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Vaccine Jul 2023The spleen is responsible for blood filtration and mounting an immune response against pathogens. In some people the spleen must be surgically removed because of...
The spleen is responsible for blood filtration and mounting an immune response against pathogens. In some people the spleen must be surgically removed because of traumatic events or oncological and hematological conditions. These patients are at higher risk of developing diseases caused by encapsulated bacteria throughout their lives. Thus, immunisations are advised for splenectomised persons to prevent infection caused by Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b (Hib). This study assessed vaccination coverage (VC) among Norwegian patients with surgical asplenia. Using the Nomesco Classification of Surgical Procedures codes, patient information (age, sex, date of initial diagnosis and date of surgery) was acquired from the Norwegian Patient Registry. The National Immunization Register provided information on vaccination status and data of any subsequent invasive bacterial infections were obtained from the Norwegian Surveillance System for Communicable Diseases. From the total population of Norway, 3155 patients who had undergone complete splenectomy were identified. Of these, 914 (29.0%) had received at least one dose of pneumococcal conjugate vaccine (PCV), 1324 (42.0%) at least one dose of pneumococcal polysaccharide vaccine and 589 (18.7%) had received both. Only 4.2% of the patients had received two doses of a meningococcal ACWY conjugate vaccine, while 8.0% of 1467 patients splenectomised after 2014 had received at least two doses of a serogroup B meningococcal vaccine. The VC for Hib was 18.7%. Nearly all splenectomised children under the age of 10 were vaccinated with Hib and PCV as these vaccines are included in the childhood immunisation program. For all vaccines, VC decreased with age. Twenty-nine invasive bacterial infections were registered post-splenectomy in 25 patients. Vaccination according to national recommendations could have prevented at least 8 (28%) of these infections. Our study showed that efforts are required to increase VC of splenectomised individuals in Norway.
Topics: Child; Humans; Bacterial Infections; Haemophilus influenzae type b; Haemophilus Vaccines; Meningococcal Vaccines; Norway; Pneumococcal Vaccines; Splenectomy; Vaccination; Vaccines, Conjugate; Guideline Adherence; Vaccination Coverage
PubMed: 37336662
DOI: 10.1016/j.vaccine.2023.06.034 -
PloS One 2021Despite China's Expanded Program on Immunization (EPI) provides 2 doses of group A and group C meningococcal polysaccharide vaccine (MPV-AC) for children at 3 years and...
BACKGROUND
Despite China's Expanded Program on Immunization (EPI) provides 2 doses of group A and group C meningococcal polysaccharide vaccine (MPV-AC) for children at 3 years and 6 years old, more self-paying group ACYW135 meningococcal polysaccharide vaccines (MPV-ACYW135) have been used as an alternative to MPV-AC to prevent Neisseria meningitidis serogroup C,Y,W135. We provide recommendations for Chinese booster immunization of meningococcal meningitis vaccine by analyzing the service status of MPV-AC and MPV-ACYW135.
METHODS
Reported data of routine immunization coverage from all districts of Hangzhou registered in the China Information Management System For Immunization Programming (CIMSFIP) between 2014 to 2019 were described and evaluated. Descriptive epidemiological methods were used to characterize the data. Adverse event following immunization (AEFI) were collected from Chinese national adverse event following immunization information system (CNAEFIIS) to compare the safety of MPV-AC and MPV-ACYW135.
RESULTS
1376919 doses of booster immunization of meningococcal meningitis vaccine (MenV) in CIMSFIP were conducted in China Hangzhou from 2014 to 2019, with reported immunization coverage rates above 95%. The proportion of children using MPV-ACYW135 increased from 12.63% in 2014 to 29.45% in 2019. The incidence of AEFI of MPV-AC and MPV-ACYW135 were 49.75 per 100,000 and 45.44 per 100,000, respectively, without statistical difference.
CONCLUSION
Children in Hangzhou had high booster immunization of MenV coverage. The use amount and use rate of MPV-ACYW135 increased year by year, indicating more and more parents had chosen MPV-ACYW135 as an alternative to MPV-AC at their own expense for children. The use proportions of MPV-ACYW135 were different in urban, suburban and rural areas. Both MPV-AC and MPV-ACYW135 were safe for children.
