{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T17:02:20Z","timestamp":1788109340578,"version":"build-2803163510"},"reference-count":99,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Reduction in the transmission of Neisseria meningitidis within a population results in fewer invasive disease cases. Vaccination with meningococcal vaccines composed of high weight capsular polysaccharide without carrier proteins has minimal effect against carriage or the acquisition of carriage. Conjugate vaccines, however, elicit an enhanced immune response which serves to reduce carriage acquisition and hinder onwards transmission. Since the 1990s, several meningococcal conjugate vaccines have been developed and, when used in age groups associated with higher carriage, they have been shown to provide indirect protection to unvaccinated cohorts. This herd protective effect is important in enhancing the efficiency and impact of vaccination. Studies are ongoing to assess the effect of protein-based group B vaccines on carriage; however, current data cast doubt on their ability to reduce transmission.<\/jats:p>","DOI":"10.3390\/microorganisms8111675","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:44:53Z","timestamp":1603964693000},"page":"1675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Herd Protection against Meningococcal Disease through Vaccination"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-3623","authenticated-orcid":false,"given":"Stephen A.","family":"Clark","sequence":"first","affiliation":[{"name":"Meningococcal Reference Unit, National Infection Service, Public Health England, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Borrow","sequence":"additional","affiliation":[{"name":"Meningococcal Reference Unit, National Infection Service, Public Health England, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"ref_1","first-page":"569","article-title":"The Milroy lectures on epidemic disease in England; the evidence of variability and of persistency of type. Delivered before the Royal College of Physicians of London, March 1st, 6th, and 8th, 1906","volume":"167","author":"Hamer","year":"1906","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1017\/S0022172400031478","article-title":"The spread of bacterial infection, the problem of herd immunity","volume":"21","author":"Topley","year":"1923","journal-title":"J. Hyg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1023\/A:1007626510002","article-title":"Herd immunity and herd effect: New insights and definitions","volume":"16","author":"John","year":"2000","journal-title":"Eur. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"881","DOI":"10.4161\/hv.7.8.16273","article-title":"Indirect effects by meningococcal vaccines: Herd protection versus herd immunity","volume":"7","year":"2011","journal-title":"Hum. Vaccines"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/oxfordjournals.aje.a121310","article-title":"Herd immunity: Basic concept and relevance to public health immunization practices","volume":"94","author":"Fox","year":"1971","journal-title":"Am. J. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"B3","DOI":"10.1016\/j.vaccine.2011.12.062","article-title":"Meningococcal disease: Clinical presentation and sequelae","volume":"30","author":"Pace","year":"2012","journal-title":"Vaccine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"B78","DOI":"10.1016\/j.vaccine.2009.04.069","article-title":"Meningococcal interactions with the host","volume":"27","author":"Carbonnelle","year":"2009","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.tim.2011.06.006","article-title":"Mechanisms of meningococcal colonisation","volume":"19","author":"Trivedi","year":"2011","journal-title":"Trends Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1179\/2047773213Y.0000000119","article-title":"An epidemiological review of changes in meningococcal biology during the last 100 years","volume":"107","author":"Abio","year":"2013","journal-title":"Pathog. Glob. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1128\/CVI.00133-14","article-title":"Implications of differential age distribution of disease-associated meningococcal lineages for vaccine development","volume":"21","author":"Brehony","year":"2014","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/S0264-410X(00)00333-9","article-title":"Development of natural immunity to Neisseria meningitidis","volume":"19","author":"Pollard","year":"2001","journal-title":"Vaccine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/S1473-3099(10)70251-6","article-title":"Meningococcal carriage by age: A systematic review and meta-analysis","volume":"10","author":"Christensen","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"950","DOI":"10.3201\/eid1206.051297","article-title":"Social behavior and meningococcal carriage in British teenagers","volume":"12","author":"MacLennan","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5814","DOI":"10.1016\/j.vaccine.2017.09.024","article-title":"Risk