Meningococcemia future or investigational therapies: Difference between revisions
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<!--MenACWY vaccines were licensed on the basis of data regarding safety and short-term immunogenicity. However, immunogenicity data alone are insufficient to predict vaccine effectiveness and herd immunity effect, which depends largely on the ability of vaccine to alter transmission patterns. Multiple changes to the recommendations have been made since 2005 (Box 1); the effect of these changes needs to be monitored over time for their effectiveness and impact on disease to be assessed. | |||
Because serogroup B capsular polysaccharide is poorly immunogenic in humans, vaccine development for serogroup B N. meningitidis has focused on common proteins, including the outer membrane vessicles (OMV) of specific epidemic strains. Efficacy of OMV vaccines has been demonstrated among older children and adults but not among infants and young children, in whom rates of disease are highest (102–105). In addition, the variability in OMV strains causing endemic disease will likely limit their usefulness in the United States (106,107). | |||
Two vaccines developed to prevent serogroup B vaccine are in late-stage clinical development in the United States. A multicomponent serogroup B meningococcal vaccine (4CMenB), approved for use in Europe by the European Medicines Agency in January 2013, was developed by sequencing the meningococcal B genome and testing surface antigens for their ability to elicit an immunogenic response. Three novel antigens identified, factor-H binding protein (fHbp), Neisserial adhesion A (NadA), and Neisseria heparin binding antigen (NHBA), were combined with OMV from the New Zealand epidemic strain NZ98/254 (108). The second vaccine, bivalent recombinant lipoprotein 2086 vaccine, contains two families of the same protein, fHbp, as 4CMenB (109). When these vaccines are licensed, vaccines to prevent all five serogroups that cause most meningococcal disease worldwide will be available for the first time. However, extensive research is needed to understand better how to conduct optimal implementation of noncapsular based meningococcal vaccines. | |||
Although the signs and symptoms of meningococcal disease are frequently nonspecific, increasing awareness for meningococcal disease can result in earlier medical care-seeking behavior and improved clinical outcomes. In addition, educating adolescents and their parents about the benefits of receiving MenACWY is key to preventing a substantial number of cases of meningococcal disease. Finally, educating policy makers and the general public about the benefits of receiving MenACWY vaccine might improve vaccination coverage rates and substantially decrease the burden of meningococcal disease in the United States.--!> | |||
==References== | ==References== | ||
Revision as of 21:03, 19 November 2014
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