Future challenges in the elimination of bacterial meningitis

► Bacterial meningitis has declined upon use of Hib, PCV and meningococcal conjugate vaccines. ► Group B streptococcus accounts for most neonatal bacterial meningitis in USA. ► We describe emerging pathogens contributing to the residual disease burden. ► We review factors influencing vaccine design and uptake. ► We discuss how future vaccines may further reduce bacterial meningitis globally.