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Assefa DG, Tesefaye T, Bekele E, Geberemickeal G, Mebratu A, Ejigu AG, Nigatu T, Zeleke ED. Active surveillance of immunization adverse effects: a multicentre, open-label, three-arm randomized uncontrolled trial in Ethiopia. Int Health 2024:ihae040. [PMID: 38828522 DOI: 10.1093/inthealth/ihae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/27/2024] [Accepted: 05/09/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Participant-centred active adverse event following immunization (AEFI) surveillance can offer real-time vaccine safety data and help in signal detection. This study aimed to evaluate the effectiveness of participant-centred active adverse events (AEs) surveillance following measles immunization in Gedeo Zone health facilities in Ethiopia. METHODS An open-label, multicentred, three-arm randomized uncontrolled trial was conducted from 1 June to 21 October 2023. After assessing enrolment eligibility, the study participants were randomized into three groups (short message service [SMS], telephone interview, and diary card). They were expected to report AEs in children 1 week after receiving immunization. Binary and multivariable logistic regression and χ2 tests were used to analyse the data. RESULTS Among the 396 participants randomized into the three groups, 80.8% (320 participants) reported back about their children's AE status. Participants in the telephone interview group exhibited a substantially superior response rate (93.2% of 132 participants; p<0.00001) compared with the SMS (71.2%) and diary card (78%) groups. The likelihood of reporting the status of AEs experienced by children was lower by 77% (adjusted odds ratio 0.23 [95% confidence interval 0.1 to 0.52], p-value <0.00001) in the diary card group compared with the telephone interview group. CONCLUSIONS In this study, a telephone interview was found to be the best method for AEFI reporting. Participant-centred active AE surveillance could potentially permit more rapid identification of emerging safety signals. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05803538.
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Affiliation(s)
- Dawit Getachew Assefa
- Department of Nursing, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Tizalegn Tesefaye
- Department of Public Health, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Etaferaw Bekele
- Department of Nursing, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Genet Geberemickeal
- Department of Nursing, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Andualem Mebratu
- Department of Midwifery, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Aschalew Gossaye Ejigu
- Department of Nursing, College of Health Science and Medicine, P.O. Box 419, Dilla University, Dilla, Ethiopia
| | - Tariku Nigatu
- Digital Health Activity, John Snow, Inc., Boston, MA, USA
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Zeleke ED, Yimer G, Lisanework L, Chen RT, Huang WT, Wang SH, Bennett SD, Makonnen E. System and facility readiness assessment for conducting active surveillance of adverse events following immunization in Addis Ababa, Ethiopia. Int Health 2023; 15:676-683. [PMID: 36622733 PMCID: PMC10472974 DOI: 10.1093/inthealth/ihac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/02/2022] [Accepted: 12/17/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To help distinguish vaccine-related adverse events following immunization (AEFI) from coincidental occurrences, active vaccine pharmacovigilance (VP) prospective surveillance programs are needed. From February to May 2021, we assessed the system and facility readiness for implementing active AEFI VP surveillance in Addis Ababa, Ethiopia. METHODS Selected hospitals were assessed using a readiness assessment tool with scoring measures. The site assessment was conducted via in-person interviews within the specific departments in each hospital. We evaluated the system readiness with a desk review of AEFI guidelines, Expanded Program for Immunization Guidelines and Ethiopian Food and Drug Administration and Ethiopian Public Health Institute websites. RESULTS Of the hospitals in Addis Ababa, 23.1% met the criteria for our site assessment. During the system readiness assessment, we found that essential components were in place. However, rules, regulations and proclamations pertaining to AEFI surveillance were absent. Based on the tool, the three hospitals (A, B and C) scored 60.6% (94/155), 48.3% (75/155) and 40% (62/155), respectively. CONCLUSIONS Only one of three hospitals assessed in our evaluation scored >50% for readiness to implement active AEFI surveillance. We also identified the following areas for improvement to ensure successful implementation: training, making guidelines and reporting forms available and ensuring a system that accommodates paper-based and electronic-based recording systems.
