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Journal ArticleDOI

The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection

TL;DR: The GMI Global Recommendations for Meningococcal Disease were updated to include a recommendation to enable access to whole-genome sequencing as for surveillance, guidance on strain typing to guide use of subcapsular vaccines, and recognition of the importance of advocacy and awareness campaigns.
Abstract: Introduction: The 2015 Global Meningococcal Initiative (GMI) meeting discussed the global importance of meningococcal disease (MD) and its continually changing epidemiology.Areas covered: Although recent vaccination programs have been successful in reducing incidence in many countries (e.g. Neisseria meningitidis serogroup [Men]C in Brazil, MenA in the African meningitis belt), new clones have emerged, causing outbreaks (e.g. MenW in South America, MenC in Nigeria and Niger). The importance of herd protection was highlighted, emphasizing the need for high vaccination uptake among those with the highest carriage rates, as was the need for boosters to maintain individual and herd protection following decline of immune response after primary immunization.Expert commentary: The GMI Global Recommendations for Meningococcal Disease were updated to include a recommendation to enable access to whole-genome sequencing as for surveillance, guidance on strain typing to guide use of subcapsular vaccines, and ...
Citations
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Journal ArticleDOI
TL;DR: Among Australian adolescents, the 4CMenB vaccine had no discernible effect on the carriage of disease-causing meningococci, including group B.
Abstract: Background The meningococcal group B vaccine 4CMenB is a new, recombinant protein-based vaccine that is licensed to protect against invasive group B meningococcal disease. However, its rol...

117 citations

Journal ArticleDOI
25 Sep 2020
TL;DR: Routine use of a MenB series for adolescents and young adults aged 16–23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis is recommended.
Abstract: This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk.In addition, ACIP recommends routine use of MenB vaccine series among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B. ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults aged 16-23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.

107 citations


Cites background from "The Global Meningococcal Initiative..."

  • ...meningitidis is classified into 12 serogroups according to the composition of its polysaccharide capsule; serogroups A, B, C, W, X, and Y cause most of the disease globally (24)....

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Journal ArticleDOI
TL;DR: The review will introduce the recent development of fully synthetic glycoconjugate vaccine, which is in different phases of clinical trial for bacteria or cancers.
Abstract: Glycoconjugate vaccines based on bacterial capsular polysaccharides (CPS) have been extremely successful in preventing bacterial infections. The glycan antigens for the preparation of CPS based glycoconjugate vaccines are mainly obtained from bacterial fermentation, the quality and length of glycans are always inconsistent. Such kind of situation make the CMC of glycoconjugate vaccines are difficult to well control. Thanks to the advantage of synthetic methods for carbohydrates syntheses. The well controlled glycan antigens are more easily to obtain, and them are conjugated to carrier protein to from the so-call homogeneous fully synthetic glycoconjugate vaccines. Several fully glycoconjugate vaccines are in different phases of clinical trial for bacteria or cancers. The review will introduce the recent development of fully synthetic glycoconjugate vaccine.

80 citations


Cites background from "The Global Meningococcal Initiative..."

  • ...Finally, serogroup X (MenX) is reported in parts of Africa [45] ....

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Journal ArticleDOI
TL;DR: Global trends in MenW-IMD epidemiology over the last 5–10 years are described, with emphasis on the response of national/regional health authorities to increased MenW prevalence in impacted areas.
Abstract: Invasive meningococcal disease (IMD) is a serious disease that is fatal in 5–15% and disabling in 12–20% of cases. The dynamic and unpredictable epidemiology is a particular challenge of IMD preven...

77 citations


Cites background from "The Global Meningococcal Initiative..."

  • ...Vaccination against IMD has been very effective in achieving control of the disease, as shown by several successful campaigns with conjugate meningococcal vaccines.(3,14,16) In...

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  • ...secondary peaks in incidence occurring in adolescents/young adults and sometimes in older adults (≥65 years of age).(3) Worldwide, most regions have experienced a downward trend in the incidence of IMD in recent years, probably due in part to a combination of active immunization and secular change impacting risk factors for the disease(8,9) (e....

