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Between 1979 and 2006, there were 610 deaths recorded as due to meningococcal disease in Australia. Mortality rates per capita consistently increased on average by 6% per annum between 1979 and 2002, but then fell significantly in 2003, coinciding with the introduction of the meningococcal C conjugate vaccine. In 2002, the mortality rate was 0.24 per 100,000. In the 4 years since, it fell progressively to 0.06 per 100,000. Since the introduction of conjugate Hib and pneumococcal vaccines, meningococcal disease has emerged as the number 1 infectious cause of death in children but conjugate meningococcal C vaccine appears to have greatly reduced total meningococcal disease deaths.