This article is more than 5 years old. Information may no longer be current.

College students at three times the risk for MenB

The overall incidence of meningococcal disease is low among college students in the United States, but they were over three times more likely to develop meningococcal B disease, or MenB, compared with those who did not attend college, according to research published in Pediatrics. The increased risk for disease among this population highlights the importance of vaccination, researchers said.

The Advisory Committee on Immunization Practices recommends that adolescents and young adults aged 16 to 23 years may be vaccinated against MenB on the basis of clinical decision-making. Recent findings published in the American Journal of Preventive Medicine found that universal vaccination of young adults against MenB before they attended college was not cost-effective.

“Although several recent outbreaks of MenB disease have been reported, the current epidemiology and risks of meningococcal disease among college students are not well described,” Sarah A. Mbaeyi, MD, MPH, from the division of bacterial diseases at the CDC, and colleagues wrote. “Previous evaluations among college students were conducted when rates of disease were higher, serogroup C was the predominant cause of disease, MenACWY and MenB vaccines had not yet become available and the ability to characterize the molecular features of Neisseria meningitidis strains in this population had not yet been developed.”

The researchers calculated the incidence and RR of disease among college and noncollege students between the ages of 18 and 24 years using data collected from the National Notifiable Diseases Surveillance System and additional meningococcal disease surveillance between 2014 and 2016.

 

Mbaeyi and colleagues identified 166 cases of meningococcal disease. The incidence of disease during the study period was 0.17 cases per 100,000 population.

The researchers observed an increased RR of MenB disease among college students compared with noncollege students (RR = 3.54; 95% CI, 2.21-5.41). During the study period, nearly one-third of all serogroup B cases occurred during outbreaks on six college campuses. However, even after excluding outbreak-associated cases, the researchers found that the risk for MenB remained elevated among college students.

“Providers, college students and parents should be aware of the availability of MenB vaccines,” Mbaeyi and colleagues wrote.

Results also showed that the most common serogroup B clonal complexes during the study period were CC32/ET-5 and CC41/44 lineage 3.

The RR of disease caused by serotypes C, W and Y, however, were similar among college and noncollege students, with a combined RR of 0.56 (95% CI, 0.27-1.14). Low rates of disease caused by these serogroups and the finding that rates are similar among college and noncollege students suggest that the universal adolescent MenACWY program has had an effect, the researchers said.

“With growing evidence of the impact of MenACWY vaccines on meningococcal disease in U.S. adolescents, all adolescents should receive this vaccine according to ACIP recommendations regardless of college attendance.” – by Katherine Bortz

References:

Leeds IL, et al. Am J Prev Med. 2018; doi:10.1016/j.amepre.2018.09.020.

Mbaeyi SA, et al. Pediatrics. 2018;doi:10.1542/peds.2018-2130.

Disclosures: The authors report no relevant financial disclosures.