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[B 群脑膜炎球菌:通过接种疫苗控制两起疫情]

[Meningococcus B: control of two outbreaks by vaccination].

作者信息

Gabutti G

出版信息

J Prev Med Hyg. 2014 Jun;55(2):35-41.

Abstract

The issue of an effective vaccine against Meningococcus B (MenB) has been overcome by identifying, with the "reverse vaccinology" methodology, some antigens able of inducing a response to the majority of MenB strains circulating in the world. The new 4-components MenB vaccine (4CMenB) has been approved in Europe, Australia and Canada, and included in international pediatric immunization schedules: Australia, Canada, UK. In Italy, the first regions that have recommended vaccination against MenB were Basilicata and Puglia. The management of epidemics/outbreaks requires the implementation of a rapid response by health authorities in respect of a medical emergency with a high impact, even emotional, on the population, as recently demonstrated in two American universities. The declaration of outbreak in place has been followed in both contexts by the adoption of a procedure for the use of the 4CMenB vaccine not yet licensed in the USA. It was thus possible to organize interventions of active prophylaxis in the two campuses, establishing the first large-scale use of the new 4CMenB vaccine and achieving, in a relatively short time, high rates of vaccination coverage. With around 14,000 students immunized with at least one dose, no safety issues have been reported following immunization. Besides, to date there have been no cases in subjects who have received the vaccine. As a result of the two outbreaks described, FDA is now evaluating for the extension of the use of the 4CMenB vaccine in adolescents and young adults in USA.

摘要

通过“反向疫苗学”方法识别出一些能够诱导针对世界上大多数流行的B型脑膜炎球菌(MenB)菌株产生反应的抗原,有效抗B型脑膜炎球菌疫苗的问题已得到解决。新型四组分B型脑膜炎球菌疫苗(4CMenB)已在欧洲、澳大利亚和加拿大获批,并被纳入澳大利亚、加拿大、英国的国际儿童免疫计划。在意大利,最早推荐接种B型脑膜炎球菌疫苗的地区是巴西利卡塔和普利亚。疫情/暴发的管理要求卫生当局针对对人群有重大影响(甚至是情感上的影响)的医疗紧急情况迅速做出反应,正如最近在美国两所大学所显示的那样。在这两种情况下,宣布发生疫情后,都采用了在美国尚未获批的4CMenB疫苗的使用程序。因此,有可能在两个校区组织主动预防干预措施,首次大规模使用新型4CMenB疫苗,并在相对较短的时间内实现了高疫苗接种覆盖率。约14000名学生至少接种了一剂疫苗,接种后未报告安全问题。此外,迄今为止,接种疫苗的人群中没有出现病例。由于上述两起疫情,美国食品药品监督管理局(FDA)目前正在评估在美国扩大4CMenB疫苗在青少年和年轻人中的使用范围。

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