{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:45:18Z","timestamp":1788021918117,"version":"build-2784847793"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100023448","name":"Robert Koch-Institut","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Germany, primary vaccination against invasive meningococcal disease (IMD) serogroup C aims to reduce the highest burden of IMD in infants aged 12\u201323 month. Due to another IMD-peak in adolescents, we modelled the potential impact of introducing adolescent boosters with conjugate meningococcal C or ACWY (MenC\/MenACWY) vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We built an age- and serogroup-structured dynamic-transmission model for Germany, which we calibrated to national surveillance data in 2005\u20132019. We simulated five vaccination scenarios of either continuing with the current MenC primary vaccination (scenario 1), or additionally introducing MenC or MenACWY boosters at age 13 years (scenarios 2\u20133) or 16 years (scenarios 4\u20135). We performed comprehensive sensitivity analyses, including on the protection against carriage and serogroup replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The calibrated model projected for scenario 1 an annual mean of 243 (95%-uncertainty interval: 220\u2013258) expected IMD cases over a 10-year period. Introducing the MenC booster prevented an estimated 5 (3.9\u20136.7) and the MenACWY booster 8 (6.7\u20139.1) IMD cases per year on average (scenario 2 and 3). The number-needed-to-vaccinate (NNVs) to prevent one IMD case were 140,000 (100,000-180,000) and 91,000 (76,000-100,000), respectively. To prevent one sequela or death, NNVs were higher (i.e., less efficient). Results were broadly similar for scenarios 4\u20135. Simulations suggested relevant serogroup replacement starting eight-to-ten years after introducing the MenACWY booster.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Introducing adolescent MenC or MenACWY boosters marginally reduces the expected IMD burden in Germany. Effectiveness and efficiency of evaluated strategies depend on future incidence. The magnitude of future serogroup replacement for the MenACWY vaccine is highly uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-025-12457-2","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:03:50Z","timestamp":1768215830000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of introducing meningococcal C\/ACWY booster vaccination among adolescents in Germany: a dynamic transmission modelling study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6582-1174","authenticated-orcid":false,"given":"Felix","family":"G\u00fcnther","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-3057","authenticated-orcid":false,"given":"Ulrich","family":"Reinacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8050-4537","authenticated-orcid":false,"given":"Sarah","family":"Chisholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5329-2751","authenticated-orcid":false,"given":"Matas","family":"Griskaitis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-6702","authenticated-orcid":false,"given":"Michael","family":"H\u00f6hle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8421-8829","authenticated-orcid":false,"given":"Stefan","family":"Scholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Sch\u00f6nfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2353-7188","authenticated-orcid":false,"given":"Ole","family":"Wichmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Harder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-1931","authenticated-orcid":false,"given":"Frank G.","family":"Sandmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"12457_CR1","first-page":"471","volume":"43","author":"Robert Koch Institute","year":"2016","unstructured":"Robert Koch Institute. Invasive Meningokokken-Erkrankungen 2012\u20132015. Epid Bull. 2016;43:471\u201384.","journal-title":"Epid Bull"},{"issue":"18","key":"12457_CR2","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1056\/NEJM200105033441807","volume":"344","author":"NE Rosenstein","year":"2001","unstructured":"Rosenstein NE, Perkins BA, et al. Meningococcal disease. N Engl J Med. 2001;344(18):1378\u201388.","journal-title":"N Engl J Med"},{"issue":"12","key":"12457_CR3","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/S1473-3099(10)70251-6","volume":"10","author":"H Christensen","year":"2010","unstructured":"Christensen H, May M, et al. