Impact on disease incidence of a routine universal and catch-up vaccination strategy against Neisseria meningitidis C in Tuscany, Italy

► In 2005, in Tuscany, a policy of active offer of MCC vaccination was approved. ► Incidence rates of meningococcal cases decreased in all the age groups targeted. ► A herd immunity effect was measured in the unvaccinated age groups. ► Since 2006, no meningococcal C infections were observed in vaccinated subjects. ► Our results should prompt all Italian Regions considering the introduction of MCC vaccination.