Abstract
Major progress has been made in the development of meningococcal vaccines in the past few years. Monovalent serogroup C conjugate vaccines, shown to be immunogenic and effective in infants, have dramatically decreased the incidence of serogroup C disease in the countries in which they have been used.1-4 This reduction has occurred among those immunized and, through a decrease in pharyngeal carriage of serogroup C Neisseria meningitidis, also among the unimmunized population.5,6 These vaccines do not cover serogroup Y strains, an important cause of meningococcal disease across all age groups in the United States, including infants, and are not licensed in the United States. A new tetravalent (serogroups A, C, W-135, and Y) conjugate vaccine licensed for 2- to 55-year-olds is now recommended for all US adolescents, as well as other high-risk groups.7 This recommendation was based on the fact that US adolescents were found to have both a relatively high incidence of meningococcal disease and a high case fatality rate.7,8

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