of invasive meningococcal disease in university students in England and optimal strategies for protection using MenACWY vaccine","volume":"35","author":"Mandal","year":"2017","journal-title":"Vaccine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ijid.2016.04.007","article-title":"Meningococcal disease during the Hajj and Umrah mass gatherings","volume":"47","author":"Yezli","year":"2016","journal-title":"Int. J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s40121-019-00262-9","article-title":"Incidence and Prevention of Invasive Meningococcal Disease in Global Mass Gathering Events","volume":"8","author":"Muttalif","year":"2019","journal-title":"Infect. Dis. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1084\/jem.129.6.1367","article-title":"Human immunity to the meningococcus. IV. Immunogenicity of group A and group C meningococcal polysaccharides in human volunteers","volume":"129","author":"Gotschlich","year":"1969","journal-title":"J. Exp. Med."},{"key":"ref_18","first-page":"279","article-title":"Meningococcal infections. 2. Field trial of group C meningococcal polysaccharide vaccine in 1969-70","volume":"45","author":"Gold","year":"1971","journal-title":"Bull. World Health Organ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1203\/00006450-197404000-00537","article-title":"Disease Prevention By Meningococcal Serogroup C Polysaccharide Vaccine In Preschool Children: Results After Eleven Months In Sao Paulo, Brazil","volume":"8","author":"Galvao","year":"1974","journal-title":"Pediatr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1111\/j.1365-3156.2007.01929.x","article-title":"Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci","volume":"12","author":"Dellicour","year":"2007","journal-title":"Trop. Med. Int. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/S1473-3099(07)70288-8","article-title":"Meningococcal carriage in the African meningitis belt","volume":"7","author":"Trotter","year":"2007","journal-title":"Lancet Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"806","DOI":"10.3201\/eid2005.130948","article-title":"Carriage rate and effects of vaccination after outbreaks of serogroup C meningococcal disease, Brazil, 2010","volume":"20","author":"Carvalhanas","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1128\/iai.37.2.579-585.1982","article-title":"Immunoglobulin M and G antibody responses and persistence of these antibodies in adults after vaccination with a combined meningococcal group A and group C polysaccharide vaccine","volume":"37","author":"Beuvery","year":"1982","journal-title":"Infect. Immun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1365-2567.2004.01971.x","article-title":"Haemophilus influenzae type b conjugate vaccines","volume":"113","author":"Kelly","year":"2004","journal-title":"Immunology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S165","DOI":"10.1093\/infdis\/165-Supplement_1-S165","article-title":"High antibody responses to booster doses of either Haemophilus influenzae capsular polysaccharide or conjugate vaccine after primary immunization with conjugate vaccines","volume":"165","author":"Eskola","year":"1992","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1086\/517407","article-title":"Antibody avidity as a surrogate marker of successful priming by Haemophilus influenzae type b conjugate vaccines following infant immunization","volume":"177","author":"Goldblatt","year":"1998","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1017\/S0950268804002122","article-title":"Long-term impact of vaccination on Haemophilus influenzae type b (Hib) carriage in the United Kingdom","volume":"132","author":"McVernon","year":"2004","journal-title":"Epidemiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/00006454-199504000-00008","article-title":"Anti-capsular polysaccharide antibody concentrations in saliva after immunization with Haemophilus influenzae type b conjugate vaccines","volume":"14","author":"Kauppi","year":"1995","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.clinthera.2011.11.027","article-title":"Two decades of experience with the Haemophilus influenzae serotype b conjugate vaccine in the United Kingdom","volume":"34","author":"Ladhani","year":"2012","journal-title":"Clin. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0264-410X(01)00299-7","article-title":"Planning, registration, and implementation of an immunisation campaign against meningococcal serogroup C disease in the UK: A success story","volume":"20","author":"Miller","year":"2001","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1128\/CVI.00529-09","article-title":"Updated postlicensure surveillance of the meningococcal C conjugate vaccine in England and Wales: Effectiveness, validation of serological correlates of protection, and modeling predictions of the duration of herd immunity","volume":"17","author":"Campbell","year":"2010","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"4477","DOI":"10.1016\/j.vaccine.2013.07.083","article-title":"Effectiveness of meningococcal serogroup C vaccine programmes","volume":"31","author":"Borrow","year":"2013","journal-title":"Vaccine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1136\/bmj.326.7385.365","article-title":"Herd immunity from meningococcal serogroup C conjugate vaccination in England: Database analysis","volume":"326","author":"Ramsay","year":"2003","journal-title":"Br. Med. