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2025 theme: Vaccines

Abstract

In November 2023, the UK Health Security Agency was notified of PCR-confirmed group B (MenB) invasive meningococcal disease (IMD) in a 3-year-old child (Case A), followed by probable IMD in a 2-year-old (Case B, culture and PCR tests negative) attending the same nursery. An incident management team (IMT) was convened. Both children were fully vaccinated with the MenB vaccine 4CMenB (Bexsero, GSK Biologicals). All 39 children attending the nursery and nine staff received ciprofloxacin chemoprophylaxis preceded by pharyngeal swabbing. Pharyngeal swabbing yielded two MenB isolates matching Case A. Antibiotic sensitivity testing and assessment of 4CMenB vaccine coverage using the meningococcal antigen typing system (MATS) revealed the strain was not covered by the 4CMenB vaccine. Although the alternative MenB vaccine, MenB-fHbp (Trumenba, Pfizer), is only licensed from 10 years and has never been given to children previously immunised with 4CMenB, the IMT considered the benefits of outbreak control outweighed potential risks. Two doses were given 4 weeks apart to 38 children (one family declined) and all staff; there were no serious adverse events. Our findings highlight the utility of swabbing to identify outbreak strains and provide first evidence for safe use of the MenB-fHbp vaccine in children previously vaccinated with 4CMenB.

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/content/10.2807/1560-7917.ES.2026.31.3.2500431
2026-01-22
2026-02-07
/content/10.2807/1560-7917.ES.2026.31.3.2500431
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References

