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Meningococcal conjugate vaccines: optimizing global impact
Terranella A,Cohn A,Clark T
Infection and Drug Resistance , 2011,
Abstract: Andrew Terranella1,2, Amanda Cohn2, Thomas Clark2 1Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, 2Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA Abstract: Meningococcal conjugate vaccines have several advantages over polysaccharide vaccines, including the ability to induce greater antibody persistence, avidity, immunologic memory, and herd immunity. Since 1999, meningococcal conjugate vaccine programs have been established across the globe. Many of these vaccination programs have resulted in significant decline in meningococcal disease in several countries. Recent introduction of serogroup A conjugate vaccine in Africa offers the potential to eliminate meningococcal disease as a public health problem in Africa. However, the duration of immune response and the development of widespread herd immunity in the population remain important questions for meningococcal vaccine programs. Because of the unique epidemiology of meningococcal disease around the world, the optimal vaccination strategy for long-term disease prevention will vary by country. Keywords: conjugate vaccine, meningitis, meningococcal vaccine, meningococcal disease
Conjugate Meningococcal Vaccines Development: GSK Biologicals Experience  [PDF]
Jacqueline M. Miller,Narcisa Mesaros,Marie Van Der Wielen,Yaela Baine
Advances in Preventive Medicine , 2011, DOI: 10.4061/2011/846756
Abstract: Meningococcal diseases are serious threats to global health, and new vaccines specifically tailored to meet the age-related needs of various geographical areas are required. This paper focuses on the meningococcal conjugate vaccines developed by GSK Biologicals. Two combined conjugate vaccines were developed to help protect infants and young children in countries where the incidence of meningococcal serogroup C or serogroup C and Y disease is important: Hib-MenC-TT vaccine, which offers protection against Haemophilus influenzae type b and Neisseria meningitidis serogroup C diseases, is approved in several countries; and Hib-MenCY-TT vaccine, which adds N. meningitidis serogroup Y antigen, is currently in the final stages of development. Additionally, a tetravalent conjugate vaccine (MenACWY-TT) designed to help protect against four meningococcal serogroups is presently being evaluated for global use in all age groups. All of these vaccines were shown to be highly immunogenic and to have clinically acceptable safety profiles. 1. Introduction Invasive diseases caused by Neisseria meningitidis, of which meningitis and septicaemia are the most important, are serious threats to global health [1, 2]. Sporadic as well as endemic cases occur worldwide, and N. meningitidis is the only encapsulated bacterium known to cause large epidemics of bacterial meningitis [3, 4]. Notably, extensive meningococcal disease outbreaks comprising hundreds of thousands of cases occur cyclically in an area of Sub-Saharan Africa, also called the Meningitis Belt [5–8]. Overall, about 500,000 cases of meningococcal disease occur each year causing at least 50,000 deaths [9]. Meningococcal meningitis has a case-fatality rate of 5% to 10% in industrialised countries, which can reach 20% in the developing world [10, 11]. In addition, 12% to 19% of survivors develop long-term neurological sequelae [3, 7, 12–14]. While the highest case-fatality rate is observed among persons older than 65?years and generally decreases with lower age [10], the risk of meningococcal disease is highest in infants and young children with a secondary peak in incidence during adolescence and young adulthood [15]. N. meningitidis is a gram-negative encapsulated diplococcus that colonises the human nasopharynx, where it is usually carried asymptomatically [1]. Meningococci are transmitted through close contact via respiratory droplets [7]. In some cases, bacteria spread from the nasopharynx to nearby epithelial cells causing local invasion of tissue. If the meningococci reach the bloodstream, they may cause
Meningococcal conjugate vaccines: optimizing global impact
Terranella A, Cohn A, Clark T
Infection and Drug Resistance , 2011, DOI: http://dx.doi.org/10.2147/IDR.S21545
Abstract: ingococcal conjugate vaccines: optimizing global impact Review (2659) Total Article Views Authors: Terranella A, Cohn A, Clark T Published Date September 2011 Volume 2011:4 Pages 161 - 169 DOI: http://dx.doi.org/10.2147/IDR.S21545 Andrew Terranella1,2, Amanda Cohn2, Thomas Clark2 1Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, 2Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA Abstract: Meningococcal conjugate vaccines have several advantages over polysaccharide vaccines, including the ability to induce greater antibody persistence, avidity, immunologic memory, and herd immunity. Since 1999, meningococcal conjugate vaccine programs have been established across the globe. Many of these vaccination programs have resulted in significant decline in meningococcal disease in several countries. Recent introduction of serogroup A conjugate vaccine in Africa offers the potential to eliminate meningococcal disease as a public health problem in Africa. However, the duration of immune response and the development of widespread herd immunity in the population remain important questions for meningococcal vaccine programs. Because of the unique epidemiology of meningococcal disease around the world, the optimal vaccination strategy for long-term disease prevention will vary by country.
Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines  [PDF]
Luciano Cesar Pontes Azevedo, Cristiana M. Toscano, Ana Luiza Bierrenbach
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0064524
Abstract: Background Bacterial meningitis is associated with significant burden in Brazil. In 2010, both 10-valent pneumococcal conjugate vaccine and meningococcal capsular group C conjugate vaccine were introduced into the routine vaccination schedule. Haemophilus influenzae type b vaccine was previously introduced in 1999. This study presents trends in demographics, microbiological characteristics and seasonality patterns of bacterial meningitis cases in Brazil from 2000 to 2010. Methods and Findings All meningitis cases confirmed by clinical and/or laboratory criteria notified to the national information system for notifiable diseases between 2000 and 2010 were analyzed. Proportions of bacterial meningitis cases by demographic characteristics, criteria used for confirmation and etiology were calculated. We estimated disease rates per 100,000 population and trends for the study period, with emphasis on H. influenzae, N. meningitidis and S. pneumoniae cases. In the decade, 341,805 cases of meningitis were notified in Brazil. Of the 251,853 cases with defined etiology, 110,264 (43.8%) were due to bacterial meningitis (excluding tuberculosis). Of these, 34,997 (31.7%) were due to meningococcal disease. The incidence of bacterial meningitis significantly decreased from 3.1/100,000 population in 2000–2002 to 2.14/100,000 in 2009–2010 (p<0.01). Among cases of meningococcal disease, the proportion of those associated with group C increased from 41% in 2007 to 61.7% in 2010, while the proportion of group B disease progressively declined. Throughout the study period, an increased number of cases occurred during winter. Conclusions Despite the reduction in bacterial meningitis incidence during the last decade, it remains a significant healthcare issue in Brazil. Meningococcal disease is responsible for the majority of the cases with group C the most common capsular type. Our study demonstrates the appropriateness of introduction of meningococcal vaccination in Brazil. Furthermore, this study provides a baseline for future evaluation of the impact of the vaccines introduction in Brazil and changes in disease epidemiology.
Meeting the challenge: prevention of pneumococcal disease with conjugate vaccines
Echániz-Avilés,Irma Gabriela; Solórzano-Santos,Fortino;
Salud Pública de México , 2001, DOI: 10.1590/S0036-36342001000400012
Abstract: streptococcus pneumoniae is one of the leading causes of both invasive and noninvasive diseases in the pediatric population and continues to represent a significant public health burden worldwide. the increasing incidence of antibioticresistant strains of the pathogen has complicated treatment and management of the various pneumococcal disease manifestations. thus, the best management strategy may be the prevention of pneumococcal diseases through vaccination. although several pneumococcal conjugate vaccines have been clinically studied in infants and children, only a 7-valent conjugate vaccine (pncrm7; prevnar?/prevenar?) is currently approved for the prevention of invasive disease. vaccination with pncrm7 is safe and effective in infants and young children. routine vaccination with the conjugate vaccine could improve outcomes by safeguarding against the development of antibiotic-resistant strains of s. pneumoniae, thus simplifying the management of pneumococcal disease. additionally, the overall costs associated with the treatment of pneumococcal diseases could be substantially reduced, particularly in developing countries. the time has come for fully applying this new advancement against s. pneumoniae, to benefit the children of the world. the spanish version of this paper is available at: http://www.insp.mx/salud/index.html
Meeting the challenge: prevention of pneumococcal disease with conjugate vaccines  [cached]
Echániz-Avilés Irma Gabriela,Solórzano-Santos Fortino
Salud Pública de México , 2001,
Abstract: Streptococcus pneumoniae is one of the leading causes of both invasive and noninvasive diseases in the pediatric population and continues to represent a significant public health burden worldwide. The increasing incidence of antibioticresistant strains of the pathogen has complicated treatment and management of the various pneumococcal disease manifestations. Thus, the best management strategy may be the prevention of pneumococcal diseases through vaccination. Although several pneumococcal conjugate vaccines have been clinically studied in infants and children, only a 7-valent conjugate vaccine (PNCRM7; Prevnar /Prevenar ) is currently approved for the prevention of invasive disease. Vaccination with PNCRM7 is safe and effective in infants and young children. Routine vaccination with the conjugate vaccine could improve outcomes by safeguarding against the development of antibiotic-resistant strains of S. pneumoniae, thus simplifying the management of pneumococcal disease. Additionally, the overall costs associated with the treatment of pneumococcal diseases could be substantially reduced, particularly in developing countries. The time has come for fully applying this new advancement against S. pneumoniae, to benefit the children of the world. The Spanish version of this paper is available at: http://www.insp.mx/salud/index.html
Progress with new malaria vaccines
Webster,Daniel; Hill,Adrian V.S.;
Bulletin of the World Health Organization , 2003, DOI: 10.1590/S0042-96862003001200009
Abstract: malaria is a parasitic disease of major global health significance that causes an estimated 2.7 million deaths each year. in this review we describe the burden of malaria and discuss the complicated life cycle of plasmodium falciparum, the parasite responsible for most of the deaths from the disease, before reviewing the evidence that suggests that a malaria vaccine is an attainable goal. significant advances have recently been made in vaccine science, and we review new vaccine technologies and the evaluation of candidate malaria vaccines in human and animal studies worldwide. finally, we discuss the prospects for a malaria vaccine and the need for iterative vaccine development as well as potential hurdles to be overcome.
