Global Public Health Response Elimination Of Meningococcal A Meningitis Epidemics In The African Meningitis Belt
In the African meningitis belt, meningococcus serogroup A accounted for 8085% of meningitis epidemics before the introduction of a meningococcal A conjugate vaccine through mass preventive campaigns and into routine immunization programmes . As of April 2021, 24 of the 26 countries in the meningitis belt have conducted mass preventive campaigns targeting 1-29 year olds , and half of them have introduced this vaccine into their national routine immunization schedules. Among vaccinated populations, incidence of serogroup A meningitis has declined by more than 99% – no serogroup A case has been confirmed since 2017. Continuing introduction into routine immunization programmes and maintaining high coverage is critical to avoid the resurgence of epidemics.
Cases of meningitis and outbreaks due to other meningococcal serogroups, apart from serogroup B, continue to strike. The roll out of multivalent meningococcal conjugate vaccines is a public health priority to eliminate bacterial meningitis epidemics in the African Meningitis Belt.
Pneumococcus
The pneumococcus has over 97 serotypes, 23 causing most disease.
Haemophilus influenzae
Haemophilus influenzae has 6 serotypes, serotype b causing most meningitis.
- Conjugate vaccines protect specifically against Haemophilus influenzae serotype b . They are highly effective in preventing Hib disease and are recommended for routine use in infant vaccine schedules.
Group B streptococcus
What Are The Risks From Meningococcal Vaccine
Most people have mild side effects from the vaccine, such as redness or pain where the shot was given. A vaccine, like any medicine, may cause serious problems, such as severe allergic reactions. This risk is extremely small. Getting the meningococcal vaccine is much safer than getting the disease.
You can learn more on the Vaccine Information Statements for meningococcal ACWY and meningococcal B.
Meningococcal Vaccine: Canadian Immunization Guide
For health professionals
Latest partial content update :
: The chapter has been updated to align with the National Advisory Committee on Immunization Statement : The Use of Bivalent Factor H Binding Protein Meningococcal Serogroup B Vaccine for the Prevention of Meningococcal B Disease.
Updates include:
MenB-fHBP vaccine may be considered as an option for use in individuals 10 years of age and older in situations when a serogroup B meningococcal vaccine should be offered:
MenB-fHBP vaccine may be considered as an option for individuals 1025 years of age who are not at higher risk of meningococcal disease than the general population, but who wish to reduce their risk of invasive serogroup B meningococcal disease.
Last complete chapter revision: May 2015
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How Are The Bacteria Spread
These bacteria are passed from person-to-person through saliva . You must be in close contact with an infected persons saliva in order for the bacteria to spread. Close contact includes activities such as kissing, sharing water bottles, sharing eating/drinking utensils or sharing cigarettes with someone who is infected or being within 3-6 feet of an infected person who is coughing or sneezing.
Haemophilus Influenzae Type B/hib
Hib vaccines protect against Haemophilus Influenzae Type B.
The Hib vaccine is on the National Immunisation Plan in Australia and is given at 2months, 4 months, 6 months and 18 months.
Conjugated Hib vaccines are highly effective in preventing Hib disease and are recommended for routine use in all infants.
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Vaccines For Meningococcal Disease
There are a number of vaccines available which protect against different types of meningococcal disease. There is no one vaccine that can protect against all of the types of meningococcal disease. Different vaccines are required to protect against the most common types of meningococcal disease one to protect against meningococcal group A,C,W & Y disease, and another vaccine to protect against meningococcal group B disease. There is also a separate vaccine available to protect against meningococcal group C disease.
Who Is At Most Risk For Meningococcal Disease
High-risk groups include anyone with a damaged spleen or whose spleen has been removed, those with persistent complement component deficiency , HIV infection, those traveling to countries where meningococcal disease is very common, microbiologists who routinely work with the bacteria and people who may have been exposed to meningococcal disease during an outbreak. People who live in certain settings such as college dormitories and military housing are also at greater risk of disease from some serotypes.
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How Long Does The Meningitis Vaccine Last
Available data suggests that protection from meningococcal conjugate decreases in many teens within five years. Getting a booster, as determined by your health care provider, may be critical in maintaining protection when most at risk for meningococcal disease.
Some adolescents and young adults may also receive a serogroup B meningococcal vaccine. The preferred age for receipt is 16 through 18 years so adolescents have protection during the ages of increased risk.2
Meningococcal Disease Is A Medical Emergency:
Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving, because meningococcal disease can cause serious illness and rapidly progress to death if untreated.
