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Simons is employed by and holds financial equities in GSK. Tjalke A. Westra was a GSK employee at the time of the study. Since 2023, Tjalke A. Westra has been employed at Moderna. Moderna has currently no portfolio interest in meningococcal disease. Florian Zeevat received support from GSK during the study via her institution (Health-Ecore). Florian Zeevat reported grants or contracts from Health-Ecore for various medical and pharmaceutical companies. She started working at Health-Ecore in November 2022. Jan C. Wilschut holds stock in ViciniVax Holding and Arbutus Corporation. Nina M. van Sorge received fees and consultancy fees for services directly paid to the institution from MSD, GSK and Pfizer. She received an Aspasia grant, a Vici grant and an Infection Prevention grant from the Dutch Health Council; an Innovation grant related to\n                      Streptococcus pyogenes\n                      surveillance from Amsterdam UMC, Contract research from Argenx. She is a member of consortium grant (iSpy) of Leducq foundation. Nina M. van Sorge declared royalties related to a patent (WO 2013\/020090 A3) on vaccine development against\n                      Streptococcus pyogenes\n                      (Vaxcyte; Licensee: University of California San Diego with Nina M. van Sorge as co-inventor), which is not part of the submitted work. She has a patent submitted to European Patent Office (EPO; application number EP25187749.4) concerning broad-range anti-ribitol phosphate (RboP) antigen-binding molecules, methods and applications thereof. Nina M. van Sorge declared receiving a science advisory board from ItsME foundation (without honorarium) and board or advisory board \u201cRapua te me ngaro ka tau\u201d paid to the institution for a project facilitating group A streptococcus (Strep A) vaccine development for Aotearoa New Zealand (honorarium paid directly to the institution). Nina M. van Sorge also declared personal stock ownership in Genmab and ASML. Cornelis Boersma declared being supported with an unrestricted grant by GSK for the present manuscript (e.g. funding, provision of study materials, medical writing, article processing charges, etc.). Cornelis Boersma received grants or contracts, consulting fees, payments or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events and payment for expert testimony via Health-Ecore (advisory company) from various medical and pharmaceutical companies outside of the present work. Cornelis Boersma reported support for attending meetings and\/or travel via Health-Ecore from various medical and pharmaceutical companies outside of the present work. Cornelis Boersma holds stock or stock options in Health-Ecore (75% stocks), SensUR Health (40% stocks), Digital Health Link (100% stocks, via Digital Health Inform Holding B.V.), Digital Health Inform Holding B.V. (50% Stocks) and Pharmecore Holding B.V. (100% stocks). Maarten J. Postma received funding and personal fees from various pharmaceutical industries, all outside of the present work. Maarten J. Postma holds stocks in Health-Ecore and Pharmacoeconomics Advice Groningen Ltd and is an advisor to Asc Academics (all pharmacoeconomic consultancy companies). All authors declare no other financial and non-financial relationships and activities.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This analysis used data from previously conducted studies and did not include any data from new studies involving human participants or animals performed by any of the authors.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}