Meningococcal B vaccine failure with a penicillin-resistant strain in a young adult on long-term eculizumab

Sydel R. Parikh, Jay Lucidarme, Coralie Bingham, Paul Warwicker, Tim Goodship, Raymond Borrow, Shamez Ladhani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

We describe a case of invasive meningococcal disease due to a vaccine-preventable and penicillin-resistant strain in a fully immunized young adult on long-term complement inhibitor therapy and daily penicillin chemoprophylaxis. Eculizumab is a humanized monoclonal antibody that binds human complement C5 protein and inhibits the terminal complement pathway. It is currently recommended for the treatment of complement-mediated thrombotic microangiopathies. An unwanted complication of inhibiting complement, however, is an increased risk of invasive meningococcal disease. Here, we report the first case of meningococcal group B vaccine failure in a young adult receiving eculizumab for atypical hemolytic uremic syndrome. She developed invasive meningococcal disease due to a vaccine-preventable and penicillin-resistant meningococcal group B strain 4 months after receiving 2 doses of meningococcal group B vaccine while on oral penicillin prophylaxis against meningococcal infection.

Original languageEnglish
Article numbere20162452
JournalPediatrics
Volume140
Issue number3
DOIs
Publication statusPublished - Sep 2017

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