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.1016\/j.vaccine.2014.03.010","article-title":"Changes in meningococcal C epidemiology and vaccine effectiveness after vaccine introduction and schedule modification","volume":"32","author":"Herruzo","year":"2014","journal-title":"Vaccine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1093\/cid\/ciu601","article-title":"A Decade of Herd Protection After Introduction of Meningococcal Serogroup C Conjugate Vaccination","volume":"59","author":"Bijlsma","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1093\/cid\/ciu597","article-title":"The Impact of the Meningococcal Serogroup C Conjugate Vaccine in Canada Between 2002 and 2012","volume":"59","author":"Sadarangani","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1016\/S0140-6736(04)16725-1","article-title":"Effectiveness of meningococcal serogroup C conjugate vaccine 4 years after introduction","volume":"364","author":"Trotter","year":"2004","journal-title":"Lancet"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1086\/527401","article-title":"Impact of meningococcal serogroup C conjugate vaccines on carriage and herd immunity","volume":"197","author":"Maiden","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.jinf.2017.02.011","article-title":"Characteristics and changes in invasive meningococcal disease epidemiology in France, 2006\u20132015","volume":"74","author":"Deghmane","year":"2017","journal-title":"J. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"665","DOI":"10.3201\/eid0906.020565","article-title":"Serogroup W-135 meningococcal disease during the Hajj, 2000","volume":"9","author":"Lingappa","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.jinf.2015.07.007","article-title":"Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage","volume":"71","author":"Lucidarme","year":"2015","journal-title":"J. Infect."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1080\/21645515.2018.1532248","article-title":"Recent changes in the epidemiology of Neisseria meningitidis serogroup W across the world, current vaccination policy choices and possible future strategies","volume":"15","author":"Booy","year":"2019","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/20477724.2016.1274068","article-title":"Emergence and control of epidemic meningococcal meningitis in sub-Saharan Africa","volume":"111","author":"Mohammed","year":"2017","journal-title":"Pathog. Glob. Health"},{"key":"ref_44","first-page":"1689","article-title":"Meningococcal serogroup Y emergence in Europe","volume":"53","author":"Broker","year":"2019","journal-title":"J. Chem. Inf. Modeling"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/14760584.2017.1258308","article-title":"The Global Meningococcal Initiative: Global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection","volume":"16","author":"Borrow","year":"2017","journal-title":"Expert Rev. Vaccines"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1080\/21645515.2018.1451810","article-title":"Progress toward the global control of Neisseria meningitidis: 21st century vaccines, current guidelines, and challenges for future vaccine development","volume":"14","author":"Dretler","year":"2018","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14760584.2019.1557520","article-title":"The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations","volume":"18","author":"Acevedo","year":"2019","journal-title":"Expert Rev. Vaccines"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"6915","DOI":"10.1016\/j.vaccine.2019.09.050","article-title":"Meningococcal invasive disease by serogroup W and use of ACWY conjugate vaccines as control strategy in Chile","volume":"37","author":"Villena","year":"2019","journal-title":"Vaccine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.3201\/eid2307.170236","article-title":"Emergency Meningococcal ACWY Vaccination Program for Teenagers to Control Group W Meningococcal Disease, England, 2015\u20132016","volume":"23","author":"Campbell","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"#cr-split#-ref_50.1","unstructured":"(2020, October 01). Public Health England Vaccine Coverage Estimates for the Meningococcal ACWY (MenACWY) Adolescent Vaccination Programme in Schools across England, in 2018\/19"},{"key":"#cr-split#-ref_50.2","unstructured":"and for the GP-Based Catch-Up Programme, to End of August 2019, Available online: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/860675\/hpr0220_menACWY-vc.pdf."