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Dr Joanne Langley @ MRF's Meningitis & Septicaemia in children and Adults 2017

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Preparedness for and response to meningococcal outbreaks: preliminary results of a Canadian Immunization Research Network (CIRN) randomized controlled trial of two schedules of 4CMenB vaccine in adolescents and young adults.
https://www.meningitis.org/mrf-conference-2017

Publicada em: Saúde e medicina
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Dr Joanne Langley @ MRF's Meningitis & Septicaemia in children and Adults 2017

  1. 1. Preparedness for and response to meningococcal outbreaks: preliminary results of a Canadian Immunization Research Network (CIRN) randomized controlled trial of two schedules of 4CMenB vaccine in adolescents and young adults JM Langley, S Gantt, C Quach,, J Bettinger, SA Halperin, J Mutch, S McNeil, B. Ward, D. MacKinnon-CameronL Ye, K Marty, D. Scheifele, J Alcantara and CIRN Funded by the Canadian Institutes of Health Research and the Public Health Agency of Canada
  2. 2. Rationale  Meningococcus B most common cause of IMD in Canada  Institutional outbreaks are rare (<5% of cases) but create public health crises  MenB vaccine in Canada:  4CMenB (Bexsero®, GlaxoSmithKline) authorized for persons 2 months -17 years in Dec 2013  Not part of routine immunization schedule  limited data on safety and immunogenicity in persons >17 years, or on various dosing schedules  Emergency vaccination programs used for outbreaks  Quebec 2014 for 2 month - 20 year olds  Acadia University 2015
  3. 3. Methods  Enrolment in first term of academic year (Sept 2015- April 2016) over 4 to 6 weeks  Eligibility  17-25 years of age, healthy  attending school  randomized, controlled, observer-blinded trial  Compare safety and immunogenicity of two 4CMenB vaccination schedules: Accelerated (0, 21 days) vs. Standard schedule (0, 60 days)
  4. 4. Solicited Local Events: pain most common, with 4CMenB
  5. 5. Solicited General Adverse Events: Muscles aches, drowsiness most common; with 4CMenB
  6. 6. Immunogenicity outcomes  Human Serum Bactericidal Titres (hSBA) on days 0, 21, 42, 81,180 using MenB strains 5/99, H44/76 and NZ98/254 (assays using epidemic strains pending)  Geometric Mean Titers (GMTs)  Reverse Cumulative Distribution graphs
  7. 7. NZ98/254 H44/765/99 GMTs by strain, days 0 to 180
  8. 8. hSBA Titers: Reverse Cumulative Distribution Day 21 Day 180
  9. 9. Conclusions: RCT of 0,21 vs. 0,60 day 4CMenB schedule in 17-25 year old students  Capacity building for rapid trials: conducted rapidly in 1st term of academic year at 3 sites, >99% retention at six months  Safety: reactogenicity greater in 4CMenB recipients: injection site pain in >96%, muscles aches and drowsiness in ~50% (tolerability outcomes pending)  Immunogenicity: protective titers present in all 4CMenB recipients 21 days after first dose, sustained in >90 % at Day 180 (hSBA to outbreak strains pending)  An accelerated 4CMenB schedule (0, 21 days) could be used to control outbreaks in adolescents/young adults

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