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New pentavalent vaccine promising for eliminating meningitis across Africa: NEJM
![New pentavalent vaccine promising for eliminating meningitis across Africa: NEJM New pentavalent vaccine promising for eliminating meningitis across Africa: NEJM](https://medicaldialogues.in/h-upload/2023/05/26/750x450_210499-vaccine.webp)
Gambia: A phase 3 trial showed a pentavalent vaccine against Neisseria meningitidis to be safe and effective among children and young adults in Africa's meningitis belt. Researchers did not report any safety concerns for the vaccine.
The new vaccine against meningococcal disease, a cause of blood poisoning and meningitis, was shown to be safe and induces a robust immune response across five strains of meningococcal bacteria: A, C, W, Y and X. The findings appeared in The New England Journal of Medicine (NEJM) on May 25, 2023.
A previous phase 2 trial showed that a single dose of NmCV-5 vaccine-elicited immune responses similar to those of MenACWY-D's two doses. The new trial showed the investigational vaccine-elicited immune responses to the four serotypes of the MenACWY-D vaccine and serogroup X, recently reported in Africa's meningitis belt. MenACWY-D is one of the three commercially available quadrivalent meningococcal conjugate vaccines.
There is a need for an effective, affordable, multivalent meningococcal conjugate vaccine to prevent epidemic meningitis in the African meningitis belt. Also, there is limited data on the immunogenicity and safety of NmCV-5, a pentavalent vaccine which targets the X, Y, W, C, and A serogroups. To fill this knowledge gap, Ed Clarke, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Gambia, and associates conducted a phase 3, noninferiority trial involving healthy 2-to-29-year-olds in Mali and Gambia.
One thousand eight hundred participants were randomly assigned in a ratio of 2:1 to receive a single intramuscular dose of NmCV-5 or the quadrivalent vaccine MenACWY-D. An immunogenicity assessment was done on day 28.
Based on the difference in the percentage of participants with seroresponse or geometric mean titer (GMT) ratios, the researchers assessed the noninferiority of NmCV-5 to MenACWY-D. A comparison was made between serogroup X responses in the NmCV-5 group and the lowest response among the MenACWY-D serogroups. A safety assessment was also done.
The study revealed the following findings:
- In the NmCV-5 group, the percentage of participants with a seroresponse ranged from 70.5% for serogroup A to 98.5% for serogroup W; the percentage with a serogroup X response was 97.2%.
- The overall difference between the two vaccines in seroresponse for the four shared serogroups ranged from 1.2 percentage points for serogroup W to 20.5 percentage points for serogroup A.
- The overall GMT ratios for the four shared serogroups ranged from 1.7 for serogroup A to 2.8 (98.98% CI, 2.3 to 3.5) for serogroup C. The serogroup X component of the NmCV-5 vaccine generated seroresponses and GMTs that met the prespecified noninferiority criteria.
- The incidence of systemic adverse events was similar in the two groups (11.1% in the NmCV-5 group and 9.2% in the MenACWY-D group).
"For all four serotypes in common with the MenACWY-D vaccine, the NmCV-5 vaccine-elicited immune responses noninferior to those elicited by the MenACWY-D vaccine," the researchers wrote. "NmCV-5 also elicited immune responses to serogroup X. No safety concerns were evident."
Reference:
Haidara et al, Meningococcal ACWYX Conjugate Vaccine in 2-to-29-Year-Olds in Mali and Gambia. New England Journal of Medicine. DOI: 10.1056/NEJMoa2214924
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751