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  • ...Vaccination against IMD has been very effective in achieving control of the disease, as shown by several successful campaigns with conjugate meningococcal vaccines.3,14,16 In 1999, in response to a steep increase in the number of MenC cases, the UK introduced conjugate MenC vaccine into the routine immunization program, first in infants, and subsequently in a single catch up program for everyone aged 12 months–17 years.35,55 The MenC vaccination program in the UK has been seen as a model for other countries across the world, with a similar “children plus catch-up” program (from 14 months of age up to 18 years old included) leading to comparable results in the Netherlands in preventing MenCIMD.56 A different approach was represented by the implementation of routine vaccination with MenC-conjugate vaccine in Brazil in 2010, for infants 3 and 5 months of age, with a booster at 12–15 months....

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  • ...onward transmission of the bacterium, particularly of hyperinvasive clones.(3) A characteristic which sets IMD apart from...

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  • ...No reduction of cases in unvaccinated age groups (herd effect of vaccination) occurred following mass vaccination of infants.(3,17,60)...

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References
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Journal Article
TL;DR: This report summarizes and updates an earlier published statement issued by the Advisory Committee on Immunization Practices concerning the control and prevention of meningococcal disease and provides updated recommendations regarding the use of menedococcal vaccine.
Abstract: Meningococcal disease describes the spectrum of infections caused by Neisseria meningiditis, including meningitdis, bacteremia, and bacteremic pneumonia. Two quadrivalent meningococcal polysaccharide-protein conjugate vaccines that provide protection against meningococcal serogroups A, C, W, and Y (MenACWY-D [Menactra, manufactured by Sanofi Pasteur, Inc., Swiftwater, Pennsylvania] and MenACWY-CRM [Menveo, manufactured by Novartis Vaccines, Cambridge, Massachusetts]) are licensed in the United States for use among persons aged 2 through 55 years. MenACWY-D also is licensed for use among infants and toddlers aged 9 through 23 months. Quadrivalent meningococcal polysaccharide vaccine (MPSV4 [Menommune, manufactured by sanofi pasteur, Inc., Swiftwater, Pennsylvania]) is the only vaccine licensed for use among persons aged ≥56 years. A bivalent meningococcal polysaccharide protein conjugate vaccine that provides protection against meningococcal serogroups C and Y along with Haemophilus influenzae type b (Hib) (Hib-MenCY-TT [MenHibrix, manufactured by GlaxoSmithKline Biologicals, Rixensart, Belgium]) is licensed for use in children aged 6 weeks through 18 months. This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of meningococcal disease in the United States, specifically the changes in the recommendations published since 2005 (CDC. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2005;54 [No. RR-7]). As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations; it is intended for use by clinicians as a resource. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination for persons at increased risk for meningococcal disease (i.e., persons who have persistent complement component deficiencies, persons who have anatomic or functional asplenia, microbiologists who routinely are exposed to isolates of N. meningitidis, military recruits, and persons who travel to or reside in areas in which meningococcal disease is hyperendemic or epidemic). Guidelines for antimicrobial chemoprophylaxis and for evaluation and management of suspected outbreaks of meningococcal disease also are provided.

1,868 citations

Book
30 Jun 2009
TL;DR: Research into vaccine-preventable disease development and prevention and the role of information technology in this regard is presented.
Abstract: EPIDEMIOLOGY AND PREVENTION OF VACCINE-PREVENTABLE DISEASES , EPIDEMIOLOGY AND PREVENTION OF VACCINE-PREVENTABLE DISEASES , کتابخانه مرکزی دانشگاه علوم پزشکی ایران

1,223 citations

Journal ArticleDOI
TL;DR: Estimates of carriage prevalence across all ages are provided, which is important for understanding the epidemiology and transmission dynamics of meningococcal infection.
Abstract: Summary Background Neisseria meningitidis is an important cause of meningitis and septicaemia, but most infected individuals experience a period of asymptomatic carriage rather than disease. Previous studies have shown that carriage rates vary by age and setting; however, few have assessed carriage across all ages. We aimed to estimate the age-specific prevalence of meningococcal carriage. Methods We searched Embase, Medline, Web of Science, the Cochrane Library, and grey literature for papers reporting carriage of N meningitidis in defined age groups in European countries or in countries with a similar epidemiological pattern (where disease caused by serogroups B and C predominates). We used mixed-effects logistic regression with a natural cubic spline to model carriage prevalence as a function of age for studies that were cross-sectional or serial cross-sectional. The model assessed population type, type of swab used, when swabs were plated, use of preheated plates, and time period (decade of study) as fixed effects, with country and study as nested random effects (random intercept). Findings Carriage prevalence increased through childhood from 4·5% in infants to a peak of 23·7% in 19-year olds and subsequently decreased in adulthood to 7·8% in 50-year olds. The odds of testing positive for carriage decreased if swabs were not plated immediately after being taken compared with if swabs were plated immediately (odds ratio 0·46, 95% CI 0·31–0·68; p=0·0001). Interpretation This study provides estimates of carriage prevalence across all ages, which is important for understanding the epidemiology and transmission dynamics of meningococcal infection. Funding None.

