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Philippe De Wals, MD, PhD; Geneviève Deceuninck, MD; Nicole Boulianne, MSc; Gaston De Serres, MD, PhD

JAMA. 2004;292:2491-2494.

Context  Meningococcal polysaccharide vaccines are of limited effectiveness. New protein-polysaccharide conjugate vaccines have yet to be evaluated in field conditions.

Objective  To assess the effectiveness of a serogroup C conjugate meningococcal vaccine in an outbreak setting.

Design, Setting, and Participants  Population-based observational study of cases of invasive serogroup C meningococcal disease from 1996 through 2002 in Quebec identified from the provincial registry of notifiable diseases and from the provincial reference laboratory. In 2001, a mass immunization campaign with a conjugate vaccine was conducted to control an emerging epidemic. The number of vaccinated individuals was extracted from meningococcal immunization registries.

Main Outcome Measures  Incidence of invasive meningococcal disease before and 1 year after the campaign in vaccinated and unvaccinated individuals.

Results  Vaccination coverage of those 2 months to 20 years was 82.1%. After the campaign, the number of cases of serogroup C disease decreased from 58 in 2001 to 27 in 2002, and the incidence from 7.8 per million to 3.6 per million. Vaccine effectiveness was found to be 96.8% (95% confidence interval, 75.0%-99.9%). There was no observed increase in the incidence of the other serogroups.

Conclusion  The new conjugate vaccine was effective in controlling an emerging epidemic of serogroup C meningococcal disease, as well as providing short-term protection across a wide age range.

Author Affiliations: Quebec National Public Health Institute and Department of Preventive and Social Medicine, Laval University (Drs De Wals and De Serres and Ms Boulianne), and the Public Health Research Unit, Quebec University Hospital Center (Drs De Wals, Deceuninck, and De Serres and Ms Boulianne), Quebec City, Quebec.

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