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Ladhani, S.N., Campbell, H., Andrews, N., Parikh, S.R., White, J., Edelstein, M., Clark, S.A., Lucidarme, J., Borrow, R., and Ramsay, M.E. (2020). First real world evidence of meningococcal group B vaccine, 4CMenB, protection against meningococcal group W disease; prospective enhanced national surveillance, England. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciaa1244"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/j.1365-3156.2006.01639.x","article-title":"Editorial: 100 years of epidemic meningitis in West Africa\u2014Has anything changed?","volume":"11","author":"Greenwood","year":"2006","journal-title":"Trop. Med. Int. Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1080\/21645515.2017.1391434","article-title":"Developmental strategy for a new Group A meningococcal conjugate vaccine (MenAfriVacR)","volume":"14","author":"Kulkarni","year":"2018","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"S140","DOI":"10.1093\/infdis\/jiz336","article-title":"Status of the Rollout of the Meningococcal Serogroup A Conjugate Vaccine in African Meningitis Belt Countries in 2018","volume":"220","author":"Bwaka","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S1473-3099(17)30301-8","article-title":"Impact of MenAfriVac in nine countries of the African meningitis belt, 2010\u20132015: An analysis of surveillance data","volume":"17","author":"Trotter","year":"2017","journal-title":"Lancet. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/tmi.13185","article-title":"Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt","volume":"24","author":"Greenwood","year":"2019","journal-title":"Trop. Med. Int. Health"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.jinf.2016.03.010","article-title":"Pharyngeal carriage of Neisseria species in the African meningitis belt","volume":"72","author":"Diallo","year":"2016","journal-title":"J. Infect."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1093\/infdis\/jiv211","article-title":"The diversity of meningococcal carriage across the African meningitis belt and the impact of vaccination with a group a meningococcal conjugate vaccine","volume":"212","author":"Ali","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1128\/CVI.00479-10","article-title":"Baseline meningococcal carriage in Burkina Faso before the introduction of a meningococcal serogroup A conjugate vaccine","volume":"18","author":"Kristiansen","year":"2011","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0140-6736(13)61612-8","article-title":"Effect of a serogroup A meningococcal conjugate vaccine (PsA-TT) on serogroup A meningococcal meningitis and carriage in Chad: A community trial","volume":"383","author":"Daugla","year":"2013","journal-title":"Lancet"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kristiansen, P.A., Ba, A.K., Ou\u00e9draogo, A.-S., Sanou, I., Ou\u00e9draogo, R., Sangar\u00e9, L., Diomand\u00e9, F., Kandolo, D., Saga, I., and Misegades, L. (2014). Persistent low carriage of serogroup A Neisseria meningitidis two years after mass vaccination with the meningococcal conjugate vaccine, MenAfriVac. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0663-4"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.4161\/hv.24129","article-title":"Vaccines against meningococcal serogroup B disease containing outer membrane vesicles (OMV) Lessons from past programs and implications for the future","volume":"9","author":"Holst","year":"2013","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1128\/CVI.13.4.486-491.2006","article-title":"The VR2 epitope on the PorA P1.7-2,4 protein is the major target for the immune response elicited by the strain-specific group B meningococcal vaccine MeNZB","volume":"13","author":"Martin","year":"2006","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0140-6736(92)92411-8","article-title":"\u201cHerd immunity\u201d and the meningococcal vaccine trial in Norway","volume":"340","author":"Bjune","year":"1992","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/0264-410X(94)00037-N","article-title":"Efficacy, safety, and immunogenicity of a meningococcal group B (15:P1.3) outer membrane protein vaccine in Iquique, Chile","volume":"13","author":"Boslego","year":"1995","journal-title":"Vaccine"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1086\/514232","article-title":"Immunogenicity of two efficacious outer membrane protein-based serogroup B meningococcal vaccines among young adults in Iceland","volume":"177","author":"Perkins","year":"1998","journal-title":"J. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1017\/S0950268807009211","article-title":"Combined administration of serogroup B meningococcal vaccine and conjugated serogroup C meningococcal vaccine is safe and immunogenic in college students","volume":"136","author":"Holmes","year":"2008","journal-title":"Epidemiol. Infect."