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(12):853\u201361.","journal-title":"Lancet Infect Dis"},{"key":"12457_CR4","volume-title":"14th Congress of the EMGM, the European meningococcal and haemophilus disease society","author":"W Hellenbrand","year":"2017","unstructured":"Hellenbrand W, Claus H, et al. Epidemiology of meningococcal disease in Germany. In: EMGM, editor. 14th Congress of the EMGM, the European meningococcal and haemophilus disease society. Prague: EMGM; 2017."},{"key":"12457_CR5","unstructured":"STIKO. Begr\u00fcndungen zur Allgemeinen Empfehlung der Impfungen gegen Pneumokokken- und Meningokokken im S\u00e4uglings- und Kindesalter. Epidemiologisches Bull. 2006;31."},{"key":"12457_CR6","first-page":"137","volume":"16","author":"Robert Koch Institute","year":"2010","unstructured":"Robert Koch Institute. Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2008. Epid Bull. 2010;16:137\u201340.","journal-title":"Epid Bull"},{"key":"12457_CR7","first-page":"3","volume":"48","author":"T Rieck","year":"2022","unstructured":"Rieck T, Feig M, et al. Impfquoten von Kinderschutzimpfungen in Deutschland \u2013 Aktuelle Ergebnisse aus der RKI-Impfsurveillance. Epid Bull. 2022;48:3\u201325.","journal-title":"Epid Bull"},{"issue":"Suppl 2","key":"12457_CR8","doi-asserted-by":"publisher","first-page":"B20","DOI":"10.1016\/j.vaccine.2009.04.067","volume":"27","author":"H Campbell","year":"2009","unstructured":"Campbell H, Borrow R, et al. Meningococcal C conjugate vaccine: the experience in England and Wales. Vaccine. 2009;27(Suppl 2):B20\u20139.","journal-title":"Vaccine"},{"issue":"8","key":"12457_CR9","doi-asserted-by":"publisher","first-page":"e12144","DOI":"10.1371\/journal.pone.0012144","volume":"5","author":"RM de Voer","year":"2010","unstructured":"de Voer RM, Mollema L, et al. Immunity against neisseria meningitidis serogroup C in the Dutch population before and after introduction of the meningococcal c conjugate vaccine. PLoS ONE. 2010;5(8):e12144.","journal-title":"PLoS ONE"},{"issue":"2","key":"12457_CR10","doi-asserted-by":"publisher","first-page":"68","DOI":"10.4161\/hv.2.2.2611","volume":"2","author":"CL Trotter","year":"2006","unstructured":"Trotter CL, Edmunds WJ, et al. Modeling future changes to the meningococcal serogroup C conjugate (MCC) vaccine program in England and Wales. Hum Vaccin. 2006;2(2):68\u201373.","journal-title":"Hum Vaccin"},{"issue":"1","key":"12457_CR11","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1136\/archdischild-2015-308928","volume":"101","author":"SN Ladhani","year":"2016","unstructured":"Ladhani SN, Ramsay M, et al. Enter B and W: two new meningococcal vaccine programmes launched. Arch Dis Child. 2016;101(1):91\u20135.","journal-title":"Arch Dis Child"},{"key":"12457_CR12","unstructured":"STIKO. Empfehlung zur Standardimpfung von S\u00e4uglingen gegen Meningokokken der Serogruppe B und die dazugeh\u00f6rige wissenschaftliche Begr\u00fcndung. Epidemiologisches Bull. 2024;3."},{"issue":"3","key":"12457_CR13","doi-asserted-by":"publisher","first-page":"e74","DOI":"10.1371\/journal.pmed.0050074","volume":"5","author":"J Mossong","year":"2008","unstructured":"Mossong J, Hens N, et al. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Med. 2008;5(3):e74.","journal-title":"PLoS Med"},{"issue":"1","key":"12457_CR14","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1093\/aje\/kwi160","volume":"162","author":"CL Trotter","year":"2005","unstructured":"Trotter CL, Gay NJ, et al. Dynamic models of meningococcal carriage, disease, and the impact of serogroup C conjugate vaccination. Am J Epidemiol. 2005;162(1):89\u2013100.","journal-title":"Am J Epidemiol"},{"issue":"12","key":"12457_CR15","doi-asserted-by":"publisher","first-page":"1692","DOI":"10.1016\/j.vaccine.2019.01.013","volume":"37","author":"S Scholz","year":"2019","unstructured":"Scholz S, Koerber F, et al. The cost-of-illness for invasive meningococcal disease caused by serogroup B neisseria meningitidis (MenB) in Germany. Vaccine. 