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The Medical Letter on Drugs and... Mar 2024
Topics: Humans; Meningococcal Vaccines; Vaccines, Combined; Bacterial Vaccines
PubMed: 38466212
DOI: 10.58347/tml.2024.1698b -
Orvosi Hetilap Feb 2016Meningococcus B is the most prevalent Neisseria meningitidis serogroup isolated in Hungary. Bexsero is one of the vaccines developed against it, which has been available... (Review)
Review
Meningococcus B is the most prevalent Neisseria meningitidis serogroup isolated in Hungary. Bexsero is one of the vaccines developed against it, which has been available in Hungary since the summer of 2014. The authors summarize the most important issues and open questions concerning the disease and the vaccine based on literature review. Based on immunological evidence, it is expected that Bexsero provides protection against this rare but very serious infection. However, the vaccine is extremely expensive, the clinical effectiveness has not yet been proven and it frequently causes fever, especially in infants where the vaccine is most needed. According to the opinion of the authors, the formulation of a Hungarian guideline concerning the application of Bexsero should be postponed until the accumulating international experience makes it possible to better judge the vaccine's benefits, risks and cost-effectiveness. For patients with asplenia, complement defect or other immunological defect, or in case of markedly increased individual risk of contracting the disease, the vaccination is already justified.
Topics: Adolescent; Adult; Age Distribution; Child; Child, Preschool; Cost-Benefit Analysis; Fever; Humans; Hungary; Infant; Meningitis, Meningococcal; Meningococcal Infections; Meningococcal Vaccines; Middle Aged; Neisseria meningitidis, Serogroup B; Quality-Adjusted Life Years; Young Adult
PubMed: 26853725
DOI: 10.1556/650.2016.30333 -
Zhonghua Yu Fang Yi Xue Za Zhi [Chinese... Feb 2019Meningococcal meningitis is an acute, severe respiratory infectious disease caused by Neisseria meningitidis. Immunization with meningococcal vaccine is the most... (Review)
Review
Meningococcal meningitis is an acute, severe respiratory infectious disease caused by Neisseria meningitidis. Immunization with meningococcal vaccine is the most effective measure to control and prevent transmission of meningococcal meningitis. Meningococcal vaccines in the Chinese market include meningococcal polysaccharide vaccine, meningococcal polysaccharide conjugate vaccine, and a combined vaccine containing meningococcal polysaccharide conjugate vaccine. This article reviews research progress on the efficacy, safety, and cost-effectiveness of meningococcal vaccines, particularly in the Chinese market, to support appropriate use of the various meningococcal vaccines for preventing meningococcal meningitis.
Topics: China; Cost-Benefit Analysis; Humans; Meningitis, Meningococcal; Meningococcal Vaccines; Vaccines, Conjugate
PubMed: 30744287
DOI: 10.3760/cma.j.issn.0253-9624.2019.02.005 -
Journal of Clinical Pharmacy and... Apr 2020This review describes invasive meningococcal disease (IMD) epidemiology in the United States, provides a brief overview of available meningococcal vaccines and discusses... (Review)
Review
WHAT IS KNOWN AND OBJECTIVE
This review describes invasive meningococcal disease (IMD) epidemiology in the United States, provides a brief overview of available meningococcal vaccines and discusses meningococcal serogroup B (MenB) vaccine development. Particular focus is given to the recombinant protein MenB vaccine, MenB-FHbp (Trumenba , bivalent rLP2086) in light of recent publication of phase 3 data; the other MenB vaccine (Bexsero , MenB-4C) has been recently reviewed. Current recommendations of the US Advisory Committee on Immunization Practices (ACIP) for MenB vaccination and potential barriers to immunization are also discussed.
METHODS
Using the published literature, this article reviews the development and use of MenB-FHbp to date, with a focus on the United States.
