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São Paulo, Brazil

Harrison L.H.,University of Pittsburgh | Pelton S.I.,Boston University | Wilder-Smith A.,National University of Singapore | Holst J.,Norwegian Institute of Public Health | And 8 more authors.
Vaccine | Year: 2011

The Global Meningococcal Initiative (GMI) is composed of an international group of scientists, clinicians and public health officials with expertise in meningococcal immunology, epidemiology and prevention. The primary goal of the GMI is the promotion of the global prevention of invasive meningococcal disease through education and research. The GMI members reviewed global meningococcal disease epidemiology, immunization strategies, and research needs. Over the past decade, substantial advances in meningococcal vaccine development have occurred and much has been learned about prevention from countries that have incorporated meningococcal vaccines into their immunization programs. The burden of meningococcal disease is unknown for many parts of the world because of inadequate surveillance, which severely hampers evidence-based immunization policy. As the field of meningococcal vaccine development advances, global surveillance for meningococcal disease needs to be strengthened in many regions of the world. For countries with meningococcal vaccination policies, research on vaccine effectiveness and impact, including indirect effects, is crucial for informing policy decisions. Each country needs to tailor meningococcal vaccination policy according to individual country needs and knowledge of disease burden. Innovative approaches are needed to introduce and sustain meningococcal vaccination programs in resource-poor settings with a high incidence of meningococcal disease. © 2011.

Safadi M.A.P.,FCM da Santa Casa de Sao Paulo
Expert Review of Vaccines | Year: 2015

Despite the success of routine immunization programs against pertussis worldwide, control of the disease in young infants has never been achieved. The greatest risk of disease, hospitalization and death occur in infants, who are too young to have received the primary pertussis immunization course. Different interventions to provide indirect protection to infants were recommended, including vaccination programs with Tdap for adolescents, adults, postpartum women and household contacts of infants, but all of them failed to effectively control the disease in infants. Based on the successful experience of maternal tetanus vaccination, and more recently influenza vaccination, maternal Tdap vaccine has been universally recommended since 2011/2012 in several countries to prevent pertussis in infants. The recent publication of data on the uptake, safety and effectiveness of these programs, as well as impact on disease rates in infants is encouraging, anticipating the possibility to at last control pertussis in this vulnerable age group. © 2015 Informa UK, Ltd.

Vetter V.,Glaxosmithkline | Baxter R.,Kaiser Permanente | Denizer G.,Glaxosmithkline | Safadi M.A.P.,FCM da Santa Casa de Sao Paulo | And 3 more authors.
Expert Review of Vaccines | Year: 2016

Adolescents have the highest rates of meningococcal carriage and transmission. Interrupting the adolescent habitat in order to reduce carriage and transmission within adolescents and to other age groups could help to control meningococcal disease at a population level. Compared to immunization strategies restricted to young children, a strategy focused on adolescents may have more profound and long-lasting indirect impacts, and may be more cost effective. Despite challenges in reaching this age-group, experience with other vaccines show that high vaccine coverage of adolescents is attainable. © 2016 The Author(s). Published by Taylor & Francis

Safadi M.A.,FCM da Santa Casa de Sao Paulo | Bettinger J.A.,University of British Columbia | Maturana G.M.,Division de Planificacion Sanitaria | Enwere G.,Voltaire | Borrow R.,Public Health England
Expert Review of Vaccines | Year: 2015

Meningococcal disease is a major public health problem and immunization is considered the best strategy for prevention. The introduction of meningococcal C conjugate immunization schedules that targeted adolescents, with catch-up programs in several European countries, Australia and Canada proved to be highly effective, with dramatic reduction in the incidence of serogroup C disease, not only in vaccinated, but also in unvaccinated individuals. Meningococcal quadrivalent (A, C, W, Y) conjugate vaccines are now licensed and are being used in adolescent programs in North America and to control serogroup W disease in South America. In the African meningitis belt, a mass immunization campaign against serogroup A disease using a meningococcal A conjugate vaccine is now controlling the devastating epidemics of meningococcal disease. After introducing new immunization programs, it is of importance to maintain enhanced surveillance for a better understanding of the changing nature of disease epidemiology. This information is crucial for identifying optimal immunization policies. © 2014 Informa UK, Ltd.

Safadi M.A.P.,FCM da Santa Casa de Sao Paulo | O'Ryan M.,University of Chile | Valenzuela Bravo M.T.,University of Los Andes, Chile | Brandileone M.C.C.,Instituto Adolfo Lutz | And 7 more authors.
Vaccine | Year: 2015

The Global Meningococcal Initiative (GMI) was established in 2009 and comprises an international team of scientists, clinicians, and public health officials with expertise in meningococcal disease (MD). Its primary goal is to promote global prevention of MD through education, research, international cooperation, and developing recommendations that include decreasing the burden of severe disease. The group held its first roundtable meeting with experts from Latin American countries in 2011, and subsequently proposed several recommendations to reduce the regional burden of MD. A second roundtable meeting was convened with Latin American representatives in June 2013 to reassess MD epidemiology, vaccination strategies, and unmet needs in the region, as well as to update the earlier recommendations. Special emphasis was placed on the emergence and spread of serogroup W disease in Argentina and Chile, and the control measures put in place in Chile were a particular focus of discussions. The impact of routine meningococcal vaccination programs, notably in Brazil, was also evaluated. There have been considerable improvements in MD surveillance systems and diagnostic techniques in some countries (e.g., Brazil and Chile), but the lack of adequate infrastructure, trained personnel, and equipment/reagents remains a major barrier to progress in resource-poor countries. The Pan American Health Organization's Revolving Fund is likely to play an important role in improving access to meningococcal vaccines in Latin America. Additional innovative approaches are needed to redress the imbalance in expertise and resources between countries, and thereby improve the control of MD. In Latin America, the GMI recommends establishment of a detailed and comprehensive national/regional surveillance system, standardization of laboratory procedures, adoption of a uniform MD case definition, maintaining laboratory-based surveillance, replacement of polysaccharide vaccines with conjugate formulations (wherever possible), monitoring and evaluating implemented vaccination strategies, conducting cost-effectiveness studies, and developing specific recommendations for vaccination of high-risk groups. © 2015 Elsevier Ltd.

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