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Affiliation(s)
- Eden Dagnachew Zeleke
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Midwifery, College of Health Science, Bule Hora University, Bule-Hora, Ethiopia
| | - Getnet Yimer
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Ohio State University, Global One Health Initiative, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Leuel Lisanework
- Ohio State University, Global One Health Initiative, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Robert T Chen
- Brighton Collaboration, Task Force for Global Health, Decatur, GA, USA
| | - Wan-Ting Huang
- Brighton Collaboration, Task Force for Global Health, Decatur, GA, USA
| | - Shu-Hua Wang
- Department of Internal Medicine, Division of Infectious Diseases, Ohio State University, N-1120 Doan Hall, 410 West 10th Ave, Columbus, OH 43210, USA
- Ohio State University Global One Health Initiative, N-1120 Doan Hall, 410 West 10th Ave, Columbus, OH 43210, USA
| | - Sarah D Bennett
- Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop H24-2, Atlanta, GA 30333, USA
| | - Eyasu Makonnen
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacology and Clinical Pharmacy, College of Health sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Nie X, Xu L, Bai Y, Liu Z, Liu Z, Farrington P, Zhan S. Self-controlled case series design in vaccine safety: a systematic review. Expert Rev Vaccines 2021; 21:313-324. [PMID: 34937500 DOI: 10.1080/14760584.2022.2020108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND : An increasing number of vaccine safety studies using the self-controlled case-series (SCCS) design have been conducted in the last decade. However, there has been no comprehensive evaluation of the methodology and reporting quality of these observational studies. The purpose of this paper is to document the methodological features of studies that focused on vaccine safety using the SCCS design, and to evaluate the reporting quality of these studies to suggest future improvements on appropriate design and transparent reporting. METHODS : Databases including Medline, Embase, Web of Science, Scopus and Chinese databases were searched from inception to May 31, 2021. All observational studies regarding vaccine safety using a SCCS design were selected. Information regarding methodological elements were extracted. In addition, reporting quality was assessed using the REporting of studies Conducted using Observational Routinely collected health Data statement for PharmacoEpidemiology (RECORD-PE). RESULTS : Of the 105 studies identified, administrative databases were the main data source for vaccination records and adverse events following immunization (AEFI). 28 articles (27%) used multiple designs to verify the association, and the results obtained with the SCCS design were robust. The top three AEFI studied were intussusception, Guillain-Barré syndrome, and convulsions. Only 21 studies (20%) reported the approach for case validation by chart review. The healthy vaccinee effect was considered by 51studies (49%), with 16 of them (31%) using extended SCCS models to alleviate this effect. Overall, the reporting quality of included studies could be improved. CONCLUSIONS : This study systematically reviewed the methodology of studies regarding vaccine safety using a SCCS design and critically assessed their respective reporting quality. Case validation, the validity of assumptions for standard SCCS, and quality of reporting should be given more importance in future research projects.
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Affiliation(s)
- Xiaolu Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.,Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Yi Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zuoxiang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhike Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Paddy Farrington
- School of Mathematics and Statistics, The Open University, Milton Keynes MK7 6AA, UK
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.,Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
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4
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Thiel N, Selwyn C, Murphy G, Simpson S, Chakrabarti AC. Recommendations for acceleration of vaccine development and emergency use filings for COVID-19 leveraging lessons from the novel oral polio vaccine. NPJ Vaccines 2021; 6:63. [PMID: 33888722 PMCID: PMC8062661 DOI: 10.1038/s41541-021-00325-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/18/2021] [Indexed: 11/17/2022] Open
Abstract
A new oral polio vaccine, nOPV2, has become the first vaccine to pursue a WHO Emergency Use Listing. Many lessons were learned as part of the accelerated development plan and submission, which have been categorized under the following sections: regulatory, clinical development, chemistry manufacturing and controls, and post-deployment monitoring. Efforts were made to adapt findings from these studies to COVID-19 vaccine candidates. Specific concepts for accelerating COVID-19 vaccine development across multiple functional domains were also included. The goals of this effort were twofold: (1) to help familiarize vaccine developers with the EUL process; and (2) to provide general guidance for faster development and preparations for launch during the COVID-19 pandemic.