RESULTS AND DISCUSSION
Despite the availability of medical treatment, IMD is associated with significant mortality and frequently occurring serious permanent sequelae in surviving individuals. Worldwide, most IMD is caused by six serogroups (A, B, C, W, X and Y). MenB is the most common disease-causing meningococcal serogroup in the United States and has caused several recent university-based IMD outbreaks. MenB vaccines, including MenB-FHbp, are available in the United States. ACIP recommends that all individuals ≥10 years of age at increased risk for meningococcal disease receive MenB vaccination; healthy individuals 16-23 years of age are recommended MenB vaccines based on individual clinical decision-making. MenB-FHbp is used on a 2-dose schedule (0, 6 months) when vaccinating healthy individuals and on a tailored 3-dose schedule (0, 1-2, 6 months) in cases of increased risk.
WHAT IS NEW AND CONCLUSION
Because vaccination provides the most effective protection against IMD, pharmacists are in an excellent position to offer evidence-based vaccine information, as well as to encourage and provide meningococcal immunizations to adolescents and young adults.
Topics: Adolescent; Child; Humans; Immunization Schedule; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; Pharmacists; Professional Role; United States; Vaccination; Young Adult
PubMed: 31820483
DOI: 10.1111/jcpt.13083 -
BMC Public Health May 2023Men who have sex with men (MSM) have suboptimal uptake of human papillomavirus (HPV) and meningococcal vaccines. This study examines barriers and facilitators to HPV and...
BACKGROUND
Men who have sex with men (MSM) have suboptimal uptake of human papillomavirus (HPV) and meningococcal vaccines. This study examines barriers and facilitators to HPV and meningococcal vaccination among MSM in a large, racially/ethnically diverse, and medically underserved U.S. region.
METHODS
In 2020, we conducted five focus groups with MSM living in the Inland Empire, California. Participants discussed (1) their knowledge about and attitudes toward HPV, meningococcal disease, and related vaccines; and (2) factors that would encourage or discourage vaccine uptake. Data were systematically analyzed to identify salient barriers and facilitators to vaccination.
RESULTS
Participants (N = 25) had a median age of 29. Most were Hispanic (68%), self-identified as gay (84%), and had college degrees (64%). Key barriers to vaccination included: (1) limited awareness and knowledge about HPV and meningococcal disease, (2) reliance on mainstream healthcare providers for vaccine information, (3) stigma and reluctance to disclose sexual orientation, (4) uncertainty about health insurance coverage and vaccine costs, and (5) distance and time required to access vaccines. Key facilitators to vaccination were: (1) vaccine confidence, (2) perceived severity of HPV and meningococcal disease, (3) bundling vaccination into routine healthcare, and (4) pharmacies as vaccination sites.
CONCLUSIONS
Findings highlight opportunities for HPV and meningococcal vaccine promotion, including targeted education and awareness campaigns for MSM, LGBT inclusivity training for healthcare providers, and structural interventions to improve vaccine accessibility.
Topics: Humans; Male; Homosexuality, Male; Meningococcal Vaccines; Papillomavirus Infections; Human Papillomavirus Viruses; Focus Groups; Qualitative Research; Health Knowledge, Attitudes, Practice; Social Stigma; Health Services Accessibility; United States; Adult; Middle Aged; Insurance, Health
PubMed: 37221575
DOI: 10.1186/s12889-023-15847-w -
The Journal of Infection Mar 2022This review article incorporates information from the 4th Global Meningococcal Initiative summit meeting. Since the introduction of stringent COVID-19 infection control... (Review)
Review
This review article incorporates information from the 4th Global Meningococcal Initiative summit meeting. Since the introduction of stringent COVID-19 infection control and lockdown measures globally in 2020, there has been an impact on IMD prevalence, surveillance, and vaccination compliance. Incidence rates and associated mortality fell across various regions during 2020. A reduction in vaccine uptake during 2020 remains a concern globally. In addition, several Neisseria meningitidis clonal complexes, particularly CC4821 and CC11, continue to exhibit resistance to antibiotics, with resistance to ciprofloxacin or beta-lactams mainly linked to modifications of gyrA or penA alleles, respectively. Beta-lactamase acquisition was also reported through horizontal gene transfer (bla) involving other bacterial species. Despite the challenges over the past year, progress has also been made on meningococcal vaccine development, with several pentavalent (serogroups ABCWY and ACWYX) vaccines currently being studied in late-stage clinical trial programmes.