Topics: Adolescent; Child; Child, Preschool; China; Humans; Immunization Programs; Immunization, Secondary; Infant; Meningitis, Meningococcal; Meningococcal Vaccines; Neisseria meningitidis; Retrospective Studies
PubMed: 34032806
DOI: 10.1371/journal.pone.0251567 -
The Journal of Infection Dec 2019The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a... (Review)
Review
The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.
Topics: Carrier State; Communicable Disease Control; Disease Outbreaks; Disease Transmission, Infectious; Europe, Eastern; Humans; Incidence; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Serogroup
PubMed: 31682877
DOI: 10.1016/j.jinf.2019.10.018 -
Expert Review of Vaccines 2024The epidemiology of invasive meningococcal disease (IMD), a rare but potentially fatal illness, is typically described as unpredictable and subject to sporadic outbreaks. (Review)
Review
INTRODUCTION
The epidemiology of invasive meningococcal disease (IMD), a rare but potentially fatal illness, is typically described as unpredictable and subject to sporadic outbreaks.
AREAS COVERED
Meningococcal epidemiology and vaccine use during the last ~ 200 years are examined within the context of meningococcal characterization and classification to guide future IMD prevention efforts.
EXPERT OPINION
Historical and contemporary data highlight the dynamic nature of meningococcal epidemiology, with continued emergence of hyperinvasive clones and affected regions. Recent shifts include global increases in serogroup W disease, meningococcal antimicrobial resistance (AMR), and meningococcal urethritis; additionally, unvaccinated populations have experienced disease resurgences following lifting of COVID-19 restrictions. Despite these changes, a close analysis of meningococcal epidemiology indicates consistent dominance of serogroups A, B, C, W, and Y and elevated IMD rates among infants and young children, adolescents/young adults, and older adults. Demonstrably effective vaccines against all 5 major disease-causing serogroups are available, and their prophylactic use represents a powerful weapon against IMD, including AMR. The World Health Organization's goal of defeating meningitis by the year 2030 demands broad protection against IMD, which in turn indicates an urgent need to expand meningococcal vaccination programs across major disease-causing serogroups and age-related risk groups.
Topics: Child; Infant; Adolescent; Young Adult; Humans; Child, Preschool; Aged; Neisseria meningitidis; Meningococcal Infections; Meningococcal Vaccines; Disease Outbreaks; Serogroup; Vaccines, Combined
PubMed: 38517733
DOI: 10.1080/14760584.2024.2329618 -
The Journal of Infection Dec 2020Serogroup B meningococci (MenB) remain a prominent cause of invasive meningococcal disease (IMD). The protein-based multicomponent 4CMenB and the bivalent MenB-FHbp are... (Review)
Review
Serogroup B meningococci (MenB) remain a prominent cause of invasive meningococcal disease (IMD). The protein-based multicomponent 4CMenB and the bivalent MenB-FHbp are the only currently available vaccines against MenB-caused IMD. Efficacy studies are not possible, due to the low incidence of IMD. Therefore, the vaccines' immunogenicity has been evaluated against several target strains chosen to quantify complement-mediated killing induced by each vaccine component in the serum bactericidal antibody assay. However, due to the wide genetic diversity and different expression levels of vaccine antigens across MenB strains, vaccine performance may differ from one strain to another. Here, we review the methods used to predict MenB strain coverage for 4CMenB and MenB-FHbp. Phenotypic assays such as the meningococcal antigen typing system (MATS, 4CMenB-specific) and the flow cytometric meningococcal antigen surface expression assay (MEASURE; MenB-FHbp-specific) were developed. Genomic approaches are also available, such as genetic MATS (gMATS) and the Bexsero antigen sequence type (BAST) scheme, both 4CMenB-specific. All methods allow tentative predictions of coverage across MenB strains, including that afforded by each vaccine antigen, and are rapid and reproducible. Real-world data on vaccine effectiveness are needed to confirm predictions obtained by these methods.
