WHO recommended that countries with high or intermediate endemic rates of meningococcal disease and countries with frequent epidemics introduce large scale vaccination programmes, using meningococcal conjugate vaccines. The recommendation was made in a position paper published in the Weekly Epidemiological Record. In countries where meningococcal disease occurs less frequently, vaccination is recommended for defined risk groups such as children and young adults living in closed communities, for instance in boarding schools or military camps. Laboratory workers at risk of exposure to meningococci and travellers to high-endemic areas should also be vaccinated. For all countries, knowledge of meningococcal disease burden is critical in ensuring that available vaccines are appropriately used. Countries considering the use of meningococcal vaccines should develop the surveillance systems to characterize meningococcal disease epidemiology. And continued surveillance should dictate the need and timing of repeat mass vaccination campaigns.
WHO noted that in Africa, major epidemics have been occurring over the past 100 years, most of them attributed to serogroup A and occurring in the African “meningitis belt”, a large area that spans sub-Saharan Africa from Senegal in the west to Ethiopia in the east. In 1996 to 1997, the largest epidemic in history swept across the belt, causing over 250,000 cases, an estimated 25,000 deaths, and disability in 50,000 people. Large epidemics recur in the meningitis belt on a regular basis. In December 2010, the first meningococcal A conjugate vaccine to be developed specifically for countries in the African meningitis belt was introduced in Burkina Faso, Mali and Niger. Three additional countries ― Cameroon, Chad and Nigeria ― are introducing the vaccine in December 2011. Position paper on meningococcal vaccines: http://www.who.int/entity/wer/2011/wer8647.pdf
vaccines and global health :: ethics and policy 