Modeling future changes to the meningococcal serogroup C conjugate (MCC) vaccine program in England and Wales

The UK meningococcal serogroup C conjugate (MCC) vaccine programme has successfully controlled serogroup C disease, due to high vaccine effectiveness and substantial herd immunity. However, children immunised at 2, 3 and 4 months of age receive only short-term direct protection and may be at risk of disease 15 months after vaccination. To investigate this we applied a mathematical model to predict the future epidemiology of serogroup C disease, with and without changes to the immunisation schedule. Only a few cases of serogroup C disease were predicted to occur over the next few years because of persisting herd immunity, even without a change to the vaccine schedule, indicating that urgent schedule changes are not required. The inclusion of a booster dose is likely to improve the impact of the MCC programme and reducing the number of doses in infancy will improve cost-effectiveness and create space in the schedule for the addition of other vaccines.