Meningococcal B (4CMenB) vaccine : uptodate and recommendations

Neisseria meningitidis is the cause of relatively rare invasive infections, but with very important morbi-mortality. Vaccines are already available for serogroups A, C, W, Y. A new vaccine against meningococcus B is on the Belgian market since March 2017. Serogroup B is the most prevalent in Western countries. The target populations are children and teenager, since it is at this age that peaks in the incidence of meningococcal disease are observed. The development of this vaccine has been made possible by a new process named " reverse vaccinology ", which uses the complete genome sequencing of the bacterium. Current studies focus on the immunogenicity of the vaccine, which is good for both children and teenager. However, there are still many unknowns with this vaccine such as the duration of protection and its impact on the pharyngeal carriage. Another difficulty lies in the extrapolation of the immunogenicity data among a population because this vaccine consists of protein antigens and we know that the expression and prevalence of these antigens may vary between different strains of meningococci. In England, where the vaccine has been included in the vaccination calendar, beneficial effects are demonstrated on the incidence of invasive meningococcal infections. The toxicity profile is also reassuring, only classic side effects have been observed, such as fever and local reactions. In 2017, the High Health Council issued a favorable opinion for individual protection, without recommending at this stage a collective vaccination in Belgium. After a review of the most recent data on this new vaccine, we will try to draw conclusions.