The Lancet Infectious Diseases
May 2014 Volume 14 Number 5 p359 – 440
http://www.thelancet.com/journals/laninf/issue/current
Editorial
The case for vaccinating against meningitis B
The Lancet Infectious Diseases
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The four-component meningococcal serogroup B vaccine (4CMenB; Bexsero, Novartis) is the first successful vaccine against the endemic form of this cause of serious bacterial meningitis and septicaemia. The vaccine has been in development for almost two decades and has been approved by licensing authorities in Europe, Canada, and Australia. But it is only now moving towards incorporation into routine infant immunisation programmes following a recommendation from the UK Joint Committee on Vaccination and Immunisation (JCVI), with the proviso that a cost-effective price be negotiated.

Rotavirus vaccination in Europe: drivers and barriers
Dr N Parez PhD a, Prof C Giaquinto MD b, C Du Roure PhD c, F Martinon-Torres PhD d, V Spoulou PhD e, Prof P Van Damme PhD f, Prof T Vesikari MD g
Summary
Rotavirus gastroenteritis is a vaccine-preventable disease that confers a high medical and economic burden in more developed countries and can be fatal in less developed countries. Two vaccines with high efficacy and good safety profiles were approved and made available in Europe in 2006. We present an overview of the status of rotavirus vaccination in Europe. We discuss the drivers (including high effectiveness and effect of universal rotavirus vaccination) and barriers (including low awareness of disease burden, perception of unfavourable cost-effectiveness, and potential safety concerns) to the implementation of universal rotavirus vaccination in Europe. By February, 2014, national universal rotavirus vaccination had been implemented in Belgium, Luxembourg, Austria, Finland, Greece, Luxembourg, Norway, and the UK. Four other German states have issued recommendations and reimbursement is provided by sickness funds. Other countries were at various stages of recommending or implementing universal rotavirus vaccination.

A vaccine against serogroup B Neisseria meningitidis: dealing with uncertainty
Sophie M Andrews BSc a, Prof Andrew J Pollard PhD b c
Summary
Neisseria meningitidis is an important cause of invasive bacterial infection in children worldwide. Although serogroup C meningococcal disease has all but disappeared in the past decade as a direct result of immunisation programmes in Europe, Canada, and Australia, meningitis and septicaemia caused by serogroup B meningococci remain uncontrolled. A vaccine (4CMenB) has now been licensed for use in the European Union, comprising three immunogenic antigens (identified with use of reverse vaccinology) combined with bacterial outer-membrane vesicles. The vaccine has the potential to reduce mortality and morbidity associated with serogroup B meningococci infections, but uncertainty remains about the breadth of protection the vaccine might induce against the diverse serogroup B meningococci strains that cause disease. We discuss drawbacks in the techniques used to estimate coverage and potential efficacy of the vaccine, and their effects on estimates of cost-effectiveness, both with and without herd immunity. For parents, and clinicians treating individual patients, the predicted benefits of vaccination outweigh existing uncertainties if any cases can be prevented, but future use of the vaccine must be followed by rigorous post-implementation surveillance to reassess its value to health systems with directly recorded epidemiological data