This case was reported in a literature article and described the occurrence of suspected vaccination failure in a subject who received Meningococcal ACWY-CRM vaccine. On an unknown date, less than a year after receiving Meningococcal ACWY-CRM vaccine, the subject developed vaccination failure. Serious criteria included death and GSK medically significant. Additional event(s) included neisseria meningitides meningitis with serious criteria of death and GSK medically significant and central nervous system infection with serious criteria of death and GSK medically significant. The outcome of vaccination failure was fatal. The outcome(s) of the additional event(s) included neisseria meningitides meningitis (fatal) and central nervous system infection (fatal). The reported cause of death was neisseria meningitides meningitis and central nervous system infection. The investigator considered that there was a reasonable possibility that the vaccination failure, neisseria meningitides meningitis and central nervous system infection may have been cause by Meningococcal ACWY-CRM vaccine. Additional information was provided. This case was reported in a literature article and described the suspected vaccination failure in a patient of unspecified age and gender who was vaccinated with unspecified quadrivalent meningococcal (groups A, C, W, and Y) vaccine (manufacturer unknown). The patient was the part of active surveillance for primary infectious disease deaths in a specific group over 16 years (1998 - 2013), identified 217 deaths. This study probably presented nearly complete capture of all specific group infectious disease deaths resulting from: the established reporting of deaths through specific administrative systems and aggressive follow-up of deaths by The Mortality Surveillance Division (MSD) staff. No information on medical or family history or concurrent condition or concomitant medication was provided. On an unspecified date, the patient received unspecified quadrivalent meningococcal (groups A, C, W, and Y) vaccine (administration route and site unspecified; dosages unknown; batch number not provided). Age of vaccination was not provided. On an unspecified date, an unknown period after vaccination, the patient had blood-borne infection. The patient developed Neisseria meningitis infection. 2 months after vaccination, the patient had central nervous system (CNS) death from Neisseria meningitis infection. Typing of the isolate associated with death was not performed. It was not reported if the autopsy was performed. This case has been considered as suspected vaccination failure being full schedule and confirmed lab serotype was unknown. This case has been considered serious due to death/suspected vaccination failure. The author did not comment on the relationship between Neisseria meningitis infection and unspecified quadrivalent meningococcal (groups A, C, W, and Y) vaccine. The author concluded, 'The time lag between death and notification of the MSD at the start of this surveillance program was 24 to 48 hours. The lag at the end of the reported surveillance period was 8 to 24 hours. The MSD surveillance system identified an agent in 140 of 217 (64.5%) uniformed deaths. In a similar program by the Centers for Disease Control and Prevention, in 122 cases with specimens, an agent could be identified in 34 (28%). Medical Mortality Registry (MMR) data and information provided strong support for re-establishing the specific group adenovirus vaccination program, which ceased in 1999 and was finally re-established in 2011. MMR data and information also assisted in monitoring the specific group meningococcal vaccine program, helped to describe the virulence of circulating influenza viruses, and identified areas where deadly malaria infections were not being prevented.'