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      A comparison of national vaccination policies to prevent serogroup B meningococcal disease

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      a , * , a , b , a
      Vaccine

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          Abstract

          Objectives:

          To understand the global landscape of prevention and control efforts targeting serogroup B meningococcal (MenB) disease and to identify the key challenges and gaps yet to be addressed.

          Methods:

          We conducted a comprehensive review of policies and practices for the use of protein-based MenB vaccines (Bexsero ® [GlaxoSmithKline] and Trumenba ® [Pfizer]) in all countries (n = 58) where either or both vaccine is authorized for use. We searched the literature (PubMed) and websites of health ministries and other relevant agencies to identify policy documents and plans and collect information about implementation timelines, target groups, vaccines being used, recommended schedules, and coverage data. Experts in the field were contacted for additional details andclarifications, as needed.

          Results:

          We found evidence of a national MenB vaccination policy in 24 out of 58 countries where one or both protein-based MenB vaccines are authorized. Of these, 15 countries have included MenB vaccination in their immunization plans for at least one age-based risk group (mostly infants), 21 have issued recommendations for various risk groups based on underlying medical conditions (e.g. asplenia), and 13 have done so for select groups at increased risk of exposure (e.g. laboratory staff). Recommended vaccination schedules and number of doses, where available, varied widely. Vaccination coverage data for age-based risk groups were not obtained for most countries.

          Conclusions:

          Our findings highlighted the significant heterogeneity in recommendations for MenB vaccination across countries. Greater transparency in reporting MenB vaccination recommendations and more robust data on implementation and the impact of vaccination would better facilitate optimizing MenB prevention strategies.

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          Most cited references56

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          BIGSdb: Scalable analysis of bacterial genome variation at the population level

          Background The opportunities for bacterial population genomics that are being realised by the application of parallel nucleotide sequencing require novel bioinformatics platforms. These must be capable of the storage, retrieval, and analysis of linked phenotypic and genotypic information in an accessible, scalable and computationally efficient manner. Results The Bacterial Isolate Genome Sequence Database (BIGSDB) is a scalable, open source, web-accessible database system that meets these needs, enabling phenotype and sequence data, which can range from a single sequence read to whole genome data, to be efficiently linked for a limitless number of bacterial specimens. The system builds on the widely used mlstdbNet software, developed for the storage and distribution of multilocus sequence typing (MLST) data, and incorporates the capacity to define and identify any number of loci and genetic variants at those loci within the stored nucleotide sequences. These loci can be further organised into 'schemes' for isolate characterisation or for evolutionary or functional analyses. Isolates and loci can be indexed by multiple names and any number of alternative schemes can be accommodated, enabling cross-referencing of different studies and approaches. LIMS functionality of the software enables linkage to and organisation of laboratory samples. The data are easily linked to external databases and fine-grained authentication of access permits multiple users to participate in community annotation by setting up or contributing to different schemes within the database. Some of the applications of BIGSDB are illustrated with the genera Neisseria and Streptococcus. The BIGSDB source code and documentation are available at http://pubmlst.org/software/database/bigsdb/. Conclusions Genomic data can be used to characterise bacterial isolates in many different ways but it can also be efficiently exploited for evolutionary or functional studies. BIGSDB represents a freely available resource that will assist the broader community in the elucidation of the structure and function of bacteria by means of a population genomics approach.
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            Meningococcal disease.

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              Antigenic similarities between brain components and bacteria causing meningitis. Implications for vaccine development and pathogenesis.

              Glycopeptides containing polysialic acid units were isolated from human and rat brain and tested for reactivity with antibodies against meningococcal capsules. The polysialosyl glycopeptides bound specifically to horse antiserum against meningococcus group B. The interaction was inhibited by capsular polysaccharides from meningococcus group B but not groups A or C. The capsular polysaccharide of Escherichia coli K1, which is immunochemically similar to the group B polysaccharide, also inhibited binding. These findings could explain the failure to develop efficient vaccines against group B meningococcus or E coli K1 and also suggest that immunological tolerance could be a factor in the pathogenesis of meningitis caused by these bacteria. The presence of the cross-reactive brain component calls for caution in efforts to develop capsular polysaccharide vaccines from these bacteria or the proposed use of passively administered antibodies as immunotherapy of neonatal meningitis.
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                Author and article information

                Journal
                8406899
                7945
                Vaccine
                Vaccine
                Vaccine
                0264-410X
                1873-2518
                12 October 2022
                09 June 2022
                14 May 2022
                17 October 2022
                : 40
                : 26
                : 3647-3654
                Affiliations
                [a ]Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
                [b ]UK Health Security Agency, Meningococcal Reference Unit, Manchester Royal Infirmary, Manchester, United Kingdom
                Author notes

                Author contributions

                G.S. and N.E.B. designed the study. G.S. and M.H. performed the searches and data collection. G.S. prepared the first draft of the manuscript with input from M.H., R.B. and N.E.B. All authors revised the manuscript and approved the final version.

                [* ]Corresponding author at: Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, 2001 McGill College, Suite 1200, H3A 1G1 Montreal, QC, Canada. giorgia.sulis@ 123456mail.mcgill.ca (G. Sulis).
                Article
                NIHMS1840068
                10.1016/j.vaccine.2022.04.101
                9575558
                35581099
                6903b422-3382-4a9e-a726-8a6d654495d5

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

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                Infectious disease & Microbiology
                Infectious disease & Microbiology

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