英国公共卫生局Shamez N. Ladhani研究团队分析了英国婴儿接种B群脑膜炎球菌疫苗（4CMenB）的效果。2020年1月23日，国际知名学术期刊《新英格兰医学杂志》发表了这一成果。

2015年9月，英国将多组分B群脑膜炎球菌疫苗（4CMenB）纳入公共资助的国家免疫计划，减少了婴儿两剂接种计划，12个月后再接种一剂。

研究组采用英国加强侵袭性脑膜炎球菌病监测的数据，评估了在该计划的前3年内接种疫苗对B群脑膜炎球菌病发病率的影响。英国4CMenB的接种率一直较高，2018年前3个月数据显示，92.5%的儿童在1岁生日前完成了初级免疫接种，87.9%的儿童在2岁前完成了全部三次接种。

2015年9月至2018年8月，英国疫苗接种合格的队列中B群脑膜炎球菌病的发病率显著低于预期发病率，完全符合疫苗接种条件的年龄组减少了75%。

婴儿两剂接种计划对B群脑膜炎球菌病的校正疫苗有效性为52.7%，两剂接种计划加上1年后再接种一剂的校正疫苗有效性为59.1%。在3年期间，疫苗接种合格的队列中共发生169例B群脑膜炎球菌病，估计预防减少了277例。

总之，4CMenB计划预防儿童B群脑膜炎球菌病有持续的阳性反应，接受3剂疫苗后可至少预防2年。

附：英文原文

Title: Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England

Author: Shamez N. Ladhani, M.R.C.P.C.H.(U.K.), Ph.D.,, Nick Andrews, Ph.D.,, Sydel R. Parikh, M.Sc.,, Helen Campbell, Ph.D.,, Joanne White, B.Sc.,, Michael Edelstein, F.F.P.H.,, Xilian Bai, Ph.D.,, Jay Lucidarme, Ph.D.,, Ray Borrow, F.R.C.Path., Ph.D.,, and Mary E. Ramsay, F.F.P.H.

Issue&Volume: 2020-01-22

Abstract: 

BACKGROUND
In September 2015, the United Kingdom introduced the multicomponent meningococcal group B vaccine (4CMenB, Bexsero) into its publicly funded national immunization program at a reduced two-dose priming schedule for infants, with a 12-month booster.

METHODS
Using data from enhanced national surveillance of invasive meningococcal disease in England, we evaluated the effect of vaccination on the incidence of meningococcal group B disease during the first 3 years of the program. The effect of vaccination was assessed by comparing the observed incidence of disease with the expected incidence based on the incidence during the 4-year prevaccination period in equivalent cohorts and with the use of disease trends in cohorts of children younger than 5 years of age who were not eligible to receive the vaccine. Vaccine effectiveness was estimated with the use of the indirect screening method.

RESULTS
4CMenB uptake in England remained consistently high; data from the first 3 months of 2018 showed that 92.5% of children had completed the primary immunizations by their first birthday and 87.9% had received all three doses by 2 years. From September 2015 through August 2018, the incidence of meningococcal group B disease in England (average annual birth cohort, approximately 650,000 infants) was significantly lower in vaccine-eligible cohorts than the expected incidence (63 observed cases as compared with 253 expected cases; incidence rate ratio, 0.25; 95% confidence interval [CI], 0.19 to 0.36), with a 75% reduction in age groups that were fully eligible for vaccination. The adjusted vaccine effectiveness against meningococcal group B disease was 52.7% (95% CI, −33.5 to 83.2) with a two-dose priming schedule for infants and 59.1% (95% CI, −31.1 to 87.2) with a two-dose priming schedule plus a booster at 1 year). Over the 3-year period, there were 169 cases of meningococcal group B disease in the vaccine-eligible cohorts, and an estimated 277 cases (95% CI, 236 to 323) were prevented.

CONCLUSIONS
The 4CMenB program was associated with continued positive effect against meningococcal group B disease in children in England, and protection after three doses of the vaccine was sustained for at least 2 years. 

DOI: 10.1056/NEJMoa1901229

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1901229