Topics: Antigens, Bacterial; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; Serogroup
PubMed: 32745637
DOI: 10.1016/j.jinf.2020.07.034 -
Expert Review of Vaccines Jun 2022Recombinant surface protein meningococcal serogroup B (MenB) vaccines are available but with different antigen compositions, leading to differences between vaccines in... (Review)
Review
INTRODUCTION
Recombinant surface protein meningococcal serogroup B (MenB) vaccines are available but with different antigen compositions, leading to differences between vaccines in their immunogenicity and likely breadth of coverage. The serology and breadth of coverage assessment for MenB vaccines are multifaceted areas, and a comprehensive understanding of these complexities is required to appropriately compare licensed vaccines and those under development.
AREAS COVERED
In the first of two companion papers that comprehensively review the serology and breadth of coverage assessment for MenB vaccines, the history of early meningococcal vaccines is considered in this narrative review to identify transferable lessons applicable to the currently licensed MenB vaccines and those under development, as well as their serology.
EXPERT OPINION
Understanding correlates of protection and the breadth of coverage assessment for meningococcal surface protein vaccines is significantly more complex than that for capsular polysaccharide vaccines. Determination and understanding of the breadth of coverage of surface protein vaccines are clinically important and unique to each vaccine formulation. It is essential to estimate the proportion of MenB cases that are preventable by a specific vaccine to assess its overall potential impact and to compare the benefits and limitations of different vaccines in preventing invasive meningococcal disease.
Topics: Antigens, Bacterial; Humans; Membrane Proteins; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B
PubMed: 34287103
DOI: 10.1080/14760584.2021.1940144 -
Human Vaccines & Immunotherapeutics Aug 2023Affordable, polyvalent meningococcal vaccines are needed for use in emergency reactive immunization campaigns. A phase IV randomized, observer-blind, controlled study... (Randomized Controlled Trial)
Randomized Controlled Trial
Safety and immunogenicity of quadrivalent meningococcal polysaccharide vaccine (MPV ACYW135) compared with quadrivalent meningococcal conjugate vaccine (Menactra®) in Malian children.
Affordable, polyvalent meningococcal vaccines are needed for use in emergency reactive immunization campaigns. A phase IV randomized, observer-blind, controlled study compared the safety and immunogenicity of a quadrivalent meningococcal polysaccharide vaccine (MPV-4, MPV ACYW135) and quadrivalent meningococcal ACWY conjugate vaccine (MCV-4, Menactra®). Healthy, 2- to 10-year-old children in Bamako, Mali, were randomized 1:1 to receive one dose of MPV-4 or MCV-4. Safety outcomes were evaluated for 6 months post-immunization. Immunogenicity for all serogroups was assessed for non-inferiority between MPV-4 and MCV-4 30 days post immunization by serum bactericidal antibody assay using baby rabbit complement (rSBA). From December 2020 to July 2021, 260 healthy subjects were consented and randomized. At Day 30 post-immunization, the proportions of subjects with rSBA titers ≥ 128 for all serogroups in the MPV-4 group were non-inferior to those in MCV-4 group. The proportions of subjects with rSBA ≥ 4-fold increase and rSBA titers ≥ 8 for all serogroups were similar among vaccine groups ( > .05). Geometric Mean Titers and Geometric Mean Fold Increases for all serogroups in both vaccine groups were similar ( > .05). Few local and systemic post-immunization reactions of similar severity and duration were observed within 7 days and were similar in both groups ( > .05). All resolved without sequelae. Unsolicited adverse events were similar in both groups regarding relationship to study vaccine, severity and duration. No serious adverse events were reported during the study period. MPV ACYW135 showed a non-inferior immunogenicity profile and a comparable reactogenicity profile to MCV-4 in Malian children aged 2-10 years.: NCT04450498.
Topics: Humans; Meningococcal Vaccines; Vaccines, Conjugate; Neisseria meningitidis; Vaccination; Serogroup; Antibodies, Bacterial; Meningococcal Infections
PubMed: 37401618
DOI: 10.1080/21645515.2023.2230829 -
Expert Review of Vaccines Oct 2021Species of the genus are important global pathogens. (gonococcus) causes the sexually transmitted disease gonorrhea and (meningococcus) causes meningitis and sepsis.... (Review)
Review
INTRODUCTION
Species of the genus are important global pathogens. (gonococcus) causes the sexually transmitted disease gonorrhea and (meningococcus) causes meningitis and sepsis. Liposomes are self-assembled spheres of phospholipid bilayers enclosing a central aqueous space, and they have attracted much interest and use as a delivery vehicle for vaccine antigens.
