• Peter B McIntyre, Katherine L O'Brien, Brian Greenwood, and Diederik van de Beek.
• National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia. peter.mcintyre@health.nsw.gov.au
• Lancet. 2012 Nov 10;380(9854):1703-11.

AbstractThree bacteria--Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis--account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.Copyright © 2012 Elsevier Ltd. All rights reserved.

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