Doug Campos-Outcalt, MD, MPA Department of Family, Community and Preventive Medicine, University of Arizona College of Medicine, Phoenix dougco@email.arizona.edu
In addition, the cost of vaccines for children has escalated over the past decade due mainly to the new, more expensive formulations.
The reason for a declining incidence of meningococcal disease is not fully known. It may be partly explained by increasing rates of vaccination among adolescents. However, the overall low rate of disease in the population makes assessing herd immunity difficult.
If ACIP decides to recommend vaccinating infants against meningococcal disease, it is unclear how long immunity will last, potentially necessitating a booster dose before the currently recommended adolescent dose.
Finally, in children at high risk, it is not fully known how meningococcal vaccines will affect the immune response to pneumococcal conjugate vaccine. This is an important consideration because the incidence of pneumococcal disease among these children is much higher than that of meningococcal disease.
