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==Impact== ==Impact==
Since its introduction the vaccine has had a dramatic impact on the epidemic.<ref name="pmid19481313">{{cite journal |author=Holst J, Martin D, Arnold R, ''et al.'' |title=Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis |journal=Vaccine |volume=27 Suppl 2 |issue= |pages=B3–12 |year=2009 |month=June |pmid=19481313 |doi=10.1016/j.vaccine.2009.04.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(09)00637-9}}</ref> In April 2008 it was unexpectedly{{By whom|date=April 2011}} announced by the New Zealand Ministry of Health that the MeNZB vaccination programme will be completed by 31 December 2008, and that after this period vaccination would require authorization of a GP. Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term<ref>Ministry of Health statement, http://www.health.govt.nz/news-media/media-releases/menzb-vaccine-helped-curb-epidemic</ref>. Others{{Who|date=April 2011}} speculate that the cost of providing the vaccine is too high for the NZ government to justify{{Citation needed|Date=2011-04}}. Since its introduction the vaccine has had a dramatic impact on the epidemic.<ref name="pmid19481313">{{cite journal |author=Holst J, Martin D, Arnold R, ''et al.'' |title=Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis |journal=Vaccine |volume=27 Suppl 2 |issue= |pages=B3–12 |year=2009 |month=June |pmid=19481313 |doi=10.1016/j.vaccine.2009.04.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(09)00637-9}}</ref> In April 2008 it was unexpectedly{{By whom|date=April 2011}} announced by the New Zealand Ministry of Health that the MeNZB vaccination programme will be completed by 31 December 2008, and that after this period vaccination would require authorization of a GP. Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term<ref>Ministry of Health statement, http://www.health.govt.nz/news-media/media-releases/menzb-vaccine-helped-curb-epidemic</ref>. Others{{Who|date=April 2011}} speculate that the cost of providing the vaccine is too high for the NZ government to justify{{Citation needed|date=April 2011}}.


The vaccine, originally developed in ] and subject to considerable public controversy as recently as October 2007{{Citation needed|Date=2011-04}}, was never released for widespread use in that country because the Norwegian ] was finishing before it was released. The vaccine, originally developed in ] and subject to considerable public controversy as recently as October 2007{{Citation needed|date=April 2011}}, was never released for widespread use in that country because the Norwegian ] was finishing before it was released.


==References== ==References==

Revision as of 22:41, 12 April 2011

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Pharmaceutical compound
MeNZB
Vaccine description
Targetgroup B meningococcus strain
Vaccine typeSubunit
Clinical data
ATC code
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MeNZB is a vaccine against a specific strain of group B meningococcus, currently being used to control an epidemic of meningococcal disease in New Zealand. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningococcal disease can cause meningitis and septicaemia, resulting in brain damage, failure of various organs, severe skin and soft-tissue damage, and death.

Immunisation with MeNZB requires three doses, administered approximately six weeks apart (except in newborns, who have them in conjunction with their 6-week, 3-month and 5-month injections). People who have been fully immunised may still carry the meningococcus bacteria and may still contract meningococcal disease.

Components

Each dose is 0.5 ml and contains:

  • 25 mcg of outer membrane vesicles from the Neisseria meningitidis group B strain NZ98/254. The vaccine does not contain any whole bacteria (alive or dead). The "outer membrane vesicles" it contains are a small part of the "skin" of the bacteria that let the immune system recognise and prepare for being infected with the real thing. MeNZB vaccine does not contain any human, blood, or bovine (cow)products, egg products, neomycin or the preservative thiomersal (mercury). There are no live meningococcal bacteria in the vaccine and it is not possible to catch the disease or become a carrier of the disease from the vaccine.
  • 1.65 mg of aluminium hydroxide (an adjuvant). The immune system will normally not mount an immune response to the outer membrane vesicles if they are presented alone. The presence of the adjuvant forces the immune system to respond to the membrane vesicles by acting to prevent their breakdown and elimination, while causing local tissue damage to provoke the desired immune reaction.
  • histidine (to stabilise the pH). The histidine pH buffer is to ensure the vaccine stays as close as possible to the pH of human body fluids. This is to ensure the immune system does not waste time trying to neutralise the vaccine instead of responding to the outer membrane vesicles.
  • normal saline. The saline (sterile salt and water) is also like packaging. It is required so that all of the above can be dissolved into a solution that can be injected. It is the same salinity (saltiness) as normal human body fluid.

The antigen in MeNZB is prepared from B:4:P1.7b,4 (NZ 98/254 ) N. meningitidis strain, grown in a fermentor. The bacteria are grown in a synthetic culture medium containing sugar, essential amino acids and essential elements such as iron and potassium. The fermentation does not use bovine or porcine products. The cellular outer membranes are extracted with the detergent deoxycholate, which kills the bacteria. Outer membrane vesicles are purified out of the culture medium by ultracentrifugation, stabilised by histidine and then adsorbed to aluminium hydroxide Al(OH)3 as an adjuvant. Purification is achieved by ultrafiltration/diafiltration.

Impact

Since its introduction the vaccine has had a dramatic impact on the epidemic. In April 2008 it was unexpectedly announced by the New Zealand Ministry of Health that the MeNZB vaccination programme will be completed by 31 December 2008, and that after this period vaccination would require authorization of a GP. Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term. Others speculate that the cost of providing the vaccine is too high for the NZ government to justify.

The vaccine, originally developed in Norway and subject to considerable public controversy as recently as October 2007, was never released for widespread use in that country because the Norwegian epidemic was finishing before it was released.

References

  1. PMID 18804134
  2. Holst J, Martin D, Arnold R; et al. (2009). "Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis". Vaccine. 27 Suppl 2: B3–12. doi:10.1016/j.vaccine.2009.04.071. PMID 19481313. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  3. Ministry of Health statement, http://www.health.govt.nz/news-media/media-releases/menzb-vaccine-helped-curb-epidemic

External links

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