The Ministry of Health of the Canary Islands Government met on Monday Vaccine Advisory Committee, in which all the scientific societies are represented, to present the proposal of incorporation of new drugs in the vaccination calendar for all ages of the Archipelago life in order to include the tetravalent conjugate against the meningococcus, against the meningococcal disease by serogroup B and the improvement of the supply against the human papilloma virus with the incorporation of one against 9 genotypes.
Presented by the director of the Canary Islands Health Service, Conrado Domínguez, the general director of Public Health, José Juan Alemán and the president of the Spanish Association of Vacunology, Amós García, the changes force a modification of the vaccination calendar and involve a strong investment effort, around three and a half million euros more and an increase in investment of around 33%.
The fundamental objective is guarantee equity in access to vaccines, within a global strategy against communicable diseases, reported Monday through a press release of Health before adding that Canary Islands, along with the implementation of quadrivalent anti-flu doses, is configured as the autonomous community with the calendar most advanced in the country
This change in the vaccination calendar will be available predictably before summer, after carrying out the administrative procedures for the corresponding acquisitions of the new products and will affect a cohort of 8,500 girls susceptible to vaccination with HPV, to which adults should be added in certain risk groups, such as men who have sex with men, transsexuals, etc .; 18,000 preadolescent children of 12 years of meningococcal conjugate tetravalent and 17,000 children less than a year of life against meningitis B.
Although there are currently twelve meningococcal serogroups described, the vast majority of cases of invasive meningococcal disease (95% of cases worldwide) are produced by only six serogroups: A, B, C, W, X and Y .
The incidence of EMI increased in the last four seasons (between 2014-2015 and 2017-2018) after a period of continuous decline since 2000. In the 2017-2018 season there was an increase of 27.6% with respect to the previous season due to the increase in cases due to serogroups C, W, Y,
Faced with invasive meningococcal disease, the Canary Islands proposed the introduction of tetravalent meningococcal conjugate vaccine, which protects against serotypes A, C, W, Y, and which will replace meningococcal C vaccine and is justified by the significant increase that is being observing in Europe of meningococcal disease of certain types included in that vaccine, which can also have a greater virulence.
The tetravalent conjugate vaccine against meningococcus will be administered at 12 years of age, substituting the doses of meningococcal C vaccine currently administered at that age.
The introduction of the vaccine against meningococcus B is justified in the severity of this disease together with the consequences that can result, and in the unpredictable behavior of meningococcus B, since, although today there is a scarce presence of cases The opposite may happen tomorrow. But, above all, it is justified as a measure to safeguard equity.
Do not forget that this vaccine has been present for a long time in the pharmacy offices and is prescribed by many pediatricians, which generates inequity in relation to it, since while the children who live in more favored neighborhoods are vaccinated in a high number, those from the most disadvantaged areas are, in most cases, unvaccinated, and sometimes given the possible living conditions, they are also a group with a higher risk of suffering from this problem. The introduction of the vaccine against meningococcus B will avoid this inequality.
The meningococcal B vaccine will be administered in a regimen of two doses plus one. The first two doses in the first year of life, and the third, as a reminder, in the second year of life.
The improvement of the offer of vaccines against HPV is justified by the increase of direct protection that would be obtained against 9 oncogenic genotypes of HPV, included in the new Gardasyl 9 vaccine. Doses of Gardasyl 9 will replace the doses of vaccine against HPV which are currently included in the childhood immunization calendar, in the same number and temporal sequence.
EMI is an acute bacterial disease caused by neisseria meningitidis or meningococcus. The clinical syndromes that characterize it are meningitis, bacteremia and sepsis8. Other less frequent presentations are pneumonia, septic arthritis, pericarditis, urethritis and conjunctivitis. The most common clinical onset is sudden onset of fever, nausea and vomiting, severe headache, altered mental status, neck stiffness and photophobia.
Sometimes, the presentation of EMI can be nonspecific (fever, myalgia, vomiting and other gastrointestinal symptoms) and quickly evolve to septic shock, especially in the child population or in that produced by some serogroups. Recently, an increase in the presentation with gastrointestinal symptoms has been described. The lethality by EMI is 8-15%, usually in the first 24 to 48 hours after the onset of symptoms. 10-15% of those who survive suffer long-term sequelae including neurological deficit, deafness and amputations.
The disease is transmitted directly from person to person through respiratory secretions. The spread of the disease is facilitated by close and prolonged contact with a case or a carrier (kissing, sneezing, coughing, dormitories, sharing cutlery and crockery). The average incubation period is 4 days, but can range from 2 to 10 days. The period of transmissibility persists as long as the microorganism remains in the nasopharynx of the carriers, it can last for weeks or even months, as well as being present in the upper tract intermittently.
The only known reservoir of N. meningitidis is the human being; there are no animal reservoirs. Meningococcal infection can be limited to the nasopharynx without producing symptoms, such as carrier status (10% of average in the general population), or progress to invasive disease and produce a picture of fulminating purpura with sudden prostration and shock.