Implicazioni organizzative della diffusione e della somministrazione della vaccinazione contro il meningococco B, in Health technology assessment della vaccinazione contro meningococco B

[Autom. eng. transl.] The multicomponent vaccine against meningococcus B authorized for marketing by the Italian Drug Agency (AIFA), with the name of Bexsero®, is indicated for active immunization against Neisseria meningitidis of serogroup B in subjects of equal age or more than 2 months. In particular, this intramuscular injection vaccine can be used: - in children aged between 2 and 5 months (3 injections at intervals of at least one month); - in children between 6 months and 2 years of age (two injections with an interval of at least two months); - in adults and adolescents from 11 years (2 injections with an interval between doses of at least 1 month). Furthermore, for subjects who have received the primary immunization cycle before the age of 2, a booster dose is provided. In light of the results of the published trials and the greater incidence of invasive MenB pathology in children under one year of age, there are several possibilities for inserting the vaccine into the pediatric immunization calendar: - interleaved schedule with sessions dedicated for the vaccine against MenB interspersed with 15 days compared to routine sessions; - concurrent schedule: vaccine against MenB administered at the 3rd and 5th month together with routine vaccines, and at the 7th month as a single injection. For both proposals, the booster dose of MenB vaccine is to be administered over one year of age (13th -15th month), as indicated in the technical data sheet. The proposals described, which guarantee both adequate protection within the first year of life, have different advantages. The intercalated schedule would be advantageous in minimizing the risk of increased reactogenicity resulting from the administration of three vaccines during the same session and also from the point of view of pharmacovigilance and surveillance of adverse reactions. The concurrent schedule would allow children to be recalled only once more compared to current programs, with consequent lower costs, both in terms of public health and the loss of parental productivity, compared to the previous proposal.