OBJECTIVES: In 2005, the US Advisory Committee on Immunization Practices (ACIP) recommended routine quadrivalent meningococcal conjugate (MenACWY) vaccination (primary dose) for adolescents aged 11-12 years, and in 2010, a booster dose for adolescents aged 16 years. In October 2015, ACIP recommended serogroup B meningococcal (MenB) vaccination in adolescents aged 16-23 years based on shared clinical decision-making but the coverage of MenB vaccine remained still suboptimal in 2020. Although, the incidence of invasive meningococcal disease (IMD) has decreased in the US since the late 1990s and remained low in recent years, the burden of disease was still substantial between 2015 and 2020. This study aims to investigate the potential impact of using a pentavalent meningococcal (MenABCWY) vaccine instead of the current meningococcal vaccines during this period.

METHODS: Using US surveillance data from 2015-2020, we calculated the impact of current meningococcal immunization programs and estimated the epidemiological outcomes for hypothetical scenarios with MenABCWY vaccine defined based on recent ACIP recommendations. The number of IMD cases and IMD-related deaths were assessed. The impact on the gonorrhea incidence was also considered. Epidemiological data for IMD and gonorrhea were obtained from surveillance sources. Vaccine efficacy and coverage rates were derived from clinical trials and national statistics, respectively. Sensitivity analysis was performed.

RESULTS: Retrospectively, replacing the current meningococcal vaccines with MenABCWY vaccine would have resulted in the avoiding of an additional 3-8 IMD cases, 0-1 IMD-related deaths, and 8-26k gonorrhea cases in the US during the period of 2015-2020. The specific impact varied slightly depending on the vaccination strategy.

CONCLUSIONS: Switching from the current vaccines to MenABCWY vaccine in the US between 2015 and 2020 would have prevented additional IMD and gonorrhea cases, although the expected impact is small. Sensitivity analysis confirmed these findings. Further research is needed to define a vaccination strategy that effectively targets the most at-risk individuals.