Abstract

Pneumococcal vaccines:

  • NACI (Canada): Following a thorough review of the evidence for Pneu-C-15 and Pneu-C-20 vaccines, and analyzing their potential impact on reducing pneumococcal disease among children in Canada, NACI has made the following strong recommendations:
    • Either Pneu-C-15 or Pneu-C-20 should be the current product of choice for routine immunization programs in children less than 5 years of age who are not at increased risk of IPD.
    • Pneu-C-20 should be the product of choice for routine immunization programs in children less than 5 years of age who are at increased risk of IPD.

The full recommendations can be found here along with the Economic Evidence Supplementary Appendix.

Dengue:

  • STIKO  recommends vaccination against dengue with the vaccine Qdenga as a travel vaccination (R) for individuals over the age of 4 years who have a history of a prior laboratory-confirmed dengue virus infection and who are travelling to a dengue-endemic region where they will have an increased risk of exposure (e.g., 2 prolonged stay, current outbreak event). Prior to travel, a full vaccination series should be completed (i.e., 2 vaccine doses at a minimum interval of 3 months). The recommendation was translated in english here.
  • The JCVI has recommended that the following groups could be offered the Qdenga® vaccine Individuals aged 4 years of age and older with confirmed dengue infection in the past who 
    • are planning to travel to areas where there is a risk of dengue infection or areas with an ongoing outbreak of dengue
    • Or who are exposed to dengue virus through their work, for example, laboratory staff working with the virus

Individuals with no previous dengue infection should not currently be offered the Qdenga® vaccine in the UK. The information from clinical trials to date is insufficient to make a recommendation for these individuals. There is a theoretical risk of severe dengue if a person with no previous dengue infection is vaccinated and then is later infected with dengue virus DENV 3 or DENV 4 serotypes.

 

Mpox:

  • In the context of a focused routine immunization program, NACI recommends that individuals at high risk of mpox should receive two doses of Imvamune®, administered by subcutaneous injection at least 28 days apart. After considering current clinical evidence and ongoing epidemiology, NACI recommends the following individuals receive Imvamune® (Strong NACI Recommendation): Men who have sex with men (MSM) who meet one or more of the following criteria:
    • Have more than one partner
    • Are in a relationship where at least one of the partners has other sexual partners
    • Have had a confirmed sexually transmitted infection acquired in the last year
    • Have engaged in sexual contact in sex-on-premises venues

Sexual partners of individuals who meet the criteria above, Sex workers regardless of gender, sex assigned at birth, or sexual orientation, Staff or volunteers in sex-on-premises venues where workers may have contact with fomites potentially contaminated with mpox, those who engage in sex tourism regardless of gender, sex assigned at birth, or sexual orientation, Individuals who anticipate experiencing any of the above scenarios. Completion of the two dose-series will provide optimal protection. Individuals who received one dose of Imvamune® should receive the second dose, even if months have elapsed. Those who have previously received smallpox vaccination and are recommended to receive Imvamune® based on risk factors for mpox should also receive a 2-dose series with a minimum interval of 28 days. Recommendation available here.

 

RSV: 

  • NACI updated guidance on The Prevention of Respiratory Syncytial Virus (RSV) disease in infants. Considering the significant burden of disease in all infants from RSV and the impacts of RSV on the Canadian health system, NACI recommends building towards a universal RSV immunization program for all infants. Program introduction could occur in stages depending on access, cost-effectiveness, and affordability of available options. NACI recommends that RSV immunization programs use nirsevimab to prevent severe RSV disease in infants.
    • Priority for immunization programs should be given to infants who are at increased risk of severe RSV disease in their first or second RSV season. When possible, the program should be expanded to all other infants entering or born during their first RSV season.
    • Nirsevimab should be offered to infants entering, or born during, their first RSV season whose transportation for severe RSV disease treatment is complex, and/or whose risk of severe RSV disease intersects with established social and structural health determinants such as those experienced by some Indigenous communities across First Nations, Métis and Inuit populations.

NACI recommends that RSVpreF may be considered as an individual decision by a pregnant woman or pregnant person together with information from their pregnancy care provider, in advance of, or during, the RSV season, to prevent severe RSV disease in their infant in the context of informed consent. Recommendation available here.

 

WHO call :

WHO published a call for application for the WHO Technical Advisory Group on Market Access for Vaccines (TAG MVAC) which supports WHO’s work related to global vaccine market topics including delivering recommendations on our global market studies under the Market Information for Access (MI4A) work. 

 

WHO is seeking for experienced and highly qualified experts to serve as members of the TAG MVAC for a two-year appointment with following expertise:

  • Global vaccine supply, demand, and market landscape dynamics across key regions and immunization areas;
  • Vaccine manufacturing; 
  • Global immunization and/or infectious disease epidemiology;
  • Global vaccine market access and/or procurement

The call for application is currently open, the deadline for submitting the application is 14 June 2024. 

 

SAGE:

  • The Vaccine position paper on Dengue is available here. 
  • The vaccine position paper on Malaria is available here.
  • SAGE held an extra-ordinary meeting on Ebola:

SAGE recommendations for Outbreaks: 

  • SAGE recommended administration of one dose of rVSVΔG-ZEBOV-GP during outbreaks using a ring vaccination strategy targeting contacts of EVD cases, contacts of contacts and “3rd level” contacts (i.e., all who request vaccination in a village with EVD cases). 
  • During an outbreak, in areas with incident-confirmed cases of EVD, though outside of the immediate rings, SAGE recommended targeting health care workers (HCWs) and front-line workers (FLWs) with a single-dose of rVSVΔG-ZEBOV-GP vaccine. In areas where the outbreak is likely to spread, HCWs and FLWs should be vaccinated with rVSVΔG-ZEBOV-GP or Ad26.ZEBOV/ MVA-BN-Filo, noting that rVSVΔG-ZEBOV-GP vaccine should only be used if sufficient supply is available to vaccinate higher risk populations.  
  • Countries could consider preventive vaccination of EVD survivors and should vaccinate close contacts of excreting survivors. 

SAGE recommendations for Preventive Vaccination Outside an Outbreak: 

  • For inter-outbreak periods, SAGE recommended that at-risk countries evaluate the transmission risk based on outbreak epidemiology and available local evidence and identify in each country priority areas and target populations for preventive vaccination.  
  • Either vaccine can be used depending on local availability, targeting the following risk groups: HCW, FLW, national Ebola response teams and laboratory workers with possible exposure to Ebola virus as well as those working in specialized research and treatment units. 

 

Dates for your diary:

  • The next ACIP meeting is in June 26-28, 2024. The draft agenda is available here. 
  • The next SAGE meeting is scheduled in September 23-26 2024. Note that any NITAG member can listen in. Please send an email to myself and Dilber (gunlud@who.int)  to be added on the SAGE mailing list.
  • The next face-to-face GNN meeting will be in 28-30 April 2025.
  • NITAG Recommendation