Evaluation of the impact of serogroup C meningococcal disease vaccination program in Brazil and its regions: a population-based study, 2001-2013

BACKGROUND Meningococcal C conjugate (MenC) vaccine was introduced as part of the Brazilian National Immunisation Program in 2010 for children < 1 year of age.

OBJECTIVES The study objective was to evaluate the impact of this vaccination strategy.

METHODS An observational, mixed ecolobical and analytical study was conducted, based on time series panel data from surveillance records (2001-2013).

FINDINGS A total of 37,538 of meningococcal disease cases were recorded during the study period. Of these, 19,997 were attributed to serogroup C. A decrease in meningococcal disease serogroup C (MDC) incidence among children aged 1 year 65.2%; 95% confidence interval (CI): 20.5-84.7% and 1-4 years (46.9%; 95%CI: 14.6-79.1%) were found in the three years following vaccination introduction. Vaccination impact on the reduction of MDC incidence varied from 83.7% (95%CI: 51.1-100.0%) in the Midwest region to 56.7% (95%CI: 37.4-76.0%) in the Northeast region.

MAIN CONCLUSIONS Vaccination against MDC in Brazil had a positive impact on the population of children aged 1 year, across all regions, and on the 1-4 year-old cohort. Nevertheless, in our view there is scope for iproving the vaccination strategy adopted in Brazil.

Keywords
meningococcal disease; Neisseria meningitides; serogroup C conjugate vaccine; surveillance; vaccination impact