New vaccine boosts hopes of eliminating meningitis

After a 13-year search, the World Health Organization (WHO) has prequalified the first meningitis conjugate vaccine —  MenFive®  — which aims to protect against five predominant causes of meningococcal meningitis in Africa.

A conjugate vaccine is a substance that is composed of a polysaccharide antigen fused (conjugated) to a carrier molecule, thus enhancing the stability and the effectiveness of the vaccine.

This comes after the Kenyan government launched a Meningitis-A vaccine campaign in 2019 at Lodwar County Referral Hospital targeting five counties (approximately three million people aged between 1 and 29 years) namely Turkana, Marsabit, Mandera, West Pokot and Wajir, which are considered to be at the highest risk of the infection since they border South Sudan, Ethiopia and Uganda, which lie within the Meningitis transmission belt.

 Meningococcal meningitis is a bacterial infection that sets in rapidly and can kill within hours. It can cause severe brain damage and sepsis leading to limb amputation and is fatal in 50 per cent of cases if untreated, according to WHO.

The bacteria is transmitted from person-to-person through droplets of respiratory or throat secretions from an infected person and symptoms include headache, stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.

At a severe stage, the infection may lead to severe disabilities such as paralysis, blindness and hearing loss.

WHO further highlights that anyone can contract meningococcal meningitis but children under age five—especially infants—are likely to suffer the most severe effects.

According to the global health regulator, the vaccine  which has   been developed through a 13-year collaboration between Serum Institute of India Pvt. Ltd. (SIIPL) and PATH, with crucial funding from the UK government’s Foreign, Commonwealth and Development Office,  protects against meningococcal serogroups A, C, W, Y and X. It is designed to eliminate annual meningitis outbreaks and epidemics in the African meningitis belt—a string of 26 countries from Senegal and Gambia in the west to Ethiopia in the east.

“MenFive® is approved by WHO for use in individuals between one  and 85 years of age and will initially be available for use in reactive vaccine campaigns for meningitis outbreaks,” PATH disclosed while further revealing that discussions are currently underway among WHO, its partners, and affected countries on the most effective strategy for controlling meningococcal meningitis with MenFive® through a combination of proactive vaccination campaigns and as a replacement for MenAfriVac® in the routine immunization schedule. 

It is also the only vaccine that prevents meningitis caused by meningococcal group X, a pathogen increasingly implicated in meningitis outbreaks in the continent.

In the recent past, polysaccharide vaccines have traditionally been used in response to African meningitis epidemics but they have limitations. They only provide short-term protection, don’t promote herd immunity and are not generally effective in infants and children younger than two years of age.

Conjugate vaccines provide better, longer lasting protection against meningococcal disease. 

Multivalent meningococcal conjugate vaccines that protect against serogroup A, C, W, and Y have been available on the global market for decades, but they aren’t affordable for meningitis belt countries to include in their meningitis prevention strategies—leaving 450 million people at risk of death or severe disability due to meningococcal disease.

This is why this WHO prequalification is important as it ensures the vaccine meets strict international quality, safety, and efficacy standards. 

“Meningococcal meningitis has long been a torment for meningitis belt countries,” Dr Nanthalile Mugala, PATH Africa Region Chief said.

 “The 2010 introduction of meningococcal A vaccine—which eliminated meningitis A epidemics from the African meningitis belt—was a landmark achievement that showed freedom from meningococcal meningitis was possible. But it was only the beginning of the story. With MenFive®, we now have the potential to finally end all meningococcal meningitis epidemics in Africa, once and for all, “the region chief assures.

  “MenFive® is a much-required medical intervention that will be available at an extremely affordable price,” says Dr Rajeev Dhere, executive director of SIIPL said.

“The prequalification of MenFive® represents a turning point for the African meningitis belt and a step forward in the global effort to defeat meningitis by 2030,” said Dr Bill Hausdorff, director of PATH’s meningitis vaccine development projects.

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