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Cold-Storage Requirement Dropped for Life-Saving Meningitis Vaccine

Women and children wait to participate in a vaccination campaign against meningitis at the community center in Al Neem camp for Internally Displaced People in El Daein, East Darfur, Sudan, October 8, 2012.
New research has shown that a vaccine against bacterial meningitis, which previously required cold storage to transport across Africa, can be shipped and administered safely for up to four days without refrigeration. Public health experts are calling this a potentially game-changing development for immunization efforts in resource-poor tropical countries.

The fact that the meningitis A vaccine can be removed from the so-called "cold chain" and transported throughout Africa at essentially room temperature means children and young adults who have not been receiving the potentially life-saving vaccine can now get it.

The breakthrough was announced by international public health officials at the American Society of Tropical Medicine and Hygiene meeting in Atlanta, Georgia.

Godwin Enwere heads the Meningitis Vaccine Project, a joint collaboration between the World Health Organization and the Program for Appropriate Technology in Health, or PATH.

Enwere said the discovery that the vaccine could be in transit for up to four days without refrigeration or even coldpacks came after an extensive re-evaluation of stability data by drug regulators in India and Canada.

Prior to the finding, the drug agencies recommended that the meningitis vaccine be transported at temperatures between two and eight degrees centigrade. The ability to transport it safely at ambient temperatures of up to 40 degrees will allow it to reach tens of thousands of children who need it.

Enwere recalls that during a meningitis outbreak in Chad last year, there wasn’t enough of the drug to go around, and public health officials were only able to immunize youngsters in three districts. That left tens of thousands of children in the rest of the country unprotected.

“So, this clearly demonstrates not only the effect of the vaccine; that if a system is developed whereby this vaccine can be carried and administered at ambient temperature, then it will increase the coverage," said Enwere. "If we had had this information as of last year, Chad would have introduced this vaccine to a larger population and then perhaps they would not have had this outbreak.”

Meningitis A is a serious, potentially fatal bacterial infection common in resource-poor counties. It causes inflammation of the protective linings of the brain and spinal cord, sometimes causing the brain to swell, producing severe fever, headache and confusion.

The vaccine is known as MenAfriVac. It originally was created to meet the needs of Africa’s so-called meningitis belt, which the WHO estimates includes 400 million people who live across a swath of 21 countries that runs from Senegal to Ethiopia.

While the vaccine costs less than 50 cents per dose and is very effective, the biggest obstacle has been keeping it cool enough in the "cold chain" so it doesn’t spoil during the final kilometers to its intended destination.

Researchers are now investigating whether other cold-chain vaccines can be shipped at room temperature. In particular, they are studying a vaccine against bacterial pneumonia, a disease that kills an estimated half a million children each year.