Meningococcal vaccine breakout

Breakout session: Meningococcal Vaccines

Break-out--Hepatitis B.pptx

What are the different serotypes prevalent globally?

Epidemiology in India

• IAPCOI does not recommend meningococcal vaccination to all children. It is recommended only for High risk individuals. What is the rationale of this?

• What is the epidemiology of meningococcal infections in India? A. Endemic B. SporadicC. Occurs only as outbreaksD. Sporadic with outbreaks

What are the various meningococcal vaccines available ?

Meningococcal Vaccines

Purified capsular polysaccharide vaccines

Bivalent vaccine against serogroups A and C

Quadrivalent vaccine for serogroups A,C, Y and W135

Protein-polysaccharide conjugate vaccines.

Three monovalent meningococcal C conjugate vaccines (Not

available in India)

Two quadrivalent conjugate vaccine (ACYW135) (Menactra

& Menveo--Not available in India)

Conjugate vaccines may be a better choice when

available in India

Why is there no vaccine against serogroup B at present?

What are target groups for routine meningococcal vaccination in India ?

IAPCOI- High Risk

• Age -children > 2 yrs (> 3 months if risk e.g. outbreaks/ contacts , children with terminal complement component deficiencies.

• Children with functional/ anatomic asplenia/ hyposplenia (vaccination 2 weeks prior to splenectomy)

• Laboratory personnel

• Travelers to Saudi Arabia for Haj

• Travelers to the African meningitis belt particularly between Dec to June

• Adjunct to chemoprophylaxis in close contacts

• Students going for study abroad

Scenario

• Many cases of Meningococcal meningitis reported from Delhi. How many cases make it an outbreak ?

• Should meningococcal vaccine be given to all the children? What is the role of meningococcal vaccine during outbreaks? Which vaccine can be used?

• What is the role of ‘mass chemoprophylaxis’ during an outbreak situation?

Case 1

• Nine-mo-old Ishan is hospitalized with meningitis and the doctors say it is meningococcal meningitis.

• Should his 4 y sister be administered meningococcal vaccine ?

Case 2

• Arnav is going for higher studies to Imperial University, London, UK. The university form asks if meningococcal vaccine has been administered.

• What vaccine should be given to him and how many doses?

• Can he take it just a day prior to his departure ?

Case 3

• Suhas, 8 years, has recently shifted to US with his parents. He has already received a dose of quadrivalent conjugate meningococcal vaccine one year earlier.

• Should he need to take another dose of the meningococcal vaccine?

• What are the current recommendations of CDC/ACIP on booster dose of conjugate meningococcal vaccines?

ACIP recommended schedule & interval

Case 4

• A concerned parent from Delhi visits your clinic and enquires about meningococcal disease, its seriousness and prevention in v/o death of his adolescent relative during Delhi epidemic in 2006-07

• How will you counsel him?

Case 5

• The parents of a 15 yrs old girl who came to you for HPV vaccination enquires about meningococcal vaccination since she is planning to go to a hostel in NE region, particularly in v/o a recently occurred mini-outbreak in Mizoram. She is also in constant contact with her 5 yrs old splenectomized brother.

• How will you counsel them?