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Meningitis Vaccine Project

Reactive polysaccharide vaccination campaigns in 2009 in Niger and Nigeria targeted 7 million people and cost about US$15 million. Because immunity lasts only two or three years, countries soon find themselves having to repeat immunization.

Up until recently, early detection of meningitis and emergency, reactive mass vaccination campaigns targeting at-risk populations with polysaccharide vaccines were the only means to control meningitis epidemics. These interventions do not provide long-term protection to those at risk, are expensive, and deplete scarce resources in an already overstretched public health system.

In 2001, the Bill & Melinda Gates Foundation funded a partnership between the World Health Organization (WHO) and PATH to establish the Meningitis Vaccine Project (MVP) with a goal of eliminating meningococcal A meningitis epidemics in Africa. By 2009, MVP had developed and licensed a new tool to fight these epidemics—a novel meningococcal A conjugate vaccine (MACV/PsA–TT; MenAfriVac™ Serum Institute of India, Ltd). MACV was prequalified by WHO in June 2010 and first introduced in Burkina Faso, Mali and Niger during mass vaccination campaigns of persons 1through 29 years of age in December 2010. By 2015, more than 217 million eligible Africans in 15 countries had been immunized. Serogroup A meningococcal disease and carriage were immediately and substantially impacted by the introduction of this novel vaccine.1-5 Additional data are required to evaluate the long-term effectiveness of MACV across the meningitis belt and inform immunization policy decisions, including whether revaccination is necessary, which age groups should be targeted and at what intervals, and whether vaccines offering broader serogroup protection should be developed to prevent the emergence of new epidemic serogroups

A supplemental issue of Clinical Infectious Diseases published in November 2015, “The Meningitis Vaccine Project: The Development, Licensure, Introduction, and Impact of a New Group A Meningococcal Conjugate Vaccine for Africa.” summarizes the available impact data.

1. Diomande FV, Djingarey MH, Daugla DM, et al. Public health impact after the introduction of PsA-TT: The first 4 years. Clin Infect Dis. 2015;61 Suppl 5: S467–72.

2. Kristiansen PA, Diomande FV, Ba AK, et al. Impact of the serogroup A meningococcal conjugate vaccine, MenAfriVac, on carriage and herd immunity. Clin Infect Dis. 2013;56: 354–63.

3. Novak RT, Kambou JL, Diomande FV, et al. Serogroup A meningococcal conjugate vaccination in Burkina Faso: Analysis of national surveillance data. Lancet Infect Dis. 2012;12:757–64.

4. Sow SO, Okoko BJ, Diallo A, et al. Immunogenicity and safety of a meningococcal A conjugate vaccine in africans. N Engl J Med. 2011;364:2293–304.

5. Djingarey MH, Diomande FV, et al. Introduction and rollout of a new group A meningococcal conjugate vaccine (PsA-TT) in African meningitis belt countries, 2010-2014. Clin Infect Dis. 2015;61 Suppl 5:S434–41.