Introduction strategy

Two-pronged approach includes mass vaccination and integration into existing programs

Our introduction strategy is two-pronged: mass-vaccinate to gain immediate benefits on a public health level and then integrate the vaccine into routine childhood vaccination programs.

Mass immunization campaigns

Comprehensive mass immunization campaigns of 1- to 29-year olds with a single dose of MenAfriVac™ are a cornerstone of the meningococcal A conjugate vaccine introduction plan. This strategy aims to strongly and immediately reduce bacterial carriage and transmission and thereby rapidly reduce disease-related morbidity and mortality rates. Because large population groups will be immunized in a short period of time, the benefits of immunization should be rapidly visible and considerable in terms of public health. If these mass campaigns are not conducted, the populations will not be protected against epidemics.

Protection of birth cohorts

After mass vaccination campaigns have been conducted among 1- to 29-year olds, the main challenge will be protecting birth cohorts throughout infancy. The strategy used will depend on the results obtained in the infant study currently taking place in Ghana and on Expanded Programme on Immunization (EPI) coverage rates in the involved countries.

• In countries where EPI coverage is high (>80% DTP3), MenAfriVac™could be integrated into the existing EPI calendar. Two schedules are being evaluated: a single dose during the second year of life or two doses at 14 weeks and 9 or 12 months (with measles or yellow fever).
• In countries where EPI coverage is low (<60% DTP3), follow-up single-dose campaigns targeting children aged 1 to 4 years could be organized every 5 years.

The plan is consistent with the WHO Global Immunization Strategy and Vision and will use the comprehensive multiyear planning process—a 3- to 5-year plan that outlines a country's immunization priorities, how they plan to integrate immunization activities, what the costs will be, what new vaccines they are planning to introduce, and how they will expand coverage. This work will require advocacy and a major public health commitment on the part of meningitis belt countries and donor agencies.

It is highly likely that a meningococcal A epidemic will occur at some time in the meningitis belt during the rollout of MenAfriVac™. It is therefore important that vaccine manufacturers maintain production of adequate stocks of polysaccharide vaccines during the next 10 years. The International Coordination Group (ICG) on Vaccine Provision for Epidemic Meningitis Control, which is currently managing emergency vaccine stockpiles, is working with vaccine manufacturers to ensure an adequate supply of polysaccharide vaccines until the threat of an epidemic is eliminated.   

Photo: Monique Berlier.