Efficacy of meningococcal vaccine and barriers to vaccination.

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Abstract
NEISSERIA MENINGITIDIS is a leading cause of bacterial meningitis in the United States, causing an estimated 2600 cases of invasive disease annually, with a mortality rate between 10% and 15%.1 In the United States, N meningitidis serogroup C accounts for 30% to 40% of invasive disease and is the most common cause of outbreaks.2 Outbreaks of serogroup C meningococcal disease (SCMD) have been rare in the United States since World War II; however, since 1991, the number of serogroup C outbreaks has increased.2 The quadrivalent meningococcal polysaccharide vaccine, which contains the purified polysaccharide capsules of serogroups A, C, W-135, and Y, has been recommended for the control of SCMD outbreaks.3