Meningococcal disease is difficult to detect because it can be mistaken for other conditions. A person may have flu-like symptoms for a few days before experiencing a rapid progression to severe meningococcal disease.
Meningococcal disease is contagious. If you experience symptoms, or you may have been exposed, immediately, day or night, at 734-764-8320 and request urgent Nurse Advice, or go to an emergency room. Also see Emergency/After Hours
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Meningitis Prevention: Avoid The Spread Of Disease
You cannot get meningitis from casual contact, such as by breathing the air that an infected person has breathed. These bacteria do not live long outside the human body. But you can get it from close or prolonged contact with an infected person. The bacteria that cause meningococcal meningitis live in the back of the nose and throat and are carried by 10% to 25% of the population.
Good personal hygiene can help prevent the spread of disease:
- Don’t share food, glasses, water bottles, or eating utensils.
- Don’t share tissues or towels.
- Don’t share lip gloss or lipstick.
- Wash hands often with soap and water.
Remember: A person with bacterial meningitis can remain contagious for about 24 hours after starting antibiotics. If a person with meningitis has exposed your teen to the disease, ask the doctor whether it is necessary to take antibiotics. Doing this for a few days may help prevent your teen from getting the disease.
Is Meningococcal Disease Serious
Meningococcal meningitis and bloodstream infections can be very serious, even deadly. The infections progress quickly. Someone can go from being healthy to very ill in 48 hours or less. Even if they get treatment, about 10 to 15 out of 100 people with meningococcal disease will die from it. Long-term disabilities from having meningococcal disease include loss of limbs, deafness, nervous system problems, and brain damage.
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Healthy Infants And Children
One dose of Men-C-C vaccine is recommended in unimmunized children less than 5 years of age. One dose of Men-C-C vaccine may be considered for children 5 to 11 years of age if they have not previously been immunized as infants or toddlers. Immunization with 4CMenB vaccine or MenB-fHBP may be considered on an individual basis, depending on individual preferences, regional serogroup B epidemiology and strain susceptibility.
Other Vaccines To Prevent Meningitis
Vaccines can prevent many of the diseases that could lead to meningitis. Most of these shots are routinely given to young children. Some of these include:
Haemophilus influenzae type B vaccine. It prevents infections that cause pneumonia, meningitis, and other problems. Kids get it when they’re between 2 months and 15 months old. It’s also given to children over age 5 or adults with certain medical conditions. While Hib used to be the most likely cause of bacterial meningitis in children under age 5, the vaccine has made it very rare.
Pneumococcal vaccines. They protect against bacterial meningitis. There are two types. Doctors give the pneumococcal conjugate vaccine to children under age 2. The pneumococcal polysaccharide vaccine is recommended for all adults over 65. Some younger adults and children with a missing spleen, weakened immune systems, and certain long-term diseases may also need it.
MMR vaccine. Children need it to protect them from meningitis that can develop from measles and mumps.
Varicella vaccineand shingles vaccine. They target the varicella virus, which can potentially lead to viral meningitis.
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What Are The Possible Side Effects Of Meningococcal Vaccines
Some of the most common side effects are swelling, redness, and pain at the site of the injection, along with headache, fever, or tiredness. Serious problems, such as allergic reactions, are rare.
The meningococcal vaccines contains only a small piece of the germ, so it can’t cause meningococcal disease.
How Does Meningococcal Disease Occur
Approximately 10% of the general population carry meningococcal bacteria in the nose and throat in a harmless state. This carrier state may last for days or months before spontaneously disappearing, and it seems to give people who harbor the bacteria in their upper respiratory tracts some protection from developing meningococcal disease.
During meningococcal disease outbreaks, close to 95% of people may carry the bacteria, yet less than 1% of people develop meningococcal disease. This low occurrence of disease following exposure suggests that a person’s own immune system, in addition to bacterial factors, plays a key role in allowing the disease to develop.
Meningococcal bacteria cannot usually live for more than a few minutes outside the body. As a result, they are not easily transmitted in water supplies, swimming pools, or by routine contact with an infected person in a classroom, dining room, bar, rest room, etc.
