Effect of vaccines on bacterial meningitis worldwide

Lancet. 2012 Nov 10;380(9854):1703-11. doi: 10.1016/S0140-6736(12)61187-8.


Three bacteria--Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis--account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.

Publication types

  • Review

MeSH terms

  • Bacterial Vaccines*
  • Clinical Trials as Topic
  • Cost of Illness
  • Developed Countries
  • Developing Countries
  • Forecasting
  • Global Health
  • Gram-Negative Bacterial Infections / prevention & control*
  • Gram-Positive Bacterial Infections / prevention & control*
  • Haemophilus Infections / prevention & control
  • Haemophilus influenzae
  • Humans
  • Immunity, Herd
  • Immunization Schedule
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Bacterial / prevention & control*
  • Meningitis, Meningococcal / prevention & control
  • Neisseria meningitidis
  • Pneumococcal Infections / prevention & control
  • Streptococcus pneumoniae
  • Treatment Outcome


  • Bacterial Vaccines