This study adds to the increasing evidence supporting the use of 4CMenB vaccine in large-scale vaccination programs. To date, most of the studies reporting the effectiveness and impact of 4CMenB were conducted in infants or in mixed populations up to 20 years of age. This is the first study exclusively in adolescents and young adults, an age group in whom the symptoms of IMD are generally recognized late, treatment initiation is delayed, and severe outcomes are more frequent. Similar to other studies, this study shows a significant reduction of IMD of 71% in this population of adolescents and young adults although the vaccination rate was low. 4CMenB immunization programs need to focus on direct (individual) protection for groups at greatest risk of meningococcal disease because no significant reduction in meningococcal carriage following 4CMenB vaccination has been shown in clinical studies. Since the disease is rare, programs for adolescents have been challenged on their cost-effectiveness. However, evidence exists that 4CMenB may provide cross-protection against Neisseria gonorrhoea, with an effectiveness of 30%-40%. In view of increasing rates of gonorrhoea and antimicrobial resistance, this is an important consideration for adolescent immunization programs with 4CMenB and could provide a significant public health impact.

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