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In the last decade, the epidemiology of meningococcal infections in Switzerland and Europe has changed. The prevalence of Y and W serogroups augmented, with more atypical clinical manifestations such as pharyngitis, pneumonia and arthritis. A hypervirulent clonal serogroup W strain of Neisseria meningitidis has emerged in Europe and Switzerland, with a noticeable potential for epidemics as evidenced by its clonality. In this context, vaccinal recommendations for risk groups have and will continue to evolve towards the use of novel conjugated vaccines., Competing Interests: Les auteurs n’ont pas de conflit d’intérêts en lien avec cet article.

Meningococcal vaccines in france. In France in 2015, several vaccines against invasive meningococcal disease (IMD) are available: non-conjugated polysaccharide vaccines (bivalent AC and tetravalent ACYW135) conjugate vaccines (monovalent A monovalent C and quadrivalent ACYW135) and a novel multicomponent meningococcal B vaccine. These vaccines have a very satisfactory safety profile. Currently in France, universal vaccination against serogroup C meningococcal disease is recommended for all infants at the age of 12 months with catch up till the age of 24 years. Vaccination against IMD B and C are also recommended to persons with specific individual risk factors (mainly asplenia, complement deficiency, hematopoietic stem cells) or travel in endemic areas. Despite recommendations, vaccination coverage remains below recommended levels in most of the targeted populations., Competing Interests: S. Kernéis déclare avoir été prise en charge lors de congrès par Pfizer vaccins. H. Coulange-Bodilis déclare avoir été prise en charge lors de congrès par Pfizer vaccins. O. Launay déclare des interventions ponctuelles pour Pfizer, GSK et MSD et avoir été prise en charge lors de congrès par Pfizer et GSK.

Background: Sub-Saharan Africa countries suffer from repeated and explosive epidemics of meningitis mainly due to Neisseria meningitidis A. In December 2010, Burkina Faso organized a vaccination campaign with MenAfriVac® for people aged 1-29 years old. The objective of this study was to analyze the determinants of immunization coverage., Methods: We used a cross-sectional survey by cluster sampling in two stages, descriptive and analytical, conducted in the region of "Boucle du Mouhoun". Data were collected during a home interview. The dependent variable was vaccination status and the independent variables included individual and household characteristics but also the means of communication used during the campaign. A logistic regression model was used to estimate the risk of being vaccinated using the 'Survey' Package (SVYGLM) of R., Results: Two thousand and twenty-five people were included with a 93.5 % estimated coverage. Factors associated with high vaccination coverage are rural areas (ORa=2.53 [1.53-4.17]) and smaller households (ORa=3.06 [1.36-6.91]). The risk of being vaccinated was lower for persons from salaried heads of household (ORa=0.14 [0.02-0.87]) versus farmers, persons informed by religious and traditional leaders (ORa=0.25 [0.11-0.57]) or family and friends (ORa=0.51 [0.29-0.9]) versus community mobilizers., Conclusion: The coverage recorded is sufficient to provide community immunity. However, a part of the target population could not benefit from vaccination due to lack of information. Particular emphasis should be placed on large urban families using community mobilizers., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Two new glycoconjugate vaccines protecting against invasive diseases caused by 13 pneumococcal serotypes or 4 meningococcal serogroups will soon be available in Switzerland. They offer real new perspectives for young children, and for high-risk group adults. As their development is recent, the data one may wish to have is not yet fully available for each age and disease categories. This article attempts to delineate the interest of these new glycoconjugate vaccines and their limits. The additional information (and the answers to numerous expected questions) will be distributed to the 4300 subscribers of InfoVac (www.infovac. ch), which just celebrated its 10th birthday.

A new category of vaccination recommendation was introduced to increase the equity of the access to the information that relatively rare but severe diseases may be prevented by immunization. This decision was supported by the observation of a 2-level vaccination practice in Switzerland, reflected by the fact that children from paediatrician parents are better immunized than other children. The introduction of "additional recommended vaccinations" to the baseline immunizations should correct this inequity. In 2006, parents may choose to protect their children against meningitis and invasive diseases caused by pneumococcus or group C meningococcus. The challenge is now to inform parents about this new possibility of an optimal prevention, in addition to baseline immunizations.