Topics: COVID-19; Communicable Disease Control; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; SARS-CoV-2; Serogroup
PubMed: 34838594
DOI: 10.1016/j.jinf.2021.11.016 -
Human Vaccines & Immunotherapeutics Apr 2020Invasive meningococcal disease (IMD) caused by the bacteria is rare but potentially fatal. For healthy adolescents, the US Advisory Committee on Immunization Practices...
Invasive meningococcal disease (IMD) caused by the bacteria is rare but potentially fatal. For healthy adolescents, the US Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with MenACWY and recommends MenB vaccination under shared clinical decision-making (previously "Category B"). The recommendation for MenB vaccination was the first category B recommendation in adolescents, and it is unclear how healthcare providers (HCPs) implement these guidelines. This 2017 web-based survey of US HCPs explored characteristics associated with prescribing or receiving MenB and MenACWY vaccines, HCP knowledge of vaccine recommendations, and real-world practice patterns. Of 529 respondents, 436 prescribed MenB vaccines to their eligible adolescent/young adult patients and 93 prescribed MenACWY vaccines only. MenB vaccine prescribers were more likely to be pediatricians compared with MenACWY vaccine only prescribers, and patients who received MenB vaccines were more likely to be non-Hispanic whites living in shared spaces (eg, college dormitories) than those not receiving the vaccine. Seventy-seven percent of HCPs indicated that they prescribe MenACWY vaccines consistently with ACIP recommendations (to all members of an age group), whereas only 7% indicated that they prescribe MenB vaccines consistently with ACIP recommendations (individual clinical decision making). Patient-related factors, disease-related factors, and guidelines all influenced HCP decisions to prescribe meningococcal vaccines. Providing HCPs with clear guidance on how to initiate discussion of MenB vaccines with patients and their caregivers may aid in fully protecting US adolescents against meningococcal disease caused by 5 of the disease-causing serogroups.
Topics: Adolescent; Humans; Immunization; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; Pediatricians; Vaccination; Young Adult
PubMed: 31634035
DOI: 10.1080/21645515.2019.1682845 -
Human Vaccines & Immunotherapeutics Jul 2017The protective effect of meningococcal vaccines targeting disease causing serogroups exemplified by the introduction of MenAfriVac™ in Africa, is well established and...
The protective effect of meningococcal vaccines targeting disease causing serogroups exemplified by the introduction of MenAfriVac™ in Africa, is well established and documented in large population-based studies. Due to the emergence of other meningococcal disease causing serogroups, novel vaccine formulations are needed. There is a high potential for novel nanotechnology-based meningococcal vaccine formulations that can provide wider vaccine coverage. The proposed meningococcal vaccine formulation contains spherical shaped micro and nanoparticles that are biological mimics of Niesseria meningitidis, therefore present to immune system as invader and elicit robust immune responses. Vaccine nanoparticles encapsulate meningococcal CPS polymers in a biodegradable material that slowly release antigens, therefore enhance antigen presentation by exerting antigen depot effect. The antigenicity of meningococcal vaccine delivered in nanoparticles is significantly higher when compared to vaccine delivered in solution. Preclinical studies are required to assess the immunogenicity of novel vaccine formulations. Therefore, implementing various in-vitro human immune cell-based assays that mimic in-vivo interactions, would provide good insight on optimal antigen dose, effective antigen presentation, facilitate screening of various vaccine and adjuvant combinations and predict in-vivo immunogenicity. This rapid approach is cost-effective and provides data required for the preclinical immunogenicity assessment of novel meningococcal vaccine formulations.