  1. Parikh SR, Campbell H, Bettinger JA, Harrison LH, Marshall HS, Martinon-Torres F, et al. The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination. J Infect. 2020;81(4):483-98.  https://doi.org/10.1016/j.jinf.2020.05.079  PMID: 32504737 
  2. Campbell H, Andrews N, Parikh SR, White J, Edelstein M, Bai X, et al. Impact of an adolescent meningococcal ACWY immunisation programme to control a national outbreak of group W meningococcal disease in England: a national surveillance and modelling study. Lancet Child Adolesc Health. 2022;6(2):96-105.  https://doi.org/10.1016/S2352-4642(21)00335-7  PMID: 34883094 
  3. Ladhani SN, Andrews N, Parikh SR, Campbell H, White J, Edelstein M, et al. Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England. N Engl J Med. 2020;382(4):309-17.  https://doi.org/10.1056/NEJMoa1901229  PMID: 31971676 
  4. Clark SA, Campbell H, Ribeiro S, Bertran M, Walsh L, Walker A, et al. Epidemiological and strain characteristics of invasive meningococcal disease prior to, during and after COVID-19 pandemic restrictions in England. J Infect. 2023;87(5):385-91.  https://doi.org/10.1016/j.jinf.2023.09.002  PMID: 37689395 
  5. United Kingdom Health Security Agency (UKHSA). Invasive meningococcal disease in England: annual laboratory confirmed reports for epidemiological year 2023 to 2024. London: GOV.UK. [Accessed: 11 Apr 2025]. Available from: https://www.gov.uk/government/publications/meningococcal-disease-laboratory-confirmed-cases-in-england-2023-to-2024/invasive-meningococcal-disease-in-england-annual-laboratory-confirmed-reports-for-epidemiological-year-2023-to-2024
  6. United Kingdom Health Security Agency (UKHSA). Guidance for public health management of meningococcal disease in the UK. London: GOV.UK. [Accessed: 4 Nov 2025]. Available from: https://assets.publishing.service.gov.uk/media/694a83a9033693d5d50eb8f7/Meningo-disease-guidelines-2025.pdf
  7. Burman C, Alderfer J, Snow VT. A review of the immunogenicity, safety and current recommendations for the meningococcal serogroup B vaccine, MenB-FHbp. J Clin Pharm Ther. 2020;45(2):270-81.  https://doi.org/10.1111/jcpt.13083  PMID: 31820483 
  8. Clark SA, Willerton L, Claus H, Carannante A, Stefanelli P, Abad R, et al. Exploring the sequence diversity and surface expression of Factor H-Binding Protein among invasive serogroup B meningococcal strains from selected European countries. Hum Vaccin Immunother. 2024;20(1):2427471.  https://doi.org/10.1080/21645515.2024.2427471  PMID: 39536321 
  9. European Medicines Agency (EMA). Trumenba. Amsterdam: EMA. [Accessed: 23 Apr 2025]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/trumenba
  10. Marshall HS, McMillan M, Koehler AP, Lawrence A, Sullivan TR, MacLennan JM, et al. Meningococcal B Vaccine and Meningococcal Carriage in Adolescents in Australia. N Engl J Med. 2020;382(4):318-27.  https://doi.org/10.1056/NEJMoa1900236  PMID: 31971677 
  11. Donnelly J, Medini D, Boccadifuoco G, Biolchi A, Ward J, Frasch C, et al. Qualitative and quantitative assessment of meningococcal antigens to evaluate the potential strain coverage of protein-based vaccines. Proc Natl Acad Sci USA. 2010;107(45):19490-5.  https://doi.org/10.1073/pnas.1013758107  PMID: 20962280 
  12. McNeil LK, Donald RGK, Gribenko A, French R, Lambert N, Harris SL, et al. Predicting the Susceptibility of Meningococcal Serogroup B Isolates to Bactericidal Antibodies Elicited by Bivalent rLP2086, a Novel Prophylactic Vaccine. MBio. 2018;9(2):e00036-18.  https://doi.org/10.1128/mBio.00036-18  PMID: 29535195 
  13. Ladhani SN, Dowell AC, Jones S, Hicks B, Rowe C, Begum J, et al. Early evaluation of the safety, reactogenicity, and immune response after a single dose of modified vaccinia Ankara-Bavaria Nordic vaccine against mpox in children: a national outbreak response. Lancet Infect Dis. 2023;23(9):1042-50.  https://doi.org/10.1016/S1473-3099(23)00270-0  PMID: 37336224 
  14. Christensen H, May M, Bowen L, Hickman M, Trotter CL. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(12):853-61.  https://doi.org/10.1016/S1473-3099(10)70251-6  PMID: 21075057 
First use of Trumenba (MenB-fHbp) vaccine to control a nursery outbreak of serogroup B invasive meningococcal disease involving children previously immunised with Bexsero (4CMenB), England, November 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Kirsty+Foster&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Foster Kirsty</a>, <a href="/search?value1=Emma+J+Heymer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Heymer Emma J</a>, <a href="/search?value1=Helen+Campbell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Campbell Helen</a>, <a href="/search?value1=Emma+Wilson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wilson Emma</a>, <a href="/search?value1=Jess+Baldasera&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Baldasera Jess</a>, <a href="/search?value1=Jay+Lucidarme&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lucidarme Jay</a>, <a href="/search?value1=Stephen+A+Clark&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Clark Stephen A</a>, <a href="/search?value1=Xilian+Bai&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bai Xilian</a>, <a href="/search?value1=Shazaad+Ahmad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ahmad Shazaad</a>, <a href="/search?value1=Ray+Borrow&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Borrow Ray</a>, <a href="/search?value1=Shamez+N+Ladhani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ladhani Shamez N</a></span>. First use of Trumenba (MenB-fHbp) vaccine to control a nursery outbreak of serogroup B invasive meningococcal disease involving children previously immunised with Bexsero (4CMenB), England, November 2023. <a href="/content/ecdc">Euro Surveill.</a> 2026;31(3):pii=2500431. <a href="https://doi.org/10.2807/1560-7917.ES.2026.31.3.2500431" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2026.31.3.2500431</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Jun 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 12 Oct 2025 </span> </p>
/content/10.2807/1560-7917.ES.2026.31.3.2500431
/content/10.2807/1560-7917.ES.2026.31.3.2500431
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