Expert Comment – First country rolls out 5-in-1 vaccine against meningitis

To mark the beginning of World Immunization Week, LSHTM experts comment on the news that Nigeria has launched a campaign to administer the Men5CV vaccine
It is highly commendable to see Nigeria, my home country, taking the first step to roll out this vaccine as an outbreak response. Ama Umesi, research clinician, MRC Unit The Gambia at LSHTM

The rollout of Men5CV, a 5-in-1 vaccine to protect against five strains of meningitis, has started in Nigeria, according to an announcement made by the World Health Organization (WHO).

Meningitis is a serious infection that leads to inflammation of the membranes that surround and protect the brain and spinal cord. Although research has shown that the disease is largely preventable with proper vaccination, last year there was a 50% jump in annual meningitis cases reported across Africa.

A key trial of the Men5CV vaccine was conducted in June 2021 with 1,800 participants aged 2 to 29 years in Mali and The Gambia. The study was led by a group of researchers at the Medical Research Council Unit The Gambia (MRCG) at the London School of Hygiene & Tropical Medicine (LSHTM) and researchers from the Centre for Vaccine Development (CVD-Mali), in Bamako, Mali.

Results showed that the vaccine, developed by the Serum Institute of India with support from PATH and funding from the UK Department for International Development, induces a strong immune response with a single dose and protects against five strains of the meningococcus bacteria: A, C, W, Y and X. Bacterial meningitis, largely caused in Africa by infection with these strains of meningococcus, is the most serious and can result in septicaemia (blood poisoning), and seriously disable or kill within 24 hours.

The important data generated in this trial led to the WHO recommendation that all countries in the African Meningitis Belt, an area spanning from The Gambia and Senegal in West Africa, to Ethiopia in Eat Africa, should introduce the meningitis Men5CV vaccine into their routine immunisation programmes.

Health workers trained to administer the vaccine in Nigeria, one of the 26 meningitis hyper-endemic countries situated in the African Meningitis Belt, are aiming to reach one million people as part of the new immunisation campaign.

Professor Ed Clarke, co-author of the study from the Vaccines and Immunity Theme at MRC Unit The Gambia at LSHTM, said:

"It’s great to see, so soon after these key trial results and the subsequent recommendation by the WHO, that the Men5CV vaccine is being introduced in Nigeria, perhaps the highest priority country in the belt. There should be no misconception that this vaccine will save countless lives and prevent long term disability in Nigeria and elsewhere across the Meningitis Belt and beyond, as rollout continues.

"As we celebrate World Immunization Week, ensuring every child, including the most hard to reach and vulnerable in every country, gets the vaccines they need must remain a global priority."

Dr Ama Umesi, also a co-author of the study from MRC Unit The Gambia at LSHTM, said:

“I’m extremely proud to have been part of the research team that worked on the phase 3 trial of this vaccine at MRC The Gambia and to see first-hand how collaborative research influences global health policies.

“Epidemic preparedness is the way forward in providing available, affordable and accessible vaccines relevant to regions prone to meningitis outbreaks, and it is highly commendable to see Nigeria, my home country, taking the first step to roll out this vaccine as an outbreak response.

“Meningitis is a deadly disease with the ability to spread like wildfire in the event of an outbreak. As we work towards the goal of defeating meningitis by 2030, the recommendation by WHO for routine and outbreak meningitis immunisation campaigns came at the right time.

“Research is key and vaccination saves lives. Credit must go to the participants, communities, sponsors, institutions, governments, and stakeholders that have made this a reality.”

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