Prevention of invasive meningococcal disease in the United States: Current state of the art

Neisseria meningitidis causes potentially fatal and often debilitating invasive meningococcal disease (IMD). IMD remains a serious health problem for healthcare providers and public health officials despite approximately 80% of US IMD being vaccine-preventable. In 2005, the Advisory Committee on Immunization Practices (ACIP) recommended routine immunization of adolescents aged 11-12 years and, in 2007, this recommendation was expanded to include all adolescents aged 11-18 years. Adolescent disease burden has since declined. For new vaccination strategies to improve beyond standard of care, they must account for current epidemiologic trends. This article reviews the current epidemiology of IMD in the United States, highlighting known risk factors. Prior ACIP recommendations (and their rationale) since the approval of the first quadrivalent conjugate meningococcal vaccine in 2005 are summarized. The scientific and logistical issues associated with extending those recommendations to include infants and other at-risk groups are also discussed.