Pediatrics
May 2015, VOLUME 135 / ISSUE 5
http://pediatrics.aappublications.org/current.shtml

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Article
First Use of a Serogroup B Meningococcal Vaccine in the US in Response to a University Outbreak
Lucy A. McNamara, PhD, MSa,b, Alice M. Shumate, PhDa,c, Peter Johnsen, MDd, Jessica R. MacNeil, MPHb, Manisha Patel, MDb, Tina Bhavsar, PharmDe, Amanda C. Cohn, MDb, Jill Dinitz-Sklar, MPHc,f, Jonathan Duffy, MD, MPHg, Janet Finnie, MBA, LSWd, Denise Garon, MSc, Robert Hary, MA, MBAh, Fang Hu, PhDb, Hajime Kamiya, MD, PhD, MPHa,b, Hye-Joo Kim, PharmDe,
John Kolligian Jr, PhDd, Janet Neglia, MDd, Judith Oakleyd, Jacqueline Wagner, MSd, Kathy Wagner, MPHd, Xin Wang, PhDb, Yon Yu, PharmDe, Barbara Montana, MD, MPHc, Christina Tan, MD, MPHc, Robin Izzo, MSd, and Thomas A. Clark, MD, MPHb
Author Affiliations
aEpidemic Intelligence Service Program, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services,
bDivision of Bacterial Diseases, National Center for Immunization and Respiratory Diseases,
eRegulatory Affairs, Office of the Director, and
gImmunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
cNew Jersey Department of Health, Trenton, New Jersey;
dPrinceton University, Princeton, New Jersey;
fMercer County Division of Public Health, Trenton, New Jersey; and
hPrinceton Health Department, Princeton, New Jersey
Abstract
BACKGROUND: In 2013–2014, an outbreak of serogroup B meningococcal disease occurred among persons linked to a New Jersey university (University A). In the absence of a licensed serogroup B meningococcal (MenB) vaccine in the United States, the Food and Drug Administration authorized use of an investigational MenB vaccine to control the outbreak. An investigation of the outbreak and response was undertaken to determine the population at risk and assess vaccination coverage.
METHODS: The epidemiologic investigation relied on compilation and review of case and population data, laboratory typing of meningococcal isolates, and unstructured interviews with university staff. Vaccination coverage data were collected during the vaccination campaign held under an expanded-access Investigational New Drug protocol.
RESULTS: Between March 25, 2013, and March 10, 2014, 9 cases of serogroup B meningococcal disease occurred in persons linked to University A. Laboratory typing results were identical for all 8 isolates available. Through May 14, 2014, 89.1% coverage with the 2-dose vaccination series was achieved in the target population. From the initiation of MenB vaccination through February 1, 2015, no additional cases of serogroup B meningococcal disease occurred in University A students. However, the ninth case occurred in March 2014 in an unvaccinated close contact of University A students.
CONCLUSIONS: No serogroup B meningococcal disease cases occurred in persons who received 1 or more doses of 4CMenB vaccine, suggesting 4CMenB may have protected vaccinated individuals from disease. However, the ninth case demonstrates that carriage of serogroup B Neisseria meningitidis among vaccinated persons was not eliminated.