First in the world, Nigeria introduces a new 5-in-1 vaccine against meningitis

In a historic move, Nigeria has become the first country in the world to introduce a new vaccine (called Men5CV) recommended by the World Health Organization (WHO), which protects people against five strains of meningococcal bacteria. Vaccine and emergency vaccination activities are funded by Gavi, the Vaccine Alliance, which funds the global meningitis vaccine stockpile and supports lower-income countries with routine meningitis vaccination.

Nigeria is one of 26 African meningitis hyperendemic countries, located in an area known as the African Meningitis Belt. Last year saw a 50% jump in annual meningitis cases reported across Africa.

In Nigeria, an outbreak Neisseria meningitidis (meningococcus) serogroup C outbreak resulted in 1,742 suspected cases of meningitis, including 101 confirmed cases and 153 deaths in seven of Nigeria's 36 states (Adamawa, Bauchi, Gombe, Jigawa, Katsina, Yobe, Zamfara) between October 1, 2023 and March 11, 2024 To curb the deadly epidemic, a vaccination campaign was launched from March 25 to 28, 2024 to initially cover more than one million people aged 1 to 29 years.

Meningitis is a serious infection that leads to inflammation of the membranes (meninges) that surround and protect the brain and spinal cord. There are multiple causes of meningitis, including viral, bacterial, fungal, and parasitic pathogens. Symptoms often include headache, fever and stiff neck. Bacterial meningitis is the most severe, it can also result in septicemia (blood poisoning) and can seriously incapacitate or kill those who contract it within 24 hours.

“Meningitis is an old and deadly enemy, but this new vaccine has the potential to change the course of the disease, preventing future outbreaks and saving many lives,” he said. WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “Nigeria's rollout brings us one step closer to our goal of eliminating meningitis by 2030.”

The revolutionary new vaccine offers a powerful shield against the five main strains of meningococcal bacteria (A, C, W, Y and X) in one shot. All five strains cause meningitis and blood poisoning. This provides broader protection than the current vaccine used in much of Africa, which is only effective against the A strain.

The new vaccine has the potential to significantly reduce cases of meningitis and advance progress in defeating meningitis. This is especially important for countries like Nigeria where multiple serogroups are prevalent. The new vaccine uses the same technology as the meningitis A conjugate vaccine (MenAfriVac®), which wiped out the meningococcal A epidemic in Nigeria.

“Northern Nigeria, particularly Jigawa, Bauchi and Yobe states have been hit hard by the deadly meningitis epidemic, and this vaccine provides health workers with a new tool to stop this epidemic and put the country on the path to elimination,” he said. Prof. Muhammad Ali Pate from the Nigerian Ministry of Health and Welfare. “We have done a lot of work preparing health workers and the health system for the introduction of this new vaccine. We have received invaluable support from our population despite this fasting period and from our community leaders, especially the Emir of Gumel in Jigawa State who personally initiated the vaccination campaign in the state. We will be closely monitoring progress and hope to expand immunization in the coming months and years to accelerate progress.”

This new multivalent conjugate vaccine was 13 years in the making and was based on a partnership between PATH and the Serum Institute of India. Funding from the UK government's Foreign, Commonwealth and Development Office was crucial to its development.

In July 2023, the WHO prequalified the new Men5CV vaccine (branded MenFive®), and in October 2023 it issued an official recommendation to countries to introduce the new vaccine. Gavi allocated resources for the December 2023 rollout of Men5CV, which is currently available for the outbreak response through emergency stocks managed by the International Coordination Group (ICG) for vaccine procurement, while rollout through mass prevention campaigns is expected to begin in 2025. Meningitis Belt countries.

“The rollout of one million vaccines in northern Nigeria will help save lives, prevent long-term illness and advance our goal to defeat meningitis globally by 2030,” he said. Andrew Mitchell, British Minister for Development and Africa. “This is exactly the kind of scientific innovation, supported by the UK, that I hope will be replicated in the years to come to help us make further discoveries, including eradicating other diseases.”

WHO is supporting the Nigeria Center for Disease Control and Prevention (NCDC) in responding to the meningitis outbreak in the country. This includes disease surveillance, active case finding, specimen testing and case management. WHO and partners have also played a key role in supporting Nigeria to prepare for the introduction of the new vaccine and train health workers.

“Year after year, meningococcal meningitis plagues countries across Africa,” he said dr. Nanthalile Mugala, PATH's Head of Africa Region. “The introduction of MenFive® in Nigeria heralds a transformative era in the fight against meningococcal meningitis in Africa. Building on the legacy of previous vaccination efforts, this milestone reflects more than a decade of steadfast, innovative partnerships. The promise of MenFive® lies not only in its immediate effect, but also in the countless lives it will protect in the years to come, bringing us closer to a future without the threat of this disease.”

In 2019, WHO and partners launched global roadmap to defeat meningitis by 2030. The roadmap sets a comprehensive vision towards a world without meningitis, and has three goals:

– elimination of bacterial meningitis epidemics; – reduction of vaccine-preventable cases of bacterial meningitis by 50% and deaths by 70%; and
– reduction of disability and improvement of quality of life after meningitis of any cause.

“With infectious disease outbreaks on the rise around the world, new innovations like MenFive® are critical to helping in the fight,” he said. Aurélia Nguyen, program manager at Gavi, the Vaccine Alliance, which funds global supplies as well as the spread of vaccines in lower-income countries. “This first delivery marks the beginning of Gavi's support for the Multivalent Meningococcal Conjugate Vaccine (MMCV) program, which, with the necessary donor funding for our next five years of work, will enable pentavalent meningococcal conjugate vaccines to be introduced to high-risk countries. Thanks to vaccines, we have eliminated large and devastating outbreaks of meningitis A in Africa: we now have the tools to respond to other serogroups that still cause large outbreaks resulting in long-term disability and death.”

After the meningitis vaccine campaign in Nigeria, a major milestone on the road to defeating meningitis is the International Meningitis Summit in Paris in April 2024 where leaders will gather to celebrate progress, identify challenges and assess next steps. It is also an opportunity for country leaders and key partners to make political and financial commitments to accelerate progress towards eliminating meningitis as a public health problem by 2030.