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Affiliation(s)
- Natalie Thiel
- University of Washington, School of Public Health, Seattle, WA, USA
| | - Casey Selwyn
- Bill & Melinda Gates Foundation, Seattle, WA, USA
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Idoko OT, Domingo C, Tapia MD, Sow SO, Geldmacher C, Saathoff E, Kampmann B. Serological Protection 5-6 Years Post Vaccination Against Yellow Fever in African Infants Vaccinated in Routine Programmes. Front Immunol 2020; 11:577751. [PMID: 33133096 PMCID: PMC7578390 DOI: 10.3389/fimmu.2020.577751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Although effective live attenuated yellow fever (YF) vaccines have been available for over 9 decades sporadic outbreaks continue to occur in endemic regions. These may be linked to several factors including epidemiological factors such as vector and intermediate host distribution or vaccine coverage and efficacy. The World Health Organization's research priorities include gathering systematic evidence around the potential need for booster vaccination with YF vaccine whether this follows full or fractional doses in children. Knowledge on the longevity of response to YF vaccine and the implications of this response needs to be consolidated to guide future vaccination policy. Methods: We measured anti-YF IgG by microneutralization assay in a group of 481 African infants who had received YF vaccine as part of routine EPI programmes, to explore serological protection from YF 5-6 years post YF vaccination, as well as the effect of co variates. Findings: Notably, 22.2% of the cohort had undetectable antibody concentrations, with another 7.5% revealing concentrations below the threshold of seropositivity of 0.5 IU/mL. Sex, season, country and time since vaccination did not affect the longevity of antibody concentration or having antibody concentrations above a defined threshold. Conclusion: Roughly 30% of children in this cohort did not demonstrate anti-yellow fever antibody concentrations above the defined threshold of protection, with 20% having no demonstrable antibody. Knowledge on the longevity of response to YF vaccine and the implications needs to be consolidated to guide future vaccination policy.
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Affiliation(s)
- Olubukola T. Idoko
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
- CIH Center for International Health, Medical Center of the University of Munich (Ludwig-Maximilians-Universität München), Munich, Germany
| | - Cristina Domingo
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Milagritos D. Tapia
- Centre pour le Développement des Vaccins, University of Maryland, Bamako, Mali
| | - Samba O. Sow
- Centre pour le Développement des Vaccins, University of Maryland, Bamako, Mali
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München Munich, Munich, Germany
- German Centre for Infection Research (Deutsches Zentrum für Infektionsforschung), Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München Munich, Munich, Germany
- German Centre for Infection Research (Deutsches Zentrum für Infektionsforschung), Munich, Germany
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Ateudjieu J, Stoll B, Bisseck AC, Tembei AM, Genton B. Safety profile of the meningococcal conjugate vaccine (Menafrivac™) in clinical trials and vaccination campaigns: a review of published studies. Hum Vaccin Immunother 2020; 16:1245-1259. [PMID: 31403358 DOI: 10.1080/21645515.2019.1652041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The study aimed to assess the capacity of AEFI surveillance during vaccination campaigns with the new conjugate meningitis vaccine (MenAfrivac). A systematic review of studies on MenAfrivac™ published in English during 2001-2016 was done.AEFIs incidence (I) was estimated and compared between MenAfrivac™ clinical trials and immunization campaigns using incidence difference (Id). Nine studies were included with an overall local AEFI I of 11,496/100,000 doses administered per week in clinical trials and 0.72/100,000 doses in immunization campaigns. An Id of 11,497.92 [11,497.91-11,497.93] and 17,243.20 [17,241.80-17,245.90] per 100,000 doses administered per week for overall local and systemic AEFI, respectively, were observed with highest from clinical trials. The incidence of AEFIs after MenAfrivac™ vaccination was far lower in campaigns than in clinical trial studies. Current capacity of AEFI surveillance during vaccination campaigns requires extensive re-assessment of its structure and capacity.
