In order to make decisions about when and how a vaccine could be introduced to be most effective, it is crucial to know the precise number of cases and how serious such infections are in different age groups.
When this project began, two meningococcal group B (MenB) vaccines were in late stage development. One has since received a European licence and will soon be available for routine use in the national immunisation programme. In order to make decisions about when and how a vaccine could be introduced to be most effective, it is crucial to know the precise number of cases and how serious such infections are in different age groups.
Also, once a vaccine is in routine use, it is vital that the number of meningococcal cases are closely monitored and recorded so that the effectiveness of the vaccine can be measured. National recording and surveillance of meningococcal disease was known to be incomplete, meaning some cases of the disease were not officially recorded. The existing system also did not routinely collect any clinical information about disease severity. We therefore knew little about the individuals who developed disease. Accurate and integrated information is vital for estimating the potential impact of any new vaccine, and monitoring impact once it becomes part of the routine immunisation programme.
What the research team did
This project, which was jointly funded with Meningitis Research Foundation, aimed to provide an accurate estimation of how much meningococcal disease there was in England. Dr Ladhani and his team integrated several different sources of information, linking data from the national meningococcal reference laboratory together with reports from NHS hospital laboratories, admissions to NHS hospitals and death data from the Office for National Statistics. The project aimed to provide a more complete picture of meningococcal disease, with more in depth information about cases than was currently available from any single national dataset, including the form of disease people suffer (e.g. meningitis, septicaemia or other infection), risk factors for developing disease, length of hospital stay, long-term complications and outcome.
Summary and impact of results
We hope that this proof of concept study will not only inform national vaccination policy, but eventually lead to routine integration of national datasets for surveillance of meningococcal disease, providing an accurate system that can be continued into future years.
It could also be extended to Scotland, Wales and Northern Ireland to achieve a true national picture of meningococcal disease in the UK, and provide a model for surveillance of other causes of meningitis.