Throughout the 1990s, the incidence of meningococcal disease was higher in England and Wales than in most other European countries (1 ). In addition to the high incidence, the pattern of disease changed, with shifts to more cases caused by serogroup C strains, and more cases occurring in older teenagers, among whom the case fatality rate is higher than in any other age group (2 ,3 ). Not surprisingly, market research undertaken by the UK Health Education Authority consistently showed that meningococcal disease is the most feared disease by parents of young children (unpublished reports based on British Market Research Bureau surveys). By 1999, serogroup C accounted for 41% of laboratory confirmed cases; 49% were serogroup B (3 ).