Background and aims: Neisseria meningitidis serogroup B (MENB) is the leading cause of Invasive Meningococcal Disease (IMD) in Israel. The recent availability of MEN B vaccines prompted a disease burden study and a cost-utility analysis of a childhood vaccination program
Methods: An epidemiological study of IMD in the Jerusalem district and a long-term follow-up study. A model was used to estimate the impact of a vaccination program (cost per QALY).
Results: During 1999-2010, 213 IMD cases were reported in the Jerusalem district, (annual incidence rate 2.13±0.6/100,000). 181/213(85%) were under 15y, 90/181(49.7%) were under 2y.
We evaluated the outcome of IMD in children under 15y (n=181). Neisseria meningitidis serogroup B comprised 78% of bacterial isolates. Case fatality rate was 11.6%. In follow-up interviews (115/160 survivors, 72%), at least one long-term sequela was reported in 38/115 children (33%), including learning difficulties (22.6%), hearing impairment (7%), neurologic (12.2%), behavioral (14.8%) and motor (10.4%) deficiencies.
Implementing a MENB vaccination program was estimated to reduce morbidity and mortality. At an assumed price of $60 per vaccine dose, the overall net cost per QALY gained deems implementation of a routine program not cost-effective unless vaccine prices decrease significantly. In special circumstances e.g. outbreaks the use of vaccine will be considered based on public-health factors and the causative meningococcal strain.
Conclusion: Disease burden data are essential in evaluating novel vaccines utilization. Depending on vaccine costs a MEN B vaccination program in Israel could be considered based on a cost-utility analysis combining epidemiological, health-services and economic data.
