Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence
Abstract
:1. Introduction
2. Materials and Methods
2.1. Epidemiology of Invasive Meningococcal Disease in Italy
2.2. Invasive Meningococcal Disease Burden and Related Costs
2.3. Immunogenicity and Safety of Anti-MenB Vaccines
2.4. Cost-Effectiveness Analyses of Anti-MenB Vaccination in Adolescents
3. Results
3.1. Invasive Meningococcal B Disease: A Low-Incidence Disease with a Heavy Disease Burden
3.2. The High Costs of Invasive Meningococcal Disease
3.3. Immunogenicity and Safety of Anti-Meningococcus B Vaccines (MenB-4C and MenB-FHbp)
3.4. The Cost-Effective Profile of an Immunization Program against Meningococcal B Targeted to the Adolescent Population in Italy
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Type of Sequelae | Probability | Ref. |
---|---|---|
Physical sequelae | ||
Skin scars | 6.4–48% | [27] |
Amputations | 0.8–14% | [27] |
Renal dysfunction | 2–8.7% | [27] |
Arthritis/vasculitis | 4.7% | [27] |
Limb deformity | 6% | [7] |
Neurological sequelae | ||
Bilateral/unilateral deafness | up to 19% | [1,25,26,27,28,29,30,31] |
Cognitive impairment | up to 24% | [1,25,26,27,28,29,30,31] |
Convulsions/epilepsy | up to 40% | [1,25,26,27,28,29,30,31] |
Visual disorders | up to 23% | [1,25,26,27,28,29,30,31] |
Problems of communication | up to 25% | [1,25,26,27,28,29,30,31] |
Psychiatric and psychological problems | ||
Depression | 5.7% | [31] |
Anxiety | 7.1% | [31] |
Parameter | Cost (EUR) | Ref. |
---|---|---|
Hospitalization (subjects <18 years) | HDF-9 code 036: € 4952.64 a HDF -9 code 0360: € 4952.64 b HDF -9 code 0362: € 4529.00 c | [36] |
Hospitalization (subjects >18 years) | HDF -9 code 036: € 6708.04 a HDF -9 code 0360: € 6542.06 b HDF -9 code 0362: € 6177.88 c | [36] |
Public health response | € 3284 | [36] |
Hospitalization in long-term care (maximum 20 days) | € 4040.00 (€ 202,00/day) | [36] |
Anti-Meningococcus B Vaccines Licensed in Italy: Recommendation for Adolescents. | ||
---|---|---|
MenB4-C [23] | MenB-FHbp [24] | |
Composition | Three recombinant antigen proteins (FHbp, NadA and NHBA) and outer membrane vesicles (OMV) as amount of total protein containing PorA P1.a | Two recombinant lapidated antigen variants of FHbp protein (subfamily A and B). |
Indications | Active immunization in subjects aged ≥ 2 months. | Active immunization in subjects aged ≥10 years. |
Posology | Primary immunization: 2-dose schedule (0, 1 or 0, 2 or 0, 6 months). Booster is recommended for high-risk group. | Primary immunization: 2-dose schedule (0, 6 months) or 3-dose schedule (0, 1, 6 or 0, 2, 6 months). Booster is recommended for high-risk group. |
Immunogenicity | FHbp, NadA, PorA P1.4: 100% NHBA: 99–100% (*) | A22: 78.1–84%; A56: 93.4–94.2% B24: 74.6–75.4%; B44: 81.7–82.2% (§). |
Safety | Most common: pain at the injection site, malaise, headache. | Most common: pain, redness and swelling at the injection site, headache, fatigue, chills, diarrhea, muscle pain, joint pain. |
Co-administration | Monovalent or combined vaccines: diphtheria, tetanus, acellular pertussis, Hib, IPV, HBV, heptavalent pneumococcal conjugate, measles, mumps, rubella, varicella, and meningococcal groups A, C, W, Y conjugate. | Tetanus Toxoid, Reduced Diphtheria Toxoid, Acellular Pertussis, and Inactivated Poliovirus Vaccine (TdaP-IPV), Quadrivalent Human Papillomavirus vaccine, meningococcal groups A, C, W, Y conjugate vaccine and Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine Adsorbed (Tdap). |
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Boccalini, S.; Zanella, B.; Landa, P.; Amicizia, D.; Bechini, A.; Innocenti, M.; Iovine, M.; Lecini, E.; Marchini, F.; Paolini, D.; et al. Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence. Microorganisms 2020, 8, 1681. https://doi.org/10.3390/microorganisms8111681
Boccalini S, Zanella B, Landa P, Amicizia D, Bechini A, Innocenti M, Iovine M, Lecini E, Marchini F, Paolini D, et al. Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence. Microorganisms. 2020; 8(11):1681. https://doi.org/10.3390/microorganisms8111681
Chicago/Turabian StyleBoccalini, Sara, Beatrice Zanella, Paolo Landa, Daniela Amicizia, Angela Bechini, Maddalena Innocenti, Mariasilvia Iovine, Elvina Lecini, Francesca Marchini, Diana Paolini, and et al. 2020. "Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence" Microorganisms 8, no. 11: 1681. https://doi.org/10.3390/microorganisms8111681