In the past decade, the introduction of meningococcal conjugate vaccines has led to substantial reductions in meningococcal disease. Monovalent serogroup C vaccines have virtually eliminated serogroup C disease from the United Kingdom and other countries, and serogroup A, C, W, and Y vaccines have reduced disease among adolescents in the United States.1,2 In 2010 and 2011, Burkina Faso, Mali, Niger, and part of Nigeria introduced serogroup A conjugate vaccine, which may eliminate epidemic meningitis from the meningitis belt of Africa. These accomplishments have been dampened by the lack of effective serogroup B meningococcal vaccines. Serogroup B meningococcal disease causes substantial morbidity and mortality globally, especially in young infants.3- 5 Serogroup B disease can be devastating; 5% to 10% of children with the disease do not survive and another 10% to 20% experience long-term sequelae such as hearing loss, limb loss, and neurologic deficits.5 Disease burden is lower in the United States than in other countries; incidence of serogroup B disease is 0.16 per 100 000 population but 3.08 per 100 000 population among infants younger than 12 months.4 In contrast, incidence of serogroup B disease in several countries in Europe, including the United Kingdom, is about 10-fold that in the United States.3
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