Review of meningococcal vaccines with updates on immunization in adults

Abstract

Meningococcal disease is a serious and global life-threatening disease. Six serogroups (A, B, C, W-135, X, and Y) account for the majority of meningococcal disease worldwide. Meningococcal polysaccharide vaccines were introduced several decades ago and have led to the decline in the burden of disease. However, polysaccharide vaccines have several limitations, including poor immunogenicity in infants and toddlers, short-lived protection, lack of immunologic memory, negligible impact on nasopharyngeal carriage, and presence of hyporesponsiveness after repeated doses. The chemical conjugation of plain polysaccharide vaccines has the potential to overcome these drawbacks. Meningococcal conjugate vaccines include the quadrivalent vaccines (MenACWY-DT, MenACWY-CRM, and MenACWY-TT) as well as the monovalent A and C vaccines. These conjugate vaccines were shown to elicit strong immune response in adults. This review addresses the various aspects of meningococcal disease, the limitations posed by polysaccharide vaccines, the different conjugate vaccines with their immunogenicity and reactogenicity in adults, and the current recommendations in adults.

A Synthetic Disaccharide Analogue from Neisseria meningitidis A Capsular Polysaccharide Stimulates Immune Cell Responses and Induces Immunoglobulin G (IgG) Production in Mice When Protein-Conjugated

“…The solvent was evaporated to give a crude residue that was purified by flash-silica gel chromatography (MeOH/CHCl 3 2:8) affording 5 as a white foam (61 mg, 85%): 1 General Procedure for Squarate-Mediated Coupling of Oligomers 5−7 to Human Serum Albumin, HSA (8−10). To a solution of HSA (29.9 mg, 0.45 μM) in a borate buffer solution (190 μL, pH 9) was added the squarate ester-linked oligomer (5, 6, or 7) (9 μM) to form a 50 mM solution with respect to the squarate ester derivative.…”

Meningococcal quadrivalent tetanus toxoid conjugate vaccine (MenACWY-TT, Nimenrix™): A review of its immunogenicity, safety, co-administration, and antibody persistence

“…Epidemics occur mostly during winter and spring in temperate areas and during the dry season in tropical areas. 18 …”

“…MenACWY-DT is approved for use as a two-dose series for children aged 9-23 months (8 weeks apart) and as a single dose in people 2 to 55 years. 11,13,18 MenACWY-CRM (Menveo TM ), developed by Novartis Vaccines and recently acquired by GSK, was approved in February 2010 by the FDA for use in subjects 11 to 55 years of age. The next year, the covered age group extended to include individuals aged 2 to 55 years.…”

“…In August 2013, the ACIP extended its recommendations to infants aged 2 to 23 months who are considered at high risk for meningococcal disease. 11,13,18,36 However, both conjugate vaccines have not been licensed for use in children below 2 years in Europe, and both are not approved for single dosing in this age group. Table 1 illustrates the global distribution of the different meningococcal serogroups and their possible prevention by available vaccines.…”

Safety of a quadrivalent meningococcal conjugate vaccine in healthy subjects aged 9 months to 55 years in Vietnam

“…Despite improvements in meningococcal disease management, overall mortality rates remain at 8% to 14%, and devastating long‐term sequelae, such as amputations, hearing loss, and seizures, are seen in 11% to 19% of survivors . The disease is caused by Gram‐negative aerobic Neisseria meningitidis bacteria, which colonize the nasopharynx of around 10% of healthy adults and are transmitted by respiratory secretions . Of the at least 12 known meningococcal serogroups, six (A, B, C, W, X, and Y) cause almost all cases of the disease .…”