Changing patterns of invasive meningococcal disease and future immunization strategies.

Invasive meningococcal diseases, which include meningitis, are rare and unpredictable, but may lead to very important/debilitating long-term sequelae, death, or reduced life expectancy. Vaccination is the best way to prevent them. Vaccination recommendations provided by national health agencies usually target infants (or toddlers), children, and adolescents. Older adults are only considered when they are at risk for invasive meningococcal diseases.Here, we analyzed the vaccination strategies for invasive meningococcal disease in different countries to identify the gaps preventing access to vaccination.We found that recommendations for invasive meningococcal disease vaccination vary markedly among countries. Vaccination programs target mainly infants and toddlers, and they successfully reduced the number of cases among them. However, we also observed that the disease now affects more adults. We also found that the lack of equitable access to vaccination prevents broader meningococcal protection for persons of any age.With this analysis, we suggest improving the current meningococcal vaccination guidelines to also provide adolescents and healthy older adults with access to vaccines. Promoting equal access to vaccination for everyone could reduce the impact on the healthcare system and help reduce social disparity. In order to do so, we advise universal recommendation of meningococcal vaccines, which would provide clear guidance to health-care practitioners.