Presentations at the UK National Immunisation Conference

Figures & data

Table 1. Phase I–III trials with the Oxford vaccine (ChAdOx1 nCoV-19).

	Population	Efficacy	Tolerability
Phase I^Citation2		Increase in spike-specific antibodies, which peaked by day 28 and remained elevated until day 56 (single dose) Neutralizing antibodies increased further after a second dose	Mostly mild or moderate injection site reactions Flu-like symptoms that could be mitigated by paracetamol
Phase II^Citation4	89 patients aged 56–69 years 120 patients aged >70 years
Phase III	UK (19 sites; 10,000 participants; 20% aged >55 years) Brazil (6 sites; 10,000 participants; 20% aged >55 years) South Africa (6 sites; 2000 participants) Kenya (1 site; 200 participants)	70% overall efficacy (90% in one dosing regimen and 62% in another)	Most favorable tolerability in 90% efficacy regimen No hospitalized or severe Covid-19 cases in anyone who received the vaccine

Table 2. Useful resources to facilitate vaccine programme communications.

World Health Organization. Vaccine safety supporting document. Vaccine safety messages (frequency of AEFIs). 2015. Available at: https://www.euro.who.int/__data/assets/pdf_file/0010/339625/Vaccine-safety-messages.pdf [Accessed November 2021]. World Health Organization. Vaccine safety supporting document. How to prepare a message map. 2017. Available at: https://www.euro.who.int/__data/assets/pdf_file/0007/337489/02_WHO_VaccineSafety_SupportDoc_MessageMap_FINAL.pdf [Accessed November 2021]. World Health Organization. Vaccine safety supporting document. How to ensure a context-specific response to events that may erode trust. 2017. Available at: https://www.euro.who.int/__data/assets/pdf_file/0009/337473/02_WHO_VaccineSafety_SupportDoc_AnalysingEvents_Proof7.pdf [Accessed November 2021].

Table 3. Key considerations when selecting appropriate personnel for COVID-19 vaccine delivery.

Ability	All necessary training completed in line with agreed training standards Assessed as competent Clinic supervisor/manager satisfied with qualifications, experience, knowledge and skills Adequate supervision and support in place on-site
Authority	Agreed job role and service delivery Vaccine delivery and set in the best interest of the individual Covered by local or national indemnity (for COVID-19 vaccine administration, the national protocol provides indemnity insurance) Legal authorization to administer a prescription-only medicine (Patient Group Directions/Patient Specific Directions, written instruction, national protocol)
Accountability	All healthcare professionals and support staff involved are accountable for their actions and practice Clinic supervisor/manager satisfied that the healthcare support worker has the necessary skills and competence to complete the procedure they are being asked to perform Clinic supervisor/manager accountable for the decision to delegate work/task and ensuring a record of their training assessment and ongoing supervision is maintained All workers are accountable for their practice during the vaccine administration process through civil law and their employer

Table 4. Shingles vaccine uptake among patients in the Maassarani Group Practice from 1 April 2017–31 March 2018 and 1 April to 31 March 2019.

	2017–2018	2018–2019
Percentage of eligible patients vaccinated	16.1%	57.2%
Number of patients vaccinated	145	461

Note: 2017/2018, n = 897 (70- and 78-year-olds); 2018/2019, n = 806 (70- and 78-year-olds).

Figure 1. Vaccine technology.

BCG, Bacillus Calmette-Guérin; GAS, Group A streptococcus; GBS, Group B Streptococcus; Haemophilus influenzae type B; RNA, ribonucleic acid.

Figure 2. Reverse vaccinology in MenB vaccine antigen identification.

Table 5. Vaccine efficacy of 4CMenB evaluated by two different techniques.

Number of 4CMenB doses	Vaccine effectiveness (Ladhani et al., 2020^Citation5 by screening method)	Vaccine effectiveness (Poisson regression)
1	24.1% (95% CI, −37-6 to 58.2)	33.5% (95% CI, 12.4 to 49.7)
2	52.7% (95% CI, −33.5 to 83.2)	78.7% (95% CI, 71.5 to 84.5)
3	59.1% (95% CI, −31.1 to 87.2)	80.1% (95% CI, 70.3 to 86.7)

Figure 3. Meningitis progress tracker.

Table 6. Key similarities/differences between gMATS and MenDeVAR.

	gMATS	MenDeVAR
Applies to	4CMenB	4CMenB and MenB-fHBP
Access	Muzzi et al. (2019)^Citation4	https://pubmlst.org/organisms/neisseria-spp/mendevar; Rodrigues et al. (2020)^Citation5
Basis	Partially published MATS dataset	Published and peer-reviewed MATS data (4CMenB), hSBA and flow cytometry data (MenB-fHBP)
Ag inclusion criteria	Data for >5 isolates	Data for ≥5 isolates
Peptide coverage criteria (fHbp and NHBA)	Covered – >60% of isolates MATS-positive^a Not covered – <40% of isolates MATS-positive^a Unpredictable – all other	Cross-reactive – ≥75% of isolates MATS-positive Not cross-reactive – ≥75% of isolates not MATS-positive Grey – 25% to 75% of isolates MATS-positive
Peptide coverage criteria (NadA)	Not covered – all (a priori)
Peptide coverage criteria (PorA)	Covered – P1.4 Not covered – other	Cross-reactive – P1.4 Not cross-reactive – other
Strain coverage criteria	Covered – ≥1 Ag covered Not covered – all Ag not covered Unpredictable – others	Green^c – ≥1 Ag exact match^b Amber^c – ≥1 Ag cross-reactive^b Red^c – all not exact and all not cross-reactive Grey^c – Ags untested/do not meet threshold
Strain coverage of national strain panels	50% of unpredictable considered covered/not covered, respectively	No further criteria

Note: ^AIf test of proportions rejected 50% coverage as a null hypothesis.

Note: ^BProtein expression not inferred.

Note: ^CTraffic light system.

Figure 4. 4CMenB coverage of English invasive MenB isolates from 2014/15 to 2017/18 as predicted by MATS, gMATS and MenDeVAR.

Folegatti PM, Ewer KJ, Aley PK, Angus B, Becker S, Belij-Rammerstorfer S, Bellamy D, Bibi S, Bittaye M, Clutterbuck EA, et al.; Oxford COVID Vaccine Trial Group. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet. 2020;396(10249):467–78. doi:10.1016/S0140-6736(20)31604-4.

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World Health Organization. COVID-19 vaccine tracker and landscape 2021. [accessed 2021 Aug 31st]. https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

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Isitt C, Cosgrove CA, Ramsay ME, Ladhani SN. Success of 4CMenB in preventing meningococcal disease: evidence from real-world experience. Arch Dis Child. 2020 Aug;105(8):784–90. doi:10.1136/archdischild-2019-318047.

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Muzzi A, Brozzi A, Serino L, Bodini M, Abad R, Caugant D, Comanducci M, Lemos AP, Gorla MC, Křížová P, et al. Genetic Meningococcal Antigen Typing System (gMATS): a genotyping tool that predicts 4CMenB strain coverage worldwide. Vaccine. 2019 Feb 8;37(7):991–1000. doi:10.1016/j.vaccine.2018.12.061.

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Rodrigues CMC, Jolley KA, Smith A, Cameron JC, Feavers IM, Maiden MCJ. Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) index: a rapid and accessible tool that exploits genomic data in public health and clinical microbiology applications. J Clin Microbiol. 2020;59(1). doi:10.1128/JCM.02161-20.

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