New frontiers in meningococcal vaccines.

Challenges remain in developing effective meningococcal vaccines and vaccination programs in both the industrialized and developing worlds. Vaccination programs should ideally provide broad coverage of disease-causing strains to prevent disease and also promote the herd immunity important for extending protection to the at-risk unvaccinated population. The success of meningococcal serogroup C conjugate vaccination programs during the last 10 years demonstrates the tremendous positive impact on human health that may be attainable; however, significant challenges remain to implement effective use of serogroup A vaccines for the developing world and to develop broadly protective vaccines against serogroup B disease. The effectiveness of vaccination programs, and shifts in disease epidemiology, must be monitored continuously to evaluate protection levels and to identify gaps in disease coverage. As these challenges are met, the possibility for removing the fear of meningococcal disease from all societies is now becoming a reality.