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"4416","DOI":"10.1016\/j.vaccine.2013.06.080","article-title":"Impact of MenBvac, an outer membrane vesicle (OMV) vaccine, on the meningococcal carriage","volume":"31","author":"Delbos","year":"2013","journal-title":"Vaccine"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1080\/00325481.2016.1203238","article-title":"Characteristics of a new meningococcal serogroup B vaccine, bivalent rLP2086 (MenB-FHbp; Trumenba\u00ae)","volume":"128","author":"Gandhi","year":"2016","journal-title":"Postgrad. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"B87","DOI":"10.1016\/j.vaccine.2012.01.033","article-title":"The new multicomponent vaccine against meningococcal serogroup B, 4CMenB: Immunological, functional and structural characterization of the antigens","volume":"30","author":"Serruto","year":"2012","journal-title":"Vaccine"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1080\/14760584.2018.1483726","article-title":"From research to licensure and beyond: Clinical development of MenB-FHbp, a broadly protective meningococcal B vaccine","volume":"17","author":"Perez","year":"2018","journal-title":"Expert Rev. Vaccines"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1542\/peds.2014-4015","article-title":"First Use of a Serogroup B Meningococcal Vaccine in the US in Response to a University Outbreak","volume":"135","author":"McNamara","year":"2015","journal-title":"Pediatrics"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.vaccine.2015.11.057","article-title":"Clinical experience with the meningococcal B vaccine, Bexsero\u00ae: Prospects for reducing the burden of meningococcal serogroup B disease","volume":"34","author":"Watson","year":"2016","journal-title":"Vaccine"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"867","DOI":"10.3201\/eid2305.161870","article-title":"Serogroup B meningococcal disease vaccine recommendations at a university, New Jersey, USA, 2016","volume":"23","author":"Soeters","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"9990","DOI":"10.1038\/s41598-019-46483-3","article-title":"Outbreak strain characterisation and pharyngeal carriage detection following a protracted group B meningococcal outbreak in adolescents in South-West England","volume":"9","author":"Clark","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2775","DOI":"10.1016\/S0140-6736(16)31921-3","article-title":"Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: A national observational cohort study","volume":"388","author":"Parikh","year":"2016","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"g5725","DOI":"10.1136\/bmj.g5725","article-title":"Re-evaluating cost effectiveness of universal meningitis vaccination (Bexsero) in England: Modelling study","volume":"349","author":"Christensen","year":"2014","journal-title":"BMJ"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.vaccine.2016.03.020","article-title":"Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France","volume":"34","author":"Lecocq","year":"2016","journal-title":"Vaccine"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"3412","DOI":"10.1016\/j.vaccine.2016.04.004","article-title":"Epidemiological impact and cost-effectiveness of universal vaccination with Bexsero(\u00ae) to reduce meningococcal group B disease in Germany","volume":"34","author":"Christensen","year":"2016","journal-title":"Vaccine"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"6783","DOI":"10.1016\/j.vaccine.2019.09.062","article-title":"Health impact and cost-effectiveness of introducing the vaccine (Bexsero) against MenB disease into the Brazilian immunization programme","volume":"37","author":"McBride","year":"2019","journal-title":"Vaccine"},{"key":"ref_81","first-page":"318","article-title":"Economic evaluation of the introduction of 4CMenB (Bexsero\u00ae) in the national vaccine schedule in Spain","volume":"34","author":"Epstein","year":"2020","journal-title":"Gac. Sanit."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1016\/S0140-6736(14)60842-4","article-title":"Effect of a quadrivalent meningococcal ACWY glycoconjugate or a serogroup B meningococcal vaccine on meningococcal carriage: An observer-blind, phase 3 randomised clinical trial","volume":"384","author":"Read","year":"2014","journal-title":"Lancet"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1093\/cid\/cix091","article-title":"Meningococcal Carriage Evaluation in Response to a Serogroup B Meningococcal Disease Outbreak and Mass Vaccination Campaign at a College\u2014Rhode Island, 2015\u20132016","volume":"64","author":"Soeters","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1093\/infdis\/jix446","article-title":"Meningococcal Carriage Following a University Serogroup B Meningococcal Disease Outbreak and Vaccination Campaign with MenB-4C and MenB-FHbp\u2014Oregon, 