AREAS COVERED
A brief background on infections and the success of licensed meningococcal vaccines are provided. The absence of a gonococcal vaccine is highlighted. The use of liposomes for delivering antigens and adjuvants, for the purposes of generating specific immune responses, is reviewed. The use of other lipid-based systems for antigen and adjuvant delivery is examined briefly.
EXPERT OPINION
With renewed interest in developing a gonococcal vaccine, liposomes remain an attractive option for delivering antigens. The discipline of nanotechnology provides additional nanoparticle-based options for gonococcal vaccine development. Future work would be needed to tailor the composition of liposomes and other nanoparticles to the specific vaccine antigen(s), in order to generate optimal anti-gonococcal immune responses. The potential use of liposomes and other nanoparticles to deliver anti-gonococcal compounds to treat infections also should be explored further.
Topics: Gonorrhea; Humans; Liposomes; Meningococcal Vaccines; Neisseria; Neisseria gonorrhoeae; Neisseria meningitidis
PubMed: 34524062
DOI: 10.1080/14760584.2021.1981865 -
Journal of Epidemiology and Global... Sep 2019Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in...
Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. As such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. The 2019 annual Hajj will take place during August 8-13, 2019. Thus, we review the recommended and mandated vaccinations for the 2019 Hajj and Umrah. The mandatory vaccines required to secure the visa include the quadrivalent meningococcal vaccine for all pilgrims, while yellow fever, and poliomyelitis vaccines are required for pilgrims coming from countries endemic or with disease activity. The recommended vaccines are influenza, pneumococcal, in addition to full compliance with basic vaccines for all pilgrims against diphtheria, tetanus, pertussis, polio, measles, and mumps. It is imperative to continue surveillance for the spread of antimicrobial resistance and occurrence of all infectious diseases causing outbreaks across the globe in the last year, like Zika virus, MDR-Typhoid, Nipah, Ebola, cholera, chikungunya and Middle East Respiratory Syndrome Coronavirus.
Topics: Guidelines as Topic; Humans; Islam; Mass Vaccination; Meningococcal Vaccines; Pneumococcal Vaccines; Saudi Arabia; Travel
PubMed: 31529930
DOI: 10.2991/jegh.k.190705.001 -
Expert Review of Vaccines 2023causes invasive meningococcal disease and, globally, significant morbidity, with serogroup B (MenB) being the most common cause of endemic disease and outbreaks in... (Review)
Review
INTRODUCTION
causes invasive meningococcal disease and, globally, significant morbidity, with serogroup B (MenB) being the most common cause of endemic disease and outbreaks in several regions. Extensive use of the four-component serogroup B meningococcal vaccine (4CMenB; Bexsero, GSK) and its inclusion in immunization programs in several countries have generated substantial safety data during the 9 years since its first authorization in 2013.
AREAS COVERED
4CMenB safety data from clinical trials and post-marketing surveillance studies (2011 to 2022), and spontaneously reported adverse events of medical interest from the GSK global safety database. We discuss these safety findings in relation to the benefit of 4CMenB vaccination and implications for further enhancing vaccine confidence.
EXPERT OPINION
4CMenB has been consistently well tolerated across clinical trials and post-licensure surveillance studies, despite a higher incidence of fever reported in infants than with other pediatric vaccines. Surveillance data have not identified any significant safety issues, consistent with an acceptable safety profile of 4CMenB. These findings highlight the need to balance the risk of relatively common, transient, post-immunization fever with the benefit of affording protection that reduces the risk of uncommon but potentially fatal meningococcal infection.
Topics: Infant; Child; Humans; Meningococcal Infections; Meningococcal Vaccines; Serogroup; Neisseria meningitidis, Serogroup B; Neisseria meningitidis
PubMed: 37278390
DOI: 10.1080/14760584.2023.2222015