Topics: Drug Carriers; Drug Evaluation, Preclinical; Humans; Meningococcal Infections; Meningococcal Vaccines; Nanoparticles; Neisseria meningitidis
PubMed: 28394704
DOI: 10.1080/21645515.2017.1305528 -
Human Vaccines & Immunotherapeutics May 2018This study aimed to evaluate the knowledge, attitudes and practice about invasive meningococcal disease and the relative vaccine for adolescent in Italy. A...
This study aimed to evaluate the knowledge, attitudes and practice about invasive meningococcal disease and the relative vaccine for adolescent in Italy. A cross-sectional study was conducted from March to May 2017 among a sample of 771 adolescents in the geographic area of Naples (Italy). A self-administered anonymous questionnaire was used to collect demographics, knowledge about meningitis and preventive measures, perceived risk for contracting meningitis, attitude towards the utility of meningococcal vaccine, and adolescents' willingness to receive a meningococcal vaccine. 85.2% of participants have heard about meningitis, 57.2% knew that adolescents are a susceptible population but only 30.3% knew that meningitis is transmitted by respiratory droplets. Moreover, 40.5% of adolescents knew that meningitis is a vaccine-preventable disease and that adolescents could be vaccinated. This knowledge was significantly greater among female participants, among those who talk with parents about vaccinations, among who have received information about vaccinations from physicians, among who have positive attitude towards the utility of information received on vaccinations and among who don't feel the need of additional information about meningitis. As regard the attitudes, 25.7% of adolescents thought that the vaccine was very useful. Males, adolescent aged 11-13 years, those who had the positive attitude towards the utility of information received about vaccinations and those who had received at least one vaccination in the last year were more likely to have this attitude. The our finding identifies the need to improve adolescents' knowledge about meningitis and its related vaccinations, through correct health education, in order to have a good acceptance of vaccination.
Topics: Adolescent; Adolescent Behavior; Adult; Age Factors; Child; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Italy; Male; Meningococcal Infections; Meningococcal Vaccines; Patient Acceptance of Health Care; Patient Education as Topic; Sex Factors; Surveys and Questionnaires; Vaccination; Young Adult
PubMed: 29452028
DOI: 10.1080/21645515.2018.1436918 -
Postgraduate Medicine Mar 2020Invasive meningococcal disease (IMD) is a potentially devastating infection associated with high mortality and long-term sequelae; however, vaccines are available to... (Review)
Review
Invasive meningococcal disease (IMD) is a potentially devastating infection associated with high mortality and long-term sequelae; however, vaccines are available to protect against the five common disease-causing serogroups (A, B, C, W, and Y). Because traditional field efficacy clinical trials were not feasible due to low IMD incidence that necessitates a very large number of participants, serum bactericidal antibody (SBA) assays using rabbit (rSBA) or human (hSBA) complement were established as surrogates of meningococcal vaccine efficacy and are now routinely used to support vaccine licensure. Specifically, rSBA assays have been used to evaluate responses to meningococcal capsular polysaccharide-protein conjugate vaccines against serogroups A, C, W, and Y; the accepted correlate of protection for rSBA assays is a titer ≥1:8. Importantly, because the bacterial capsular polysaccharide antigen is conserved across strains, only one test strain that expresses an invariant polysaccharide capsule for each serogroup is required to assess coverage. rSBA assays are unsuitable for subcapsular protein-based serogroup B (MenB) vaccines, and therefore, hSBA assays have been used for licensure; titers ≥1:4 are considered the correlate of protection against IMD for hSBA. In contrast to MenACWY vaccines, because bacterial surface proteins are antigenically variable, MenB vaccines must be tested with hSBA assays using multiple test strains that represent the antigenic diversity of disease-causing isolates. As this complexity regarding SBA assessment methods can make data interpretation difficult, herein we describe the use of hSBA assays to evaluate MenB vaccine efficacy and to support licensure. In addition, we highlight how the two recently approved MenB vaccines differ in their use of hSBA assays in clinical studies to demonstrate broad protection against MenB IMD.
Topics: Animals; Antibodies, Bacterial; Antigens, Bacterial; Complement System Proteins; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; Rabbits
PubMed: 32124678
DOI: 10.1080/00325481.2019.1696582