved in Brazil for active immunization of individuals aged 2 months to 50 years. This modeling study assessed the public health impact on all age groups in Brazil of introducing routine vaccination with the 4CMenB vaccine in infants aged < 1 year. Methods A static multigenerational multicohort model was developed using a discrete-time Markov approach over a 100-year time horizon. The model incorporates vaccine effectiveness, coverage, and waning rates to estimate the decrease in IMD incidence under the vaccination strategy (2 + 1 schedule at ages 3, 5, and 12 months) evaluated vs. no vaccination. Annual incidence rates of IMD by age group and serogroup between 2007 and 2023, excluding the COVID-19 pandemic period, were retrieved and adjusted for underreporting. Annual IMD-related deaths were calculated from age-specific case fatality rates. Results Assuming 69% cross-protection against serogroup W (MenW), the 4CMenB vaccination of infants would avert 63,038 (− 21%) IMD cases caused by MenB and MenW, and 11,301 (− 20%) deaths in all age groups. The model predicted a reduction of 21,408 (− 43%) MenB cases and 3335 (− 43%) deaths due to MenB in the < 1-year age group. Conclusion This modeling study highlights the considerable public health impact of introducing the 4CMenB vaccine for infants as part of Brazil’s routine vaccination schedule. By reducing IMD morbidity and mortality, routine 4CMenB immunization has the potential to substantially decrease the disease burden, improve long-term health outcomes, and reinforce the potential impact of preventive measures within the national immunization program. Graphical Abstract available for this article. Graphical Abstract

Background: Invasive meningococcal disease (IMD) is associated with high case-fatality rates and severe long-term sequelae. In the United States (US), IMD incidence rate (IR) is highest among infants aged <1 year, with most cases occurring in infants aged <6 months. This study estimated IMD incidence in commercially and Medicaid-insured infants, toddlers, and children aged <11 years. Methods: This retrospective claims analysis utilized real-world data (01 January 2005 to 31 December 2022) from the MarketScan® Commercial and Multi-State Medicaid Research Databases of infants (aged <1 year), toddlers (aged 1–4 years), and children (aged 5–10 years). IMD incidence, time at risk for IMD, IR, and IR ratio (IRR) were evaluated overall and by demographic/clinical characteristics. Results: Within the commercially and Medicaid-insured cohorts, 21 and 115 infants, 34 and 80 toddlers, and 36 and 37 children with IMD were identified, respectively. Overall IMD IRs in infants, toddlers, and children were 0.45, 0.17, and 0.11 per 100 000 person-years (PY; commercially insured) and 1.97, 0.45, and 0.18 per 100 000 PY (Medicaid-insured), respectively. Incidence rates were highest in infants aged <4 months (1.03 and 4.65 per 100 000 PY for infants aged 2 to <3 months [commercially insured] and 1 to <2 months [Medicaid-insured], respectively). Significantly elevated IRRs were observed among infants and children with specific demographic and clinical characteristics, including residence in rural counties, immunocompromised status, and complement component deficiency. Conclusions: IMD incidence is low in the United States, but varies by age, insurance type, and demographic/clinical characteristics. Timely preventative interventions, such as early vaccination, may reduce the incidence, risk, and associated burden of IMD.

Introduction Herpes zoster (HZ) can cause substantial patient morbidity and lead to large healthcare costs. However, the disease burden of HZ in Southeast Asia may be underestimated. This study aimed to estimate the public health burden of HZ and the impact of vaccinating adults aged ≥ 50 years old in five Southeast Asian countries (Indonesia, Malaysia, Philippines, Thailand, and Vietnam), with adjuvanted recombinant zoster vaccine (RZV) compared with no vaccination. Methods For each country, we adapted a static multicohort Markov model developed with a 1-year cycle length and lifetime horizon. Demographics were obtained from the World Health Organization, HZ incidence from a worldwide meta-regression reporting Asian-specific values, proportions of postherpetic neuralgia (PHN) and non-PHN complications from local/regional studies, and vaccine efficacy from a long-term follow-up trial. First-dose coverage and second-dose compliance were assumed to be 30% and 70%, respectively. A one-way deterministic sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA) were performed to assess the robustness and uncertainty of inputs for each country. Results Without RZV, it was estimated that there would be a total of approximately 10 million HZ cases, 2.1 million PHN cases, and 1.4 million non-PHN complications in individuals aged ≥ 50 years included in the model. Introducing RZV under 30% coverage could avoid approximately 2.2 million (22%) HZ cases, almost 500,000 (21%) PHN cases, and around 300,000 (22%) non-PHN complications. OWSA showed that first-dose coverage and initial HZ incidence had the largest impact on the estimated number of HZ cases avoided. The number needed to vaccinate ranged from 15 to 21 to prevent one case of HZ and from 68 to 104 to prevent one case of PHN across each country. Conclusions This study demonstrated that there is substantial HZ disease burden in older adults for the five selected countries in Southeast Asia, negatively impacting national healthcare systems. Introducing RZV could potentially reduce this burden. A graphical abstract is available with this article. Graphical Abstract