From 1991 to the end of 2003 there have been 5293 cases and 216 deaths from meningococcal disease in New Zealand. On 10 March 2004, the New Zealand Ministry of Health hosted a special meeting to release the first results of the clinical trial in 16 to 24 month olds of a new vaccine (MeNZB), which has been tailor-made to provide protection against the New Zealand epidemic strain. These proceedings summarise the key points from the meeting presentations and highlight some of the important issues considered in the subsequent discussion. In the toddler age-group trial, 75% of the MeNZB recipients exhibited a four-fold or greater rise in serum bactericidal antibodies after three doses of MeNZB--compared with 4% of the control vaccine recipients. Local reactions to MeNZB and the control vaccine were common, especially injection site tenderness. These data, along with data from New Zealand clinical trials in four other age groups and efficacy and safety data from the Norwegian parent vaccine, were used to support the application for a licence to use MeNZB in a proposed mass immunisation programme for 0-19 year olds. During the immunisation programme, a comprehensive safety monitoring programme will be in place to monitor for any adverse reactions following MeNZB immunisation. This will include real-time hospital-based monitoring in the regions first to roll out the vaccine.