Caroline Trotter

..With the exception of children aged 3 to 11 months, there was no clear relationship between disease incidence and seroprevalence...

..The magnitude of the herd effects following MCC vaccination was largely unanticipated, and has important consequences for the design and evaluation of new meningococcal vaccines...

..Age-specific seroprevalence of reference strain SBA titres most likely reflects exposure to meningococci and consecutive reactive immunity. We could not define any serological correlate of protection...

..6; 95% CI, 5.9, 12.7). Unlike seroprevalence against group B meningococci, there was not an obvious peak in SBA titers in samples from teenagers. Natural immunity against group W135 and Y meningococci in England appears to be low...

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..The aim of this paper is to review the state of the current evidence on conjugate vaccines and to identify important areas for further study, in order to inform the debate regarding the best use of these vaccines...

..It may be attributable to other population factors, changes in HES coding, changes to health service organization, other biologic phenomenon, or a combination of these effects...

..Carefully designed carriage studies are needed to measure and interpret the impact of meningococcal group A conjugate vaccines in Africa...

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..To describe the epidemiology of invasive pneumococcal disease (IPD) in England & Wales in the pre-conjugate vaccine era...

..Previous studies have shown that carriage rates vary by age and setting; however, few have assessed carriage across all ages. We aimed to estimate the age-specific prevalence of meningococcal carriage...

..Peer-led approaches may increase screening uptake but their feasibility and acceptability to young people is not known...

..Main outcome measure All completed hospital admissions with a mention of assault by sharp object (International Classification of Diseases, Tenth Revision, code X99) in the relevant diagnosis fields in HES...

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..The number of individuals in these cohorts remains low, but alternative routine immunisation schedules should be considered to ensure high levels of protection are sustained...

..No association was found between reduced penicillin susceptibility and fatal outcome, but the increasing frequency of isolates less susceptible to penicillin highlights the need for continued surveillance...

..Childhood immunisation programmes may have unanticipated effects on the epidemiology of disease in older age groups, and surveillance strategies must be targeted at entire populations...

..This model can be used to help predict the potential impact of vaccine strategies both in the United Kingdom and elsewhere...

..This program dominated the current strategy. CONCLUSIONS: Models that do not include the indirect effects of vaccination will underestimate the impact of MCC vaccination and may lead to distorted decision making...

..This paper outlines recommendations on the use of conjugate vaccines in Europe based on the experience with meningococcal C conjugate (MCC) vaccines so far...

..The importance of close collaboration between networks of epidemiologists, microbiologists, and the wider scientific and public health community is demonstrated...

..The inclusion of a booster dose is likely to improve the impact of the MCC program and reducing the number of doses in infancy will improve cost-effectiveness and create space in the schedule for the addition of other vaccines...

..To assess the cost effectiveness of a meningococcal serogroup C conjugate vaccination campaign in 0-17 year olds...

..In order to improve the international comparability of such studies, firmer national and international modelling guidelines and better adherence to such guidelines seem necessary...