First mass campaigns

Introduction strategy prioritizes countries most at risk

Participants in the scientific workshop "Introduction of a Men A Conjugate Vaccine" that was held in Burkina Faso in 2005 identified several criteria to rank meningitis belt countries for introduction of MenAfriVac, including:

• Disease burden.
• Country readiness (existence of an updated comprehensive multi-year plan, quality of district microplanning, quality of vaccine introduction plan and vaccine management, technical ability of country to successfully implement a national immunization campaign, good surveillance system and laboratory capacity in the country).
• Participation in clinical trial for vaccine development.
• Financial viability.
• Vaccine availability.

African meningitis belt countries can be roughly divided into three groups according to prevailing disease incidence rates: core countries, bordering countries with hyperendemic zones, and other at-risk countries.

• Core countries: Burkina Faso, Chad, Ethiopia, Mali, Niger, the northern states of Nigeria, and Sudan.
• Bordering countries with hyperendemic zones: Benin, Cameroon, Central African Republic, Côte d'Ivoire, Democratic Republic of the Congo, the Gambia, Ghana, Kenya, the remaining states of Nigeria, Senegal, Togo, and Uganda.
• Other at-risk countries without hyperendemic zones: Burundi, Eritrea, Guinea, Guinea-Bissau, Mauritania, Rwanda, and Tanzania.

Taking into account the priority factors mentioned above, Burkina Faso, Mali, and Niger were chosen as the first three countries for phased vaccine introduction. Burkina Faso has been the most affected country in the last decade, Niger is a heavily affected country, and Mali hosts a clinical study site.

The first round of vaccination took place in September 2010 in Mali (2 districts immunized), Niger (1 district), and Burkina Faso (1 district). Mali immunized an additional 21 health districts during the second round of vaccination in December 2010, while Niger immunized an additional 10 districts. Burkina Faso became the first African country to introduce MenAfriVac® nationwide and immunized more than 11 million people between 6–15 December 2010.

Mali and Niger vaccinated the rest of their 1- to 29-year-old population (8 million in Niger, 6 million in Mali) in 2011.

Photo: UNICEF/Jon Shadid.