513 citations


"The Global Meningococcal Initiative..." refers background in this paper

  • ...‘catch-up’ campaigns and illustrate that conjugate vaccines’ effect on carriage was crucial to the success of the MenC and MenAfriVac® vaccine programs [18,72,116]....

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  • ...In general, carriage is most frequent in young adults, with a prevalence of ~24% and approaching 100% in closed or semiclosed populations, such as military recruits and university students [18]....

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Journal ArticleDOI
TL;DR: The impact of vaccination with MCC vaccine on the prevalence of carriage of group C meningococci was consistent with herd immunity, and the high impact on the carriage of ST-11 complex serogroup C could be attributed to high levels of capsule expression.
Abstract: BACKGROUND: In 1999, meningococcal serogroup C conjugate (MCC) vaccines were introduced in the United Kingdom for those under 19 years of age. The impact of this intervention on asymptomatic carriage of meningococci was investigated to establish whether serogroup replacement or protection by herd immunity occurred. METHODS: Multicenter surveys of carriage were conducted during vaccine introduction and on 2 successive years, resulting in a total of 48,309 samples, from which 8599 meningococci were isolated and characterized by genotyping and phenotyping. RESULTS: A reduction in serogroup C carriage (rate ratio, 0.19) was observed that lasted at least 2 years with no evidence of serogroup replacement. Vaccine efficacy against carriage was 75%, and vaccination had a disproportionate impact on the carriage of sequence type (ST)-11 complex serogroup C meningococci that (rate ratio, 0.06); these meningococci also exhibited high rates of capsule expression. CONCLUSIONS: The impact of vaccination with MCC vaccine on the prevalence of carriage of group C meningococci was consistent with herd immunity. The high impact on the carriage of ST-11 complex serogroup C could be attributed to high levels of capsule expression. High vaccine efficacy against disease in young children, who were not protected long-term by the schedule initially used, is attributed to the high vaccine efficacy against carriage in older age groups.

429 citations


"The Global Meningococcal Initiative..." refers background or methods in this paper

  • ...promote (indirect) herd protection (Figure 2) [61,62]....

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  • ...Such models are used to best effect in combination with data from surveillance, clinical trials, and carriage studies [61,64,65]....

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  • ...In such situations, conjugate vaccines provide herd protection by providing long-lasting protection and reducing nasopharyngeal carriage [61,64,65], for example, through the presence of high levels of mucosal antibodies, thus reducing total transmission in the population....

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  • ...(a) Reduction in MenC carriage [61] (immunized individuals aged 15–19 years)....

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Journal ArticleDOI
15 Feb 2003-BMJ
TL;DR: Rates of disease in vaccinated and unvaccinated children are presented to provide the first evidence of an indirect effect from meningococcal conjugate vaccine.
Abstract: In November 1999, the United Kingdom introduced routine meningococcal serogroup C conjugate vaccination for infants. The vaccine was also offered to everyone aged under 18 years in a phased catch-up programme.1 The first to be vaccinated were adolescents, and the entire programme was completed by the end of 2000. On the basis of direct protection provided by the vaccine, 1 2 this catch-up programme was likely to be cost effective.3 Maiden et al described a 67% reduction (from 0.45% to 0.15%) in the prevalence of nasopharyngeal carriage of serogroup C meningococci in adolescents before and after the vaccination programme.4 A fall in meningococcal carriage would be expected to reduce exposure among unvaccinated children and therefore to enhance the effectiveness of meningococcal conjugate vaccine. We present rates of disease in vaccinated and unvaccinated children to provide the first evidence of an indirect effect from meningococcal conjugate vaccine. Since December 1999 we have investigated the vaccination history of all cases of …

398 citations


"The Global Meningococcal Initiative..." refers background in this paper

  • ...promote (indirect) herd protection (Figure 2) [61,62]....

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  • ...(b) Direct and herd protection [62] against MenC (attack rates in infants and overall attack rate reduction in age group 2 months to 18 years)....

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