Assessing Different Combinations of 4CMENB and Menacwy-CRM197 Vaccines in Infants, Toddlers and Adolescents of Argentina to Maximize Its Impact Against Invasive Meningococcal Disease

OBJECTIVES: Invasive meningococcal disease (IMD) is a rare yet unpredictable, severe and life-threatening disease with the highest burden in infants and young children. In Argentina, the highest incidence occurs in infants, with an increasing predominance of IMD caused by meningococcal serogroup B (MenB) over W (MenW) infection in recent years. This trend is even more evident after the incorporation of MenACWY-CRM197 in infants, toddlers, and adolescent’s vaccination to national calendar in 2017, and especially among <5 years old children. This analysis assesses the public health impact (between 2023-2047) of six alternative vaccination strategies compared to the current National Immunization Program (NIP).

METHODS: A dynamic transmission model was adapted for Argentina to assess the public health impact (IMD cases, long-term sequelae, deaths and lost quality-adjusted life-years) of different vaccination strategies (started in 2023 with 25 years of follow-up). Six alternative vaccination strategies using MenACWY-CRM197 and/or the four-component MenB (4CMenB) vaccine in infants, toddlers and/or adolescents were compared to the current NIP with MenACWY-CRM197 vaccine in infants/toddlers and adolescents since 2017.

RESULTS: Strategies using 4CMenB in infants/toddlers and MenACWY-CRM197 in adolescents are the most effective options to prevent IMD caused by MenB and MenW, respectively. Therefore, 25 years after replacing the present NIP program with a strategy that combines 4CMenB in infants/toddlers and MenACWY-CRM197 only in adolescents is expected to reduce by 28) the number of IMD cases between 0-4 years of age, compared to present NIP. Alternatively, adding 4CMenB in infant/toddlers to the present NIP program is expected to reduce by 34% (745 cases) the number of IMD cases between 0-4 years of age, compared to present NIP.

CONCLUSIONS: This analysis can help policymakers determine the best strategy to control IMD in Argentina and improve public health.