2019;37(12):1692\u2013701.","journal-title":"Vaccine"},{"issue":"1","key":"12457_CR16","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s40121-021-00573-w","volume":"11","author":"S Scholz","year":"2022","unstructured":"Scholz S, Schwarz M, et al. Public health impact and Cost-Effectiveness analysis of routine infant 4CMenB vaccination in Germany to prevent serogroup B invasive meningococcal disease. Infect Dis Ther. 2022;11(1):367\u201387.","journal-title":"Infect Dis Ther"},{"issue":"29","key":"12457_CR17","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.1016\/j.vaccine.2016.04.004","volume":"34","author":"H Christensen","year":"2016","unstructured":"Christensen H, Irving T, et al. Epidemiological impact and cost-effectiveness of universal vaccination with Bexsero((R)) to reduce meningococcal group B disease in Germany. Vaccine. 2016;34(29):3412\u20139.","journal-title":"Vaccine"},{"issue":"4","key":"12457_CR18","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1093\/ije\/14.4.628","volume":"14","author":"P De Wals","year":"1985","unstructured":"De Wals P, Bouckaert A. Methods for estimating the duration of bacterial carriage. Int J Epidemiol. 1985;14(4):628\u201334.","journal-title":"Int J Epidemiol"},{"key":"12457_CR19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.21105\/joss.02959","volume":"6","author":"W Landau","year":"2021","unstructured":"Landau W. The targets R package: a dynamic Make-like function-oriented pipeline toolkit for reproducibility and high-performance computing. J Open Source Softw. 2021;6:57.","journal-title":"J Open Source Softw"},{"key":"12457_CR20","doi-asserted-by":"crossref","unstructured":"Soetaert K, Petzoldt T, et al. Solving differential equations inr: packagedesolve. J Stat Softw. 2010;33(9).","DOI":"10.18637\/jss.v033.i09"},{"key":"12457_CR21","unstructured":"Robert Koch Institute. Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten f\u00fcr 2022. Berlin. 2024."},{"issue":"5","key":"12457_CR22","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jinf.2023.09.002","volume":"87","author":"SA Clark","year":"2023","unstructured":"Clark SA, Campbell H, 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\u201391.","journal-title":"J Infect"},{"issue":"9","key":"12457_CR23","doi-asserted-by":"publisher","first-page":"e582","DOI":"10.1016\/S2589-7500(23)00108-5","volume":"5","author":"D Shaw","year":"2023","unstructured":"Shaw D, Abad R, et al. Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS consortium. Lancet Digit Health. 2023;5(9):e582\u201393.","journal-title":"Lancet Digit Health"},{"key":"12457_CR24","unstructured":"Piechotta V, G\u00fcnther F, et al. Beschluss und wissenschaftliche Begr\u00fcndung zur Evaluation einer quadrivalenten Meningokokken-Impfung f\u00fcr Kleinkinder sowie \u00e4ltere Kinder, Jugendliche und junge Erwachsene. 2025."},{"issue":"9960","key":"12457_CR25","doi-asserted-by":"publisher","first-page":"2123","DOI":"10.1016\/S0140-6736(14)60842-4","volume":"384","author":"RC Read","year":"2014","unstructured":"Read RC, Baxter D, et al. Effect of a quadrivalent meningococcal ACWY glycoconjugate or a serogroup B meningococcal vaccine on meningococcal carriage: an observer-blind, phase 3 randomised clinical trial. Lancet. 2014;384(9960):2123\u201331.","journal-title":"Lancet"},{"issue":"12","key":"12457_CR26","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1016\/j.cmi.2022.07.004","volume":"28","author":"JP Carr","year":"2022","unstructured":"Carr JP, MacLennan JM, et al. Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme. Clin Microbiol Infect. 2022;28(12):1649. e1\u2013 e8.","journal-title":"Clin Microbiol Infect"},{"issue":"4","key":"12457_CR27","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1007\/s40121-024-00958-7","volume":"13","author":"S Gruhn","year":"2024","unstructured":"Gruhn S, Batram M, et al. Modelling the public health impact of MenACWY and menc adolescent vaccination strategies in Germany. Infect Dis Ther. 2024;13(4):907\u201320.","journal-title":"Infect Dis Ther"},{"key":"12457_CR28","doi-asserted-by":"publisher","first-page":"127871","DOI":"10.1016\/j.vaccine.2025.127871","volume":"67","author":"P Bosetti","year":"2025","unstructured":"Bosetti P, Peckeu-Abboud L, et al. Modelling the impact of a quadrivalent ACWY meningococcal vaccination and vaccination targeting serogroup B in France. Vaccine. 