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New meningitis vaccine renews hope for African infants

By  Sola Ogundipe

SHORTLY after the Federal government adopted the inclusion of the Pneumococcal Conjugate Vaccine, PCV, into the National Programme on Immunisation protocol, the World Health Organisation, WHO, has approved the routine immunisation of infants with the MenAfricVac vaccine – an innovative and affordable meningitis vaccine in sub-Saharan Africa.

Making the announcement last week, the Meningitis Vaccine Project, MVP —a partnership between the global health nonprofit PATH and WHO—and Serum Institute of India Ltd, manufacturer of the MenAfriVac vaccine, said the stage has been set for the elimination of menigitis within the continent’s epidemic belt.

In a statement, Dr. Marie-Pierre Préziosi, Director of MVP, said: “Initial mass vaccination campaigns with MenAfriVac have been highly effective in reducing the number of meningitis A cases, but epidemics will return when rising numbers of unprotected newborns become a larger proportion of the total population over time. Now, with this decision, health officials will be able to ensure that population-wide protection is sustained by routinely immunising infants.”

Before the introduction of MenAfriVac, people living in countries of the meningitis belt, which stretches from Senegal in the west to Ethiopia in the east, were regularly struck by meningitis A epidemics in which sudden onset of symptoms could rapidly lead to death or permanent disability.

One of the most devastating outbreaks ever recorded was in 1996-1997, when an epidemic wave infected more than 250,000 people and killed over 25,000 in just a few months.

In 2004, MVP partnered with SIIL to develop an affordable, tailor-made vaccine for use against meningitis A in sub-Saharan Africa. MenAfriVac was developed in record time at less than a tenth the cost of a typical new vaccine. Since 2010, MenAfriVac has been administered to over 215 million people in the African meningitis belt including Benin, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Ethiopia, Ghana, Mali, Niger, Mauritania, Senegal, Sudan, Togo, The Gambia and Nigeria.

One year after large-scale vaccine introduction, experience from Burkina Faso provided early evidence that mass vaccination was associated with a significantly reduced risk of meningitis in the targeted population, as well as among the unvaccinated age groups, suggesting MenAfriVac induced “community” protection.

In parallel to the large-scale vaccination campaigns, clinical studies were designed and conducted to determine the safety, immunogenicity, and optimal dosage and immunisation schedule for administering the vaccine to infants and toddlers alongside other routine childhood vaccines in African meningitis belt countries.

Results from two infant clinical studies in Ghana and Mali and vaccine introduction impact data were presented to the WHO Strategic Advisory Group of Experts (SAGE) on Immunisation in October 2014, and these SAGE experts concluded that a one-dose schedule at nine months of age or older was recommended to achieve sustainable disease control following the initial mass campaigns in 1-29 year olds.

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