Economic Evaluation of Adolescent Vaccination with Serogroup ACWY and C Meningococcal Vaccines in Germany.

Introduction: Invasive meningococcal disease (IMD) is a rare but serious condition caused by Neisseria meningitidis, with rising cases of serogroups W and Y in Germany. Currently, routine vaccination in Germany includes MenC vaccination in toddlers, and as of early 2024, MenB vaccination has been recommended in infancy. MenACWY vaccination, however, is currently only recommended for high-risk individuals. This study evaluates the potential public health impact and cost-effectiveness of introducing routine adolescent MenACWY or MenC vaccination in Germany.

Methods: This study presents a health economic evaluation based on a previously published dynamic transmission model, which simulates the introduction of MenACWY vaccination in adolescents in Germany. The evaluation incorporates costs and quality-adjusted life years (QALYs), and is conducted from a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the findings and to account for parameter uncertainty.

Results: The introduction of adolescent MenACWY vaccination was estimated to prevent 1467 IMD cases and 156 deaths by 2060, leading to a total gain of 2333 QALYs. The MenACWY vaccination strategy was associated with incremental costs of approximately €306 million, resulting in an incremental cost-effectiveness ratio (ICER) of €131,150 per QALY gained. Scenarios assuming higher levels of carriage protection reduced the ICER to as low as €76,000 per QALY. In contrast, adolescent MenC vaccination had a comparatively minor impact on IMD incidence and mortality, with ICERs exceeding €1 million per QALY. Sensitivity analyses highlighted the significant influence of assumed vaccine carriage protection and duration of protection on the ICER.

Conclusions: Adolescent MenACWY vaccination in Germany has the potential to reduce the incidence and mortality of IMD, particularly from serogroups W and Y. Although the cost-effectiveness of the strategy depends on several assumptions, particularly the extent of carriage protection, the ICER for MenACWY introduction appears favorable.