Serogroup A meningococcal conjugate (PsA-TT) vaccine coverage and measles vaccine coverage in Burkina Faso—Implications for introduction of PsA-TT into the Expanded Programme on Immunization

Abstract

Background A new serogroup A meningococcal conjugate vaccine (PsA-TT, MenAfriVac™) has been developed to combat devastating serogroup A Neisseria meningitis (MenA) epidemics in Africa. A mass immunization campaign targeting 1–29 year olds was conducted in Burkina Faso in December 2010. Protection of subsequent infant cohorts will be necessary through either introduction of PsA-TT into the routine Expanded Programme on Immunization (EPI) or periodic repeat mass vaccination campaigns. Objectives To inform future immunization policy for PsA-TT vaccination of infants through a comparison of PsA-TT campaign vaccination coverage and routine measles-containing vaccine (MCV) coverage in Burkina Faso. Methods A national survey was conducted in Burkina Faso during December 17–27, 2011 using stratified cluster sampling to assess PsA-TT vaccine coverage achieved by the 2010 nationwide immunization campaign among 2–30 year olds and routine MCV coverage among 12–23 month olds. Coverage estimates and 95% Confidence Intervals (CI) were calculated, reasons for non-vaccination and methods of campaign communication were described, and a multivariable analysis for factors associated with vaccination was conducted. Results National overall PsA-TT campaign coverage was 95.9% (95% CI: 95.0–96.7) with coverage greater than 90% all 13 regions of Burkina Faso. National overall routine MCV coverage was 92.5% (95% CI: 90.5–94.1), but ranged from 75.3% to 95.3% by region. The primary predictor for PsA-TT vaccination among all age groups was a head of household informed of the campaign. PsA-TT vaccination was more likely in residents of rural settings, whereas MCV vaccination was more likely in residents of urban settings. Conclusion Overall national vaccination rates in Burkina Faso were similar for PsA-TT and MCV vaccine. The regions with MCV coverage below targets may be at risk for sub-optimal vaccination coverage if PsA-TT is introduced in EPI. These results highlight the need for assessments of routine vaccination coverage to guide PsA-TT immunization policy in meningitis belt countries.

Cost-Effectiveness of Alternative Uses of Polyvalent Meningococcal Vaccines in Niger: An Agent-Based Transmission Modeling Study

“…Figure 3, Figure 5 and Figure S9 show that trajectories generated by our model also match other key properties of meningococcal epidemics in Niger (e.g., age-distribution of cases, age-specific carriage prevalence, average weekly meningococcal incidence at national and district level, and number of districts in each year between 2002-2015 where the threshold of 10 meningitis cases per 100,000 population is exceeded). Table 3 Table 3 Age 5+ years [3][4][5] years [29,57] PMC [10][11][12][13][14][15][16][17][18][19][20] years [39,55] Delay between administration of vaccine and the establishment of immunity PMP or PMC 2 weeks [58] Vaccine uptake Routine # 80%-90% [59] Reactive and Preventive (within 10 days) 90%-100% [60][61][62] PMC: Polyvalent meningococcal conjugate; PMP: Polyvalent meningococcal polysaccharide. * These parameters are sampled for each individual in a simulated trajectory.…”

Introduction and Rollout of a New Group A Meningococcal Conjugate Vaccine (PsA-TT) in African Meningitis Belt Countries, 2010–2014

“… Source: World Health Organization Inter-country Support Team report on PsA-TT campaigns (meningvax.org). a Regional and weighted national PsA-TT vaccine coverage (95% confidence interval) [ 9 ]. …”

Serogroup A meningococcal conjugate vaccines in Africa

“…Administrative coverage may be reported as >100% because of inaccurate population size estimates and because some people >29 years might have received the vaccine [64]. Excellent vaccination coverage was generally obtained, but studies also showed that there were local variations between districts and also between villages in the same district [68,69].…”

“…Vaccine uptake was lower in the age group 15-29 years, but did not differ by gender. Another study from Burkina Faso showed that the primary predictor for MenAfriVac vaccination among all age groups was that the head of the household was informed of the campaign [69]. MVP reported highest vaccination coverage rates in the 1-4 age group and lowest rates in the 15-29 and the 5-14 age groups in Cameroon and Chad, respectively [58].…”

“…Tartof et al developed a mathematic model of serogroup A meningitis incidence in the meningitis belt and concluded that the most effective strategy was mass vaccination of 1-to 5-year-old children every 5 years, and that introducing the vaccine in EPI programs at 9 months of age was less effective [85]. Overall vaccination coverage in Burkina Faso after MenAfriVac mass vaccination was comparable to that attained for routine measles vaccination, but regions with suboptimal vaccination coverage for measles might also be at risk for coverage below targets if MenAfriVac is introduced in EPI [69].…”