Invasive serogroup B meningococci in England following three years of 4CMenB vaccination - first real-world data: Meningococcal B following 4CMenB

Objectives In 2015 the UK became the first country to implement the meningococcal B (MenB) vaccine, 4CMenB, into the national infant programme. 4CMenB is expected to cover meningococci expressing sufficient levels of cross-reactive proteins. This study presents clonal complex, 4CMenB antigen genotyping, and 4CMenB coverage data for all English invasive MenB isolates from 2014/15 (1 year pre-vaccine) through 2017/18 and compares data from vaccinated and unvaccinated ≤ 3 year olds. Methods Vaccine coverage of all invasive MenB isolates from 2014/15 to 2017/18 (n=784) was analysed using the Meningococcal Antigen Typing System. Genotyping utilised the Meningococcus Genome Library. Results Among ≤3 year olds, proportionally fewer cases in vaccinees (1, 2 or 3 doses) were associated with well-covered strains e.g. cc41/44 (20.5% versus 36.4%; P Conclusions 4CMenB reduces disease due to strains with cross-reactive antigen variants. No increase in absolute numbers of cases due to poorly covered strains was observed in the study period.