1722Potential Impact of Vaccination of College-Age Adolescents against N. meningitidis Serogroup B: Results of a Transmission Dynamic Model

Background. Studies in the 1990s establishing an increased risk of invasive meningococcal disease (IMD) in first year college students living in residence halls were the foundation for US ACIP recommendations for routine meningococcal serogroup A, C, W-135 and Y (MenACWY) vaccination in this group. Recent college campus outbreaks of meningococcal serogroup B (MenB), such as that at Princeton University where the attack rate was 134 per 100,000, highlight the unpredictability of IMD and the need in the US for a licensed, broadly protective MenB vaccine. We estimated the potential impact of introducing routine MenB vaccination of students preparing for the first year of college. Methods. A transmission dynamic model was adapted to simulate MenB carriage prevalence and IMD incidence within the college-attending US young adult population (17-22 year olds). Carriage prevalence and vaccine efficacy against IMD and carriage were obtained from published literature and expert opinion. Incidence of IMD was estimated from the US national surveillance system utilizing the 2008 to 2011 average. College attendance data were obtained from US Bureau of Labor and Statistics. IMD cases and deaths avoided over a 30 year period were calculated for the entire US population, and separately for a closed (i.e., no transmission into or out of the population) college-attending cohort. Results. In a closed-cohort of college-attending young adults aged 17-22 years, routine vaccination of 90% of 17-year-olds entering college would prevent an estimated 293 cases and 35 deaths. If college attendees had limited interaction with other members of general population, an estimated 2,278 cases and 224 deaths could be prevented in the US. An estimated 2,788 cases and 266 deaths could be prevented with routine vaccination of 11 year olds receiving a booster dose at 16 years of age. Conclusion. A strategy of vaccinating first year college entrants could have a sizable impact on MenB disease and help control college campus outbreaks. However, the overall cases of disease and deaths prevented utilizing a strategy of vaccinating college entrants are fewer than if an age-based vaccination strategy was pursued. A program addressing disease in college students and adolescents would have the greatest impact. Disclosures. S. J. Snedecor, Pharmerit: Employee, Consulting fee R. Farkouh, Pfizer: Employee, Salary L. York, Pfizer: Employee, Salary M. Xue, Pharmerit: Employee, Consulting fee D. Strutton, Pfizer: Employee, Salary