Diomandé Fabien V K, Yaméogo Téné M, Vannice Kirsten S, Preziosi Marie-Pierre, Viviani Simonetta, Ouandaogo Claude-Roger, Keita Modibo, Djingarey Mamoudou H, Mbakuliyemo Nehemie, Akanmori Bartholomew Dicky, Sow Samba O, Zuber Patrick L F
Centers for Disease Control and Prevention, Atlanta, Georgia.
Institut Supérieur des Sciences de la Santé, Université Polytechnique de Bobo-Dioulasso, Burkina Faso.
Clin Infect Dis. 2015 Nov 15;61 Suppl 5(Suppl 5):S459-66. doi: 10.1093/cid/civ599.
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.
National authorities and their technical partners set up effective vaccine pharmacovigilance systems, including conducting active surveillance projects.
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.
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.
A群脑膜炎球菌疫苗PsA-TT在非洲脑膜炎带国家的推广,是专门为世界这一地区设计的疫苗首次引入。仅在第一年,通过大规模疫苗接种运动接种该疫苗的人数就比参加密切监测的临床试验的受试者人数高出数百倍。因此,建立一个系统来识别罕见但可能严重的疫苗反应,是这些运动设计和实施中的高度优先事项。
国家当局及其技术伙伴建立了有效的疫苗药物警戒系统,包括开展主动监测项目。
各国成立国家专家咨询小组,以审查所有国家免疫接种后的严重不良事件,并对3个早期采用国家关注的情况进行主动监测,但未发现对PsA-TT安全性的特别担忧,该疫苗已带来了巨大的公共卫生效益。
从这一经验中吸取的教训将有助于改善在资源匮乏地区引入未来疫苗的准备工作,并利用此类努力在未来推进疫苗安全系统。