Seroprevalence of antibodies against serogroup C meningococci in the region of Valencia, Spain: Impact of meningococcal C conjugate vaccination

Vaccine. 2017 May 19;35(22):2949-2954. doi: 10.1016/j.vaccine.2017.04.022. Epub 2017 Apr 21.


Background and aims: Meningococcal C conjugate (MCC) vaccination programs provide direct and indirect protection against meningococcal disease. However, a decrease in the antibodies could affect herd immunity. We conducted a seroprevalence study to assess the immunity in subjects 8-12years after different MCCV vaccination programs were launched and evaluated the impact of vaccination on seroprotection.

Methods: Seroepidemiological study conducted from October 2010 to April 2012 in the region of Valencia, Spain. Sample size was not proportional to the population but to the expected seroprotection by age group. Sera from subjects that were≥3years old were tested using a standardized complement-mediated serum bactericidal antibodies (SBA) assay. Age-stratified proportions of subjects with SBA titers≥8 were considered seroprotected and evaluated. A multivariate logistic regression model was performed to evaluate the impact of vaccination on the seroprotection.

Results: Serum samples from 1880 subjects were collected. In total, 523 (27.8%) of the 1880 subjects and 446 (31.2%) of the 1430 subjects<30years (targeted to any vaccination campaign) showed protective SBA titers. The highest percentage of seroprotected subjects (67.8%, 95%CI 56.9-77.4) was observed in those that were vaccinated in a catch-up campaign at 10-13years of age (20-21years old at the time of blood sampling). Those scheduled for immunization in infancy at 2, 4 and 6months of age (7-8years at blood sample) represented the lowest (7.1%, 95% CI 3.3-13.1) number of seroprotected subjects. Having received one vaccine dose after 12months of age was associated with increased seroprotection. The present study revealed a positive correlation between the increasing age at vaccination and longer duration of seroprotection.

Conclusion: Only one in three subjects who were vaccinated with MCC vaccine was seroprotected after 8-12years. These findings emphasize that seroprevalence studies are essential to identify susceptible cohorts and to inform vaccine policy.

Keywords: Meningococcal C disease; Meningococcal vaccines; Seroepidemiological studies; Seroprevalence studies; Serum bactericidal assay.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies, Bacterial / blood*
  • Child
  • Female
  • Humans
  • Immunity, Herd
  • Immunization Programs
  • Infant
  • Logistic Models
  • Male
  • Meningococcal Infections / epidemiology*
  • Meningococcal Infections / immunology*
  • Meningococcal Infections / prevention & control
  • Meningococcal Vaccines / administration & dosage
  • Meningococcal Vaccines / immunology*
  • Neisseria meningitidis, Serogroup C / immunology*
  • Seroepidemiologic Studies
  • Spain / epidemiology


  • Antibodies, Bacterial
  • Meningococcal Vaccines
  • serogroup C meningococcal conjugate vaccine