Objective: In 2003, asplenia had involved 250000 patients in France. These patients are at risk of severe infection, mostly with capsulated bacteria as pneumococci, meningococci and Haemophilus. The higher mortality and morbidity due to infection in asplenic patient led in June 2003 a French expert committee to propose preventive management based on vaccination and antibioprophylaxis., Study Design: Update article., Data Synthesis: For vaccination, two vaccines against pneumococci are available. The first one, the antipolysaccharide (Pneumo 23) is recommended for adults. It is effective for the majority of the serotypes even if its efficacy can be variable. The second one a conjugated pneumococcal vaccine (Prenevar) is used for children under two years because it has higher activity on antibiotic resistant strains therefore increasing antibiotic prophylaxis efficiency. When splenectomy is required, vaccination against pneumococci, Haemophilus (b type) and C meningococci must be performed at least 15 days before surgery, in order to get better immune stimulation. In case of emergency, vaccines have to be administrated within 30 days after surgery. Antibioprophylaxis is based on cefazolin injection before splenectomy and by postoperative intravenous amoxicillin administration. As soon as oral intake is allowed, antibioprophylaxis is continued for at least two years in adults and five years in children. Both antibiotic and vaccination have been reported to reduce pneumococcus infections.

Background: In October 2002, the Midi-Pyrenees centre of pharmacovigilance (Southwest of France) was in charge of an extensive pharmacovigilance follow-up of a campaign of meningococcal serogroup C vaccination performed in the Hautes-Pyrénées area., Objective: The purpose of this study was to evaluate the incidence, nature and seriousness of adverse drug reactions (ADRs) occurring during the 15 days after vaccination., Methods: 'Immediate' and 'late' ADRs were recorded., Results: Local immediate ADRs were mainly nonserious local or inflammatory responses with a favourable evolution. General immediate ADRs occurred in 198 subjects and were principally neurological in nature (54%, mainly headache). Moreover, 1529 subjects suffered from general late ADRs (i.e. general health status or neurological [headache] ADRs [41%]). The incidence of ADRs leading to hospitalisation or medical consultation was defined as 'very rare' (0.1% led to consultation and 0.03% to hospitalisation)., Conclusion: These results underline that most of the ADRs occurring during the 15 days after meningococcal serogroup C vaccination were benign. This study shows that the methods used in France for pharmacovigilance studies of drugs can also be used for vaccines, especially for an intensive and prospective survey. Further pharmacoepidemiological studies could be used after the pharmacovigilance survey to investigate the benefit/risk ratio in large populations.

Neisseria meningitidis can cause asymptomatic carriage, followed by acquired immunity, or septicaemia, meningitis, septic arthritis or pericarditis. Vaccination induces protective bactericidal antibodies to invasive diseases. Meningococcal capsular polysaccharides are immunoprotective antigens from which vaccines are produced against serogroups A, C, Y and W135, including conjugate vaccines against serogroup C. There is no available vaccine against serogroup B, but outermembrane protein-based vaccines against this serogroup are currently being evaluated. Polysaccharide meningococcal vaccines are effective, but their strictly serogroup-specific efficacy raises concerns about the possible selection of escape variants. Therefore, meningococcal polysaccharide vaccines, either plain or conjugated, are indicated against the clonal expansion of strains whose serogroup has been properly identified and corresponds to the vaccine valence.

Two kinds of meningococcal vaccines are available for invasive meningococcal infections (IMI) prevention, non conjugated polysaccharide vaccines anti A+C or anti A+C+W135+Y and conjugated polysaccharide vaccines anti-C. The last one have the advantage of being effective from 2 months of age. Vaccination should to be used in four circumstances: for subjects remaining in close contact with an IMI case; for pilgrims going to Mecca (A+C+W135+Y vaccine must be used); for travelers to a location with active transmission of IMI and close contacts with local population; in case of "mass" vaccination decided by health authorities. Generalised vaccination of all of one or more age groups has been done for serotype C in some European countries, because of high incidence. Effectiveness of this kind of intervention should be weighted with the risk of immunoselection of another serotype and with the possibility of a spontaneous decrease of the incidence.

This article is the full-length text (including arguments and recommendations) written by the Conseil Supérieur d'Hygiène Publique de France, in its session of march 8th 2002, expressing its opinion on the immunization policy with the heptavalent pneumococcal conjugate vaccine (Prevenar).