Evaluation of the Impact of Meningococcal Serogroup A Conjugate Vaccine Introduction on Second-Year-of-Life Vaccination Coverage in Burkina Faso

• Published in: The Journal of infectious diseases 2019-10, Vol.220 (220 Suppl 4), p.S233-S243
• Main Authors: Zoma, Robert L, Walldorf, Jenny A, Tarbangdo, Felix, Patel, Jaymin C, Diallo, Alpha Oumar, Nkwenkeu, Sylvain F, Kambou, Ludovic, Nikiema, Moumouni, Ouedraogo, Arnaud, Bationo, Ange B, Ouili, Romeo, Badolo, Hermann, Sawadogo, Guetawende, Krishnaswamy, Akshaya, Hatcher, Cynthia, Hyde, Terri B, Aké, Flavien, Novak, Ryan T, Wannemuehler, Kathleen, Mirza, Imran, Medah, Isaïe, Soeters, Heidi M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Children; Female; Humans; Immunization; Immunization Programs; Immunization Schedule; Infant; Male; Mass Vaccination; Measles; Meningitis, Meningococcal - epidemiology; Meningitis, Meningococcal - microbiology; Meningitis, Meningococcal - prevention & control; Meningococcal Vaccines - administration & dosage; Meningococcal Vaccines - immunology; Middle Aged; Neisseria meningitidis, Serogroup A - immunology; Outcome Assessment, Health Care; Vaccination; Vaccination Coverage; Vaccines; Vaccines, Conjugate - administration & dosage; Vaccines, Conjugate - immunology; Young Adult
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiz304

After successful meningococcal serogroup A conjugate vaccine (MACV) campaigns since 2010, Burkina Faso introduced MACV in March 2017 into the routine Expanded Programme for Immunization schedule at age 15-18 months, concomitantly with second-dose measles-containing vaccine (MCV2). We examined MCV2 coverage in pre- and post-MACV introduction cohorts to describe observed changes regionally and nationally. A nationwide household cluster survey of children 18-41 months of age was conducted 1 year after MACV introduction. Coverage was assessed by verification of vaccination cards or recall. Two age groups were included to compare MCV2 coverage pre-MACV introduction (30-41 months) versus post-MACV introduction (18-26 months). In total, 15 925 households were surveyed; 7796 children were enrolled, including 3684 30-41 months of age and 3091 18-26 months of age. Vaccination documentation was observed for 86% of children. The MACV routine coverage was 58% (95% confidence interval [CI], 56%-61%) with variation by region (41%-76%). The MCV2 coverage was 62% (95% CI, 59%-65%) pre-MACV introduction and 67% (95% CI, 64%-69%) post-MACV introduction, an increase of 4.5% (95% CI, 1.3%-7.7%). Among children who received routine MACV and MCV2, 93% (95% CI, 91%-94%) received both at the same visit. Lack of caregiver awareness about the 15- to 18-month visit and vaccine unavailability were common reported barriers to vaccination. A small yet significant increase in national MCV2 coverage was observed 1 year post-MACV introduction. The MACV/MCV2 coadministration was common. Findings will help inform strategies to strengthen second-year-of-life immunization coverage, including to address the communication and vaccine availability barriers identified.