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Affiliation(s)
- Jerome Ateudjieu
- Department of Biomedical Sciences, Faculty of Sciences, University of Dschang , Dschang, Cameroon.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland.,Division of Health Operations Research, Ministry of Public Health , Nonthaburi, Cameroon
| | - Beat Stoll
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva , Geneva, Switzerland
| | - Anne Cecile Bisseck
- Division of Health Operations Research, Ministry of Public Health , Nonthaburi, Cameroon.,Faculty of Medicine, University of Yaounde 1 , Yaounde, Cameroon
| | - Ayok M Tembei
- Department of Research and Training, M.A. SANTE (Meileur Accès aux soins de santé) , Yaounde, Cameroon
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland.,Department of Ambulatory Care and Community Medicine-Infectious Disease Service, University Hospital , Lausanne, Switzerland
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7
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Torre C, Cary M, Borges FC, Ferreira PS, Alarcão J, Leufkens HG, Costa J, Martins AP. Intensive Monitoring Studies for Assessing Medicines: A Systematic Review. Front Med (Lausanne) 2019; 6:147. [PMID: 31380375 PMCID: PMC6659411 DOI: 10.3389/fmed.2019.00147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/12/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction: Intensive monitoring (IM) is one of the methods of post-marketing active surveillance based upon event monitoring, which has received interest in the current medicines regulatory landscape. For a specific period of time, IM involves primary data collection and is actively focused on gathering longitudinal information, mainly safety, since the first day of drug use. Objectives: To describe IM systems and studies' data published over 11-years period (2006–2016). Specifically, we reviewed study population/event surveillance, methodological approaches, limitations, and its applications in the real-world evidence generation data. Methods: We completed a systematic search of MEDLINE and EMBASE to identify studies published from 2006 to 2016, that used IM methodology. We extracted data using a standardized form and results were analyzed descriptively. The methodological quality of selected studies was assessed using the modified Downs and Black checklist. Results: From 1,400 screened citations, we identified 86 papers, corresponding to 69 different studies. Seventy percent of reviewed studies corresponded to established IM systems, of which, more than half were prescription event monitoring (PEM) and modified-PEM. Among non-established IM systems, vaccines were the most common studied drugs (n = 14). The median cohort size ranged from 488 (hospitals) to 10,479 (PEM) patients. Patients and caregivers were the event data source in 39.1% of studies. The mean overall quality score was similar between established and non-established IM. Conclusions: Over the study period, IM studies were implemented in 26 countries with different maturity levels of post-marketing surveillance systems. We identified two major limitations: only 20% of studies were conducted at hospital-level, which is a matter of concern, insofar as healthcare systems are facing a lack of access to new medicines at ambulatory care level. Additionally, IM access to data of drug exposure cohorts, either at identification or at follow-up stages, could somehow constitute a barrier, given the complexity of managerial, linkable, and privacy data issues.
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Affiliation(s)
- Carla Torre
- Centre for Health Evaluation and Research (CEFAR), National Association of Pharmacies, Lisbon, Portugal.,Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Maria Cary
- Centre for Health Evaluation and Research (CEFAR), National Association of Pharmacies, Lisbon, Portugal
| | - Fábio Cardoso Borges
- Department of Epidemiology and National Cancer Registry (RON), Portuguese Institute of Oncology, Francisco Gentil, E.P.E., Lisbon, Portugal
| | - Paula S Ferreira
- Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal.,Setubal and Santarem Regional Pharmacovigilance Unit, Lisbon, Portugal
| | - Joana Alarcão
- Faculty of Medicine, Center for Evidence-Based Medicine, University of Lisbon, Lisbon, Portugal
| | - Hubert G Leufkens
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - João Costa
- Faculty of Medicine, Center for Evidence-Based Medicine, University of Lisbon, Lisbon, Portugal.,Faculty of Medicine, Institute of Molecular Medicine and Laboratory of Clinical Pharmacology and Therapeutics, University of Lisbon, Lisbon, Portugal
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Cashman P, Macartney K, Khandaker G, King C, Gold M, Durrheim DN. Participant-centred active surveillance of adverse events following immunisation: a narrative review. Int Health 2017; 9:164-176. [PMID: 28582563 PMCID: PMC5881255 DOI: 10.1093/inthealth/ihx019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/24/2017] [Indexed: 11/14/2022] Open
Abstract
The importance of active, participant-centred monitoring of adverse events following immunisation (AEFI) is increasingly recognised as a valuable adjunct to traditional passive AEFI surveillance. The databases OVID Medline and OVID Embase were searched to identify all published articles referring to AEFI. Only studies which sought participant response after vaccination were included. A total of 6060 articles published since the year 2000 were identified. After the application of screening inclusion and exclusion criteria, 25 articles describing 23 post-marketing AEFI systems were identified. Most countries had a single system: Ghana, Japan, China, Korea, Netherlands, Singapore, Brazil, Cambodia, Sri Lanka, Turkey and Cameroon except the USA (2), Canada (4) and Australia (6). Data were collected from participants with and without AEFI in all studies reviewed with denominator data enabling AEFI rate calculations. All studies considered either a single vaccine or specified vaccines or were time limited except one Australian system, which provides continuous automated participant-centred active surveillance of all vaccines. Post-marketing surveillance systems using solicited patient feedback are emerging as a novel AEFI monitoring tool. A number of exploratory systems utilising e-technology have been developed and their potential for scaling up and application in low and middle income countries deserves further investigation.