2015\u20132016","volume":"216","author":"McNamara","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1056\/NEJMoa1900236","article-title":"Meningococcal B vaccine and meningococcal carriage in adolescents in Australia","volume":"382","author":"Marshall","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_86","unstructured":"Carr, J., Plested, E., Aley, P., Camera, S., MacLennan, J., Gray, S., Borrow, R., Maiden, M.C.J., Christensen, H., and Trotter, C. (2018, January 23). Be on the TEAM (Teenagers Against Meningitis): A clinical trial evaluating the impact of two licensed group B meningococcal vaccines on pharyngeal carriage of meningococcus in adolescents. Proceedings of the International Pathogenic Neisseria Conference, Asilomar, CA, USA."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"6250","DOI":"10.4049\/jimmunol.166.10.6250","article-title":"Activity of Human IgG and IgA Subclasses in Immune Defense Against Neisseria meningitidis Serogroup B","volume":"166","author":"Vidarsson","year":"2001","journal-title":"J. Immunol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1084\/jem.152.2.452","article-title":"IgA-dependent, Monocyte-Mediated Antibacterial Activity","volume":"152","author":"Lowell","year":"1980","journal-title":"J. Exp. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.1128\/IAI.68.5.2692-2697.2000","article-title":"Mucosal immune responses to meningococcal group C conjugate and group A and C polysaccharide vaccines in adolescents","volume":"68","author":"Zhang","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"4337","DOI":"10.1128\/IAI.69.7.4337-4341.2001","article-title":"Primary and booster mucosal immune responses to meningococcal group A and C conjugate and polysaccharide vaccines administered to University students in the United Kingdom","volume":"69","author":"Zhang","year":"2001","journal-title":"Infect. Immun."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1017\/S0950268899002915","article-title":"Salivary antibodies following parenteral immunization of infants with a meningococcal serogroup A and C conjugated vaccine","volume":"123","author":"Borrow","year":"1999","journal-title":"Epidemiol. Infect."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0264-410X(00)00180-8","article-title":"Salivary antibody response to vaccination with meningococcal A\/C polysaccharide vaccine in previously vaccinated and unvaccinated Gambian children","volume":"19","author":"Nurkka","year":"2000","journal-title":"Vaccine"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/sji.12451","article-title":"Salivary and Serum Antibody Response Against Neisseria meningitidis After Vaccination With Conjugate Polysaccharide Vaccines in Ethiopian Volunteers","volume":"84","author":"Workalemahu","year":"2016","journal-title":"Scand. J. Immunol."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Van Ravenhorst, M.B., Hartog, G., den van der Klis, F.R.M., Van Rooijen, D.M., Sanders, E.A.M., and Berbers, G.A.M. (2018). Induction of salivary antibody levels in Dutch adolescents after immunization with monovalent meningococcal serogroup C or quadrivalent meningococcal serogroup A, C, W and Y conjugate vaccine. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191261"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.4049\/jimmunol.114.6.1779","article-title":"Bactericidal activity of meningococcal antisera. Blocking by IgA of lytic antibody in human convalescent sera","volume":"114","author":"Griffiss","year":"1975","journal-title":"J. Immunol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1002\/eji.1830191210","article-title":"Anti-inflammatory activity of human IgA antibodies and their Fab alpha fragments: Inhibition of IgG-mediated complement activation","volume":"19","author":"Russell","year":"1989","journal-title":"Eur. J. Immunol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1001\/jama.280.19.1685","article-title":"Induction of immunologic memory by conjugated vs plain meningococcal C polysaccharide vaccine in toddlers: A randomized controlled trial","volume":"280","author":"MacDonald","year":"1998","journal-title":"JAMA"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Vianzon, V., Illek, B., and Moe, G.R. (2017). Effect of Vaccine-Elicited Antibodies on Colonization of Neisseria meningitidis Serogroup B and C Strains in a Human Bronchial Epithelial Cell Culture Model. Clin. Vaccine Immunol., 24.","DOI":"10.1128\/CVI.00188-17"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/8\/11\/1675\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:30:15Z","timestamp":1760178615000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/8\/11\/1675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,28]]},"references-count":99,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["microorganisms8111675"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms8111675","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,28]]}}}