Neisseria meningitidis still leads to deaths and severe disability in children, 
adolescents and adults. Six different capsular groups of N. meningitidis cause 
invasive meningococcal disease in the form of meningitis and septicaemia in 
humans. Although conjugate meningococcal vaccines have been developed to provide 
protection against four of the capsular groups causing most diseases in humans, 
vaccines against capsular group B, which causes 85% of cases in Australia and 
the United Kingdom, have only recently been developed. A capsular group B 
meningococcal vaccine - 4CMenB (Bexsero) - has recently been licensed in the 
European Union, Canada and Australia. In Australia, a submission for inclusion 
of 4CMenB in the funded national immunization programme has recently been 
rejected. The vaccine will now be introduced into the national immunization 
programme in the United Kingdom following negotiation of a cost-effective price. 
With the current low incidence of invasive meningococcal disease in many 
regions, cost-effectiveness of a new capsular group B meningococcal vaccine is 
borderline in both the United Kingdom and Australia. Cost-effectiveness of an 
infant programme is determined largely by the direct protection of those 
vaccinated and is driven by the higher rate of disease in this age group. 
However, for an adolescent programme to be cost-effective, it must provide both 
long-term protection against both disease and carriage. The potential of 
vaccination to reduce the rate of severe invasive disease is a real possibility. 
A dual approach using both an infant and adolescent immunization programme to 
provide direct protection to those age groups at highest risk of meningococcal 
disease and to optimize the potential herd immunity effects is likely to be the 
most effective means of reducing invasive meningococcal disease. This commentary 
aims to describe the known disease burden and consequences of meningococcal 
disease, and the development and potential effectiveness of new capsular group B 
meningococcal vaccines.