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Affiliation(s)
- Patrick Cashman
- Hunter New England Population Health, Newcastle, Australia.,University of Newcastle, NSW, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Australia
| | - Gulam Khandaker
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Australia.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, Australia
| | - Michael Gold
- University of Adelaide, Discipline pf Paediatrics, Women's and Children's Health Network, Adelaide, Australia
| | - David N Durrheim
- Hunter New England Population Health, Newcastle, Australia.,Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
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Diomandé FVK, Yaméogo TM, Vannice KS, Preziosi MP, Viviani S, Ouandaogo CR, Keita M, Djingarey MH, Mbakuliyemo N, Akanmori BD, Sow SO, Zuber PLF. Lessons Learned From Enhancing Vaccine Pharmacovigilance Activities During PsA-TT Introduction in African Countries, 2010-2013. Clin Infect Dis 2016; 61 Suppl 5:S459-66. [PMID: 26553675 PMCID: PMC4639501 DOI: 10.1093/cid/civ599] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background. The rollout of the group A meningococcal vaccine, PsA-TT, in Africa's meningitis belt countries represented the first introduction of a vaccine specifically designed for this part of the world. During the first year alone, the number of people who received the vaccine through mass vaccination campaigns was several hundredfold higher than that of subjects who participated in the closely monitored clinical trials. Implementation of a system to identify rare but potentially serious vaccine reactions was therefore a high priority in the design and implementation of those campaigns. Methods. National authorities and their technical partners set up effective vaccine pharmacovigilance systems, including conducting active surveillance projects. Results. Implementation of national expert advisory groups to review serious adverse events following immunization in all countries and active monitoring of conditions of interest in 3 early-adopter countries did not identify particular concerns with the safety profile of PsA-TT, which had already provided tremendous public health benefits. Conclusions. Lessons learned from this experience will help to improve preparations for future vaccine introductions in resource-poor settings and capitalize on such efforts to advance vaccine safety systems in the future.
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Affiliation(s)
| | - Téné M Yaméogo
- Institut Supérieur des Sciences de la Santé, Université Polytechnique de Bobo-Dioulasso, Burkina Faso
| | - Kirsten S Vannice
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marie-Pierre Preziosi
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France Meningitis Vaccine Project, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Claude-Roger Ouandaogo
- Direction Générale de la Pharmacie du Médicament et des Laboratoire, Ministère de la santé, Ouagadougou, Burkina Faso
| | - Modibo Keita
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Mamoudou H Djingarey
- Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Nehemie Mbakuliyemo
- Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Bartholomew Dicky Akanmori
- Department of Immunization Vaccines and Emergency, World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Samba O Sow
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Patrick L F Zuber
- Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
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Assaf-Casals A, Dbaibo G. Meningococcal quadrivalent tetanus toxoid conjugate vaccine (MenACWY-TT, Nimenrix™): A review of its immunogenicity, safety, co-administration, and antibody persistence. Hum Vaccin Immunother 2016; 12:1825-37. [PMID: 26900984 DOI: 10.1080/21645515.2016.1143157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Meningococcal disease is a major cause of morbidity and mortality worldwide with reported epidemics and outbreaks in different parts of the world. Despite the availability of antimicrobial therapy, challenges remain in early recognition and prevention of disease. Several vaccines have been developed to date aiming at preventing disease spread. DISCUSSION MenACWY-TT (Nimenrix™) has been extensively studied for use in different age groups. Phase II and III randomized trials have demonstrated its immunogenicity when administered in children aged 1 year and older, adolescents and adults. It has an acceptable safety profile with minor adverse events comparable to other vaccines. Follow up studies have shown persistence of protective antibodies up to three years. MenACWY-TT was safely and effectively co-administered with different recommended vaccines. CONCLUSION MenACWY-TT is a safe and immunogenic vaccine that can be used to protect against these four serogroups in individuals older than 1 year of age.
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Affiliation(s)
- Aia Assaf-Casals
- a Department of Pediatrics and Adolescent Medicine , Center for Infectious Diseases Research, American University of Beirut , Beirut , Lebanon
| | - Ghassan Dbaibo
- a Department of Pediatrics and Adolescent Medicine , Center for Infectious Diseases Research, American University of Beirut , Beirut , Lebanon
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