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Effectiveness of Serogroup C Meningococcal Conjugate Vaccine: A 7-Year Follow-up in Quebec, Canada

De Wals, Philippe MD, PhD*†‡; Deceuninck, Geneviève MSc; Lefebvre, Brigitte PhD§; Boulianne, Nicole MSc†‡; De Serres, Gaston PhD*†‡

The Pediatric Infectious Disease Journal: July 2011 - Volume 30 - Issue 7 - p 566-569
doi: 10.1097/INF.0b013e31820e8638
Original Studies

Background: A mass immunization campaign was implemented in 2001 to control a serogroup C meningococcal disease outbreak, and a newly licensed serogroup C meningococcal conjugate vaccine (C-MCV) was used. In 2002, 1 C-MCV dose was routinely offered to children 12 months of age.

Objective: To assess the epidemiologic effect of the campaign and C-MCV effectiveness during a 7-year period according to age at vaccination and delay since vaccine administration.

Methods: Cases of invasive meningococcal infection reported to public health authorities and the reference laboratory during the period 1990 to 2008 were obtained to calculate year- and age-specific incidence rates. Multiple sources were used to ascertain the immunization status of cases. Immunization registry data were used to estimate age-specific C-MCV uptake rates in different birth cohorts. Vaccine effectiveness was estimated by Mantel–Haenszel method and logistic regression models.

Results: After mass immunization campaign, meningococcal C disease incidence decreased markedly not only in highly vaccinated but also in poorly vaccinated and nonvaccinated birth cohorts. Overall vaccine effectiveness was 87.4% (95% CI: 75.4%–94.2%) with lower protection in children vaccinated <2 years of age and waning of protection of higher magnitude in this age group.

Conclusion: Results support the current Canadian recommendation to provide booster vaccination for adolescents.


From the *Department of Social and Preventive Medicine, Laval University, Quebec City, Canada; †Quebec University Hospital Research Centre, Quebec City, Canada; ‡Quebec National Public Health Institute, Quebec City, Canada; and §Quebec Public Health Laboratory, Quebec National Public Health Institute, Montreal, Canada.

Accepted for publication December 29, 2010.

Supported by a grant from the Quebec Ministry of Health and Social Services; research grants, honoraria, and reimbursements of travel expenses from vaccine manufacturers including Glaxo-Smith-Kline, Novartis, Sanofi Pasteur, Merck and Pfizer (to P.D.W.); research grants from Sanofi Pasteur and Chiron (now Novartis) (to G.D.S.); and research grants from Sanofi Pasteur and GlaxoSmithKline (to N.B.).

Address for correspondence: Philippe De Wals, MD, PhD, Département de Médecine sociale et préventive, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec (QC), G1V 0A6, Canada. E-mail:

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© 2011 by Lippincott Williams & Wilkins, Inc.