Guideline
Recommendations for the use of meningococcal vaccines in South Africa
Submitted: 14 May 2019 | Published: 01 October 2017
About the author(s)
Susan Meiring, Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, a division of the National Health Laboratory Services, Johannesburg, South AfricaGregory Hussey, Vaccines for Africa Initiative, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
Prakash Jeena, Department of Paediatrics, University of KwaZulu-Natal, Durban, South Africa
Salim Parker, General Practitioner, South African Society of Travel Medicine, Cape Town, South Africa
Anne von Gottberg, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a division of the National Health Laboratory Services, Johannesburg, South Africa
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Background: Although meningococcal disease (MD) incidence in South Africa is low, Neisseria meningitidis (NM) causes severe disease that is often life-threatening and can cause long-term disabilities. A quadrivalent protein-conjugated meningococcal vaccine (MCV4) is available, and provides protection against 75% of disease causing serogroups in South Africa.
Recommendations: We advise vaccination of persons at high risk of meningococcal disease including those with complement deficiency and asplenia; laboratory personnel from reference laboratories who work with NM; and travellers to Saudi Arabia. The need for routine vaccine against meningococcal disease in South Africa is controversial given the current burden of disease. However, due to the high morbidity/mortality of MD we recommend that clinicians consider vaccination of healthy infants and children; HIV-infected persons with a CD4 count > 25%; students attending college /university /military academies; and miners.
Conclusion: Protein-conjugated meningococcal vaccine is preferable to the polysaccharide vaccine given the ability of the protein-conjugated meningococcal vaccine to induce immune memory, allow for booster responses and eliminate carriage of the organism in the person vaccinated.
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