Can a vaccine fight fear, along with disease?

April 22, 2016 by PATH

One expert shares how life for people in Ghana has improved without the threat of meningitis A.

A doctor examines a toddler in a clinic.

MenAfriVac® has put a stop to the deadly epidemics that once ravaged communities across Africa’s meningitis belt. Photo: PATH/Doune Porter.

Ghana’s most recent dry season has slipped by quietly and harmlessly. This may not seem noteworthy, but in years past the dry weather brought dread, disability, and even death. The sub-Saharan winds that blow from December to March carried with them meningococcal meningitis, a severe infection of the thin lining that surrounds the brain and the spinal cord. When the disease would strike, our communities ceased to operate: people stopped working and families lived locked in fear as friends and neighbors fell ill all around them.

But now, thanks to the introduction of MenAfriVac®, a group A meningococcal meningitis vaccine specifically designed for use in Africa, the dry season is no longer a harbinger of disease. Thanks to MenAfriVac®, life in Ghana goes on.

Developed at an affordable price and designed to be cold-chain independent, MenAfriVac® has put a stop to the deadly epidemics that once ravaged communities across Africa’s meningitis belt. I’ve seen that devastation up close. On the other side of a 1996–1997 epidemic, I studied the survivors. Some had subsequently died even though we thought they had conquered the disease, and others were left suffering from lifelong disabilities such as deafness and neurological impairment. The damage meningitis inflicts upon a community lasts long after the disease—and the attention it garners—fades.

I carried these people and their stories with me when I served as project investigator for the MenAfriVac® vaccine trial conducted in infants in Ghana. A clinical trial on such a vulnerable population is tremendously significant, both in the study process itself and the broad implications the results will have on the public’s health. The development of a vaccine that can be incorporated into a childhood immunization program means long-term elimination of that disease. It is a huge point of pride for Ghana to have been one of the countries that made it possible for infants to receive MenAfriVac®—as well as an experience for which we have much gratitude.

“The damage meningitis inflicts upon a community lasts long after the disease—and the attention it garners—fades.”
Health workers sitting at a table with carrier boxes filled with MenAfriVac vaccine.

The development of a vaccine that can be incorporated into a childhood immunization program means long-term elimination of that disease. Photo: PATH/Amy MacIver.

The MenAfriVac® roll out in 2012, a mass vaccination campaign that inoculated people between 1 and 29 years of age against group A meningitis, marked a change in Ghana’s history. No longer are we victims to group A meningococcal meningitis; we now have a weapon in the fight. Coverage during the initial campaign reached 98 percent. We never struggled to get people vaccinated. In fact, one of our largest challenges was turning away people 30 years of age and older who wanted the vaccine but were outside of the target age range for the campaign. Everyone saw the potential of this vaccine.

Now, you can feel the change in the communities. There is no longer a sense of apprehension as the dry season approaches, and there is no more fear that the disease will come and wreak havoc within our families. In the past, when meningitis epidemics would strike and we initiated reactive vaccination campaigns with polysaccharide vaccine—which only provides short-term protection—people who had been immunized the year prior would rush back to the clinics and beg to be revaccinated. Now, they don’t have that feeling of anxiety. They know that they are immune, and that is that.

Even so, they also know that this isn’t the end of meningitis; recently, some people have fallen ill with group W meningococcal meningitis and streptococcal meningitis. These numbers come nowhere near to what we experienced with group A in the past, but still, people wonder when we will finally eliminate all forms of meningitis. MenAfriVac® has given us hope, and a chance, but to truly free Ghanaians from the grip of meningitis, we need a vaccine that targets all epidemic-causing serogroups. Thankfully, the lessons learned during the MenAfriVac® project have and will continue to have huge impacts on public health interventions and disease education—not just for Ghana, but for the entire meningitis belt.

MenAfriVac® is a registered trademark of Serum Institute of India Private Ltd.

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