Teens may need meningitis booster to remain protected

Last Updated: 2008-06-05 19:01:15 -0400 (Reuters Health)

NEW YORK (Reuters Health) – A booster dose of serogroup C meningococcal glycoconjugate vaccine during early adolescence may be required to maintain bactericidal antibody titers, according to a British study published in BMJ Online First on June 6.

Dr. Matthew D. Snape at the University of Oxford and colleagues evaluated the persistence of serum bactericidal antibody against meningococcal serogroup C in a cohort of 987 adolescents originally immunized at 6 to 15 years of age.

Five years after immunization, 84.1% had a bactericidal antibody titer of at least 1:8.

However, protective levels were less frequent in the 11 to 13 age group (79.1%) than in the 14 to 16 group (87.3%) and in the 17 to 20 group (88.2%). Corresponding geometric mean titers of bactericidal antibody were 147, 300, and 260.

"Protective concentrations of antibody persist better after immunization with a serogroup C meningococcal vaccine in the second decade of life than in the first decade," the authors write. They ascribe the difference to "immunological maturation" in older children.

Three vaccines were used in the 1999-2000 immunization campaign (Menjugate, Novartis Vaccines and Diagnostics; Meningitec, Wyeth Vaccines; NeisVac-C, Baxter Vaccines). There were no significant differences among the vaccines in antibody persistence.

Dr. Snape’s group recommends a booster dose of meningococcal vaccine in early adolescence for children who received primary immunizations in early childhood.

In a related editorial, Dr. Lucieni O. Conterno at Marilia Medical School in Sao Paulo, Brazil, and Dr. Paul T. Heath at the University of London highlight the success of the UK’s meningococcal vaccination program, noting that "for the fist time ever, no one under 19 years old has died of this disease in the past year."

Still, because of the propensity of antibody titers to wane over time, the editorialists emphasize that "continued high quality surveillance must continue, even long after disease seems to have been controlled."

BMJ Online First 2008.