Progress with new malaria vaccines  [cached]
Webster Daniel,Hill Adrian V.S.
Bulletin of the World Health Organization , 2003,
Abstract: Malaria is a parasitic disease of major global health significance that causes an estimated 2.7 million deaths each year. In this review we describe the burden of malaria and discuss the complicated life cycle of Plasmodium falciparum, the parasite responsible for most of the deaths from the disease, before reviewing the evidence that suggests that a malaria vaccine is an attainable goal. Significant advances have recently been made in vaccine science, and we review new vaccine technologies and the evaluation of candidate malaria vaccines in human and animal studies worldwide. Finally, we discuss the prospects for a malaria vaccine and the need for iterative vaccine development as well as potential hurdles to be overcome.
Meningoccal Vaccines  [cached]
Erdal ?nce
Cocuk Enfeksiyon Dergisi , 2008,
Abstract: Neisseria meningitidis causes different types of clinical conditions. Among these meningococcemia and bacterial meningitis are the two most frequent and dangerous. These two forms are termed invasive meningococcal disease. For the countries where the Haemophilus influenzae and the pneumococcal vaccines are in the routine vaccination schedules, N. meningitidis has become the leading pathogen of bacterial meningitis and community acquired sepsis. Meningococcus is still sensitive to many of the routinely used antibiotics including the penicillins and antibiotic resistance is not a significant problem for the treatment of the disease. The mortality of invasive meningococcal disease is 10-14% and the morbidity is high with 11-19% of survivors having sequelae including neurological disability, severe scar tissue of the skin, hearing loss and limb loss. There are several types of vaccines available for N. meningitidis. However, currently, there is no vaccine available for use in early infancy which can provide long term protection for all serogroups that can cause disease,but research to produce a vaccine with these properties is ongoing. The meningococcal vaccines available now are either polysaccharide vaccines or conjugate vaccines. The polysaccharide vaccines are produced by purification of the polysaccharide in the capsule of the meningococcus. The conjugate vaccines are produced by conjugating the capsular polysaccharides with different proteins. Currently, monovalent, bivalent and tetravalent polysaccharide and conjugate vaccines for the serogroups A, C, Y and W-135 are available. The immunogenicity of the capsular polysaccharide of the serogroup B is low, therefore it has not been possible to develop a vaccine using the capsular polysaccharide of this serogroup.However, there is ongoing research to produce a vaccine for serogroup B using other structural proteins.
The New Generation of Meningococcal Conjugate Vaccines: Rationale and Global Potential  [PDF]
Jacqueline Miller,Jan Poolman,Dominique Boutriau
Vaccimonitor , 2009,
Abstract: The serogroup distribution of Neisseria meningitidis strains implicated in invasive disease varies geographicallyand temporally. Monovalent serogroup C conjugate vaccines have successfully reduced serogroup C disease in countries where they are used. However, combinations containing multiple serogroups are needed to fully address disease prevention. GlaxoSmithKline Biologicals’ combined serogroups C, Y and Haemophilus influenzae type b conjugate vaccine (Hib-MenCY-TT) has been shown to be immunogenic and well tolerated in infants. The novelHib-MenCY-TT vaccine has the potential to prevent approximately 90% of non-serogroup B disease in the US.Several manufacturers have investigated tetravalent ACWY conjugate vaccines. One ACWY conjugate vaccine has been licensed for use 2-55 year olds, but the immunogenicity in infants was reduced. Results of other ACWYvaccines using different protein conjugates have shown higher immunogenicity in infants. The next generation ofcombination meningococcal conjugate vaccines has potential to further reduce morbidity and mortality due to N.meningitidis, provided they are safe and immunogenic in infants and toddlers. A Hib-MenCY-TT vaccine could substantially reduce meningococcal disease in the US, while tetravalent ACWY conjugate vaccines have thepotential to provide coverage across age strata against four of the five major serotypes implicated in invasivemeningococcal disease.
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