A new MenACWY conjugate vaccine manufactured by Novartis has been given the go ahead by the European commission. Menveo® was licensed in Europe for ages 11 to 55 on 15 March 2010.
The current MenACWY vaccine is a polysaccharide vaccine that provides protection for 3-5 years, is 80-90% effective in adults and less effective in children under 5. It is offered in the UK as a vaccine for people travelling to high risk destinations such as parts of Africa and pilgrims on Hajj or Umrah, are required to get vaccinated in order to enter Saudi Arabia.
The new vaccine is a breakthrough because as a conjugate vaccine it is likely to offer longer lasting protection than the current polysaccharide vaccine. In addition, unlike the polysaccharide vaccine it prevents carriage of the disease causing bacteria which will decrease the spread of disease. There is also very good evidence to show that it will protect younger children, so a licence for babies and children may not be too far away.
A question being raised at the moment is whether Menveo should have wider use in the UK than for travel. Many people think that in order to maintain immunity to MenC, we will need a teenage booster. Research has shown that conjugate vaccines provide longer lasting protection if a dose is given in the second year of life. However, after MenC vaccine was introduced in 1999, the routine immunisation schedule for babies did not include a dose of MenC vaccine beyond the age of one until 2006. The Hib/MenC booster was introduced to the schedule in 2006 for children aged 12 months, but many children born before 2006 did not receive a booster. The question of whether they will be sufficiently protected as teenagers has been raised, and this is important because teenagers run a higher risk of meningococcal disease than younger school-age children and older adults, and because carriage of meningococcal bacteria is highest in this age group. Making sure that teenagers are immune not only protects them, but reduces transmission to other vulnerable people. A current topic for debate is therefore whether or not teenagers should be offered a meningococcal booster. If so, we could take advantage of the wider protection Menveo offers, particularly for an age group that may be more likely to travel to countries where meningococcal A, W and Y disease is much more common than in the UK.
Read Professor Andrew Pollard and Dr Andrew Snape on "Do we need an extra dose of a meningococcal vaccine in adolescence in the UK"
1. Novartis Vaccines, SPC Menveo Group A, C, W135 and Y conjugate vaccine Summary of Product Characteristics, March 2010
2. GSK UK, ACWY Vax Vaccine Summary of Product Characteristics, August 2008.
3. Trotter CL, Andrews NJ, Kaczmarski EB, Miller E, Ramsay ME. Effectiveness of meningococcal serogroup C conjugate vaccine 4 years after introduction. The Lancet 2004;364:365-367
4. Pollard AJ, Perrett KP, Beverley PC. Maintaining protection against invasive bacteria with protein-polysaccharide conjugate vaccines. Nat Rev Immunol. 2009 Mar;9(3):213-20.
Posted in About meningitis & septicaemia by Claire Wright on 31 March 2010
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