2025;67:127871.","journal-title":"Vaccine"},{"issue":"2","key":"12457_CR29","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/S2352-4642(21)00335-7","volume":"6","author":"H Campbell","year":"2022","unstructured":"Campbell H, Andrews N, 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\u2013105.","journal-title":"Lancet Child Adolesc Health"},{"key":"12457_CR30","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1017\/S0950268823000870","volume":"151","author":"L Hadley","year":"2023","unstructured":"Hadley L, Karachaliou Prasinou A, et al. Modelling the impact of COVID-19 and routine MenACWY vaccination on meningococcal carriage and disease in the UK. Epidemiol Infect. 2023;151:e98.","journal-title":"Epidemiol Infect"},{"issue":"23","key":"12457_CR31","doi-asserted-by":"publisher","first-page":"126240","DOI":"10.1016\/j.vaccine.2024.126240","volume":"42","author":"L Adams","year":"2024","unstructured":"Adams L, Prasinou AK, et al. Estimating the potential number of cases prevented by infant\/ toddler immunisation with a MenACWY vaccine. Vaccine. 2024;42(23):126240.","journal-title":"Vaccine"},{"issue":"5","key":"12457_CR32","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1017\/S0950268811001385","volume":"140","author":"TJ Irving","year":"2012","unstructured":"Irving TJ, Blyuss KB, et al. Modelling meningococcal meningitis in the African meningitis belt. Epidemiol Infect. 2012;140(5):897\u2013905.","journal-title":"Epidemiol Infect"},{"issue":"Suppl 5","key":"12457_CR33","doi-asserted-by":"publisher","first-page":"S594","DOI":"10.1093\/cid\/civ508","volume":"61","author":"A Karachaliou","year":"2015","unstructured":"Karachaliou A, Conlan AJ, et al. Modeling Long-term vaccination strategies with MenAfriVac in the African meningitis belt. Clin Infect Dis. 2015;61(Suppl 5):S594\u2013600.","journal-title":"Clin Infect Dis"},{"issue":"11","key":"12457_CR34","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1111\/1469-0691.12308","volume":"19","author":"A Huppert","year":"2013","unstructured":"Huppert A, Katriel G. Mathematical modelling and prediction in infectious disease epidemiology. Clin Microbiol Infect. 2013;19(11):999\u20131005.","journal-title":"Clin Microbiol Infect"},{"issue":"8","key":"12457_CR35","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1086\/428590","volume":"191","author":"H Claus","year":"2005","unstructured":"Claus H, Maiden MC, et al. Genetic analysis of meningococci carried by children and young adults. J Infect Dis. 2005;191(8):1263\u201371.","journal-title":"J Infect Dis"},{"issue":"3","key":"12457_CR36","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1017\/S0950268805005339","volume":"134","author":"CL Trotter","year":"2006","unstructured":"Trotter CL, Gay NJ, et al. The natural history of meningococcal carriage and disease. Epidemiol Infect. 2006;134(3):556\u201366.","journal-title":"Epidemiol Infect"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-025-12457-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-12457-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-12457-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:36:16Z","timestamp":1781627776000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-025-12457-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12457"],"URL":"https:\/\/doi.org\/10.1186\/s12879-025-12457-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"27 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Due to the aggregated nature of the data, no personal patient information was disclosed and no informed consent or ethics approval was necessary for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests, or other interests that might be perceived to influence the results and\/or discussion reported in this paper. After completing his work on the project, co-author S.S. changed his affiliation and is now an employee of Moderna Germany GmbH.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"176"}}