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When Are Meningococcal Vaccines Given
Vaccination with MenACWY is recommended:
- when kids are 11 or 12 years old, with a booster given at age 16
- for teens 1318 years old who haven’t been vaccinated yet
Those who have their first dose between the ages of 1315 should get a booster dose between the ages of 1618. Teens who get their first dose after age 16 won’t need a booster dose.
Kids and teens who are at higher risk for meningococcal disease need the full series of MenACWY vaccines, even if they’re younger than 11 years old. This includes kids who:
- live in or travel to countries where the disease is common
- are present during an outbreak of the disease
- have some kinds of immune disorders. If the immune disorders are chronic, these kids also need a booster dose a few years later, depending on their age at the first dose.
The sequence and dosage depends on the child’s age, medical condition, and vaccine brand. Some types of meningococcal vaccines can be given as early as 8 weeks of age.
Kids 10 years and older with these risk factors also should get the MenB vaccine. They’ll need 2 or 3 doses depending on the brand. They might need more booster doses as long as the risk factor remains.
For those without risk factors, the decision to receive the MenB vaccine should be made together by teens, their parents, and the doctor. For them, the preferred age range is 1618 years. Usually, they need 2 doses.
What Are The Possible Side Effects Of The Vaccine
The vaccine is considered relatively free of side effects and is generally effective for three-five years. Minor reactions may include redness and swelling at the injection site that may last one to two days. About 2 percent of recipients may develop fever after vaccination. If you develop a high or persistent fever, consult a physician. Extremely rare allergic reactions have occurred, including those resulting in hives, asthma, and even anaphylaxis. As with any vaccine, vaccination with meningitis vaccine does not protect 100 percent of all susceptible individuals.
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How Effective Is It
A 2021 study examined Bexsero using data from Quebec, Italy, the United Kingdom, Portugal, and South Australia to determine its safety and effectiveness.
The researchers found that meningitis B rates decreased by 50 to 100 percent in vaccine-eligible populations. The vaccines were found to be 79 to 100 percent effective in people who received two or more doses.
Clinical trials have found promising results for Trumenba as well. is needed to understand its true effectiveness, but researchers believe that it can also provide a high level of protection.
What Are The Options For Meningococcal Vaccine
Meningococcal vaccine is highly effective at protecting against four strains of the meningococcal bacteria. Three strains are common in the United States and the fourth strain protects travelers to certain countries where the disease is more common.
The MenACWY vaccine does not contain the meningococcal B strain that is more commonly found in infants and may cause some cases in adolescents. There is an additional vaccine, meningococcal B vaccine , that contains the B strain. If your clinic does not carry the MenB vaccine, you can ask them to order it for you, or to refer you to another clinic that has the vaccine. Talk to your health care provider about getting this additional vaccine.
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Where And When Can I Get The Vaccine
Talk to your doctor or local public health clinic to find out where and when your child should get vaccinated.
- The cost of Men-C-C is covered everywhere in Canada.
- Many provinces currently cover the cost of MCV-4 vaccine.
- Currently, no provinces or territories cover the cost of Men-B vaccine for all children. Some provide it for children at high risk of getting meningococcal disease.
Is There A Meningococcal Vaccine
The vaccine called “Menveo” is available against four of the most common strains of N. meningitidis in the United States and can be used in adults and children greater than two years old. The vaccine is between 85 to 100 percent effective in preventing meningococcal disease. A single-dose vaccination produces protective antibody levels in 10 to 14 days. The vaccine does not currently provide any protection against the B strain or serotype.
Based on the possibility of increased risk of this disease among segments of the college population, the American College Health Association recommends that students consider vaccination to reduce their risk for potentially fatal meningococcal disease. Recently, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has decided to support ACHA’s decision to educate students and parents about meningococcal disease and the availability of a safe and effective vaccine to help prevent it. ACHA and the CDC are collaborating on surveillance studies to further assess the risk of meningococcal disease in the college population. Their current recommendation reads:
“Vaccination should be provided or made easily available to those freshmen who wish to reduce their risk of disease. Other undergraduate students wishing to reduce their risk of meningococcal disease can also choose to be vaccinated.”
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Meningococcal C Conjugate Vaccine
NeisVac-C is a meningococcal conjugate vaccine to protect against meningococcal group C only.
This can be used to protect babies under the age of 9 months. Babies who are less than 9 months of age need three doses to be protected. Children over 9 months of age and adults should be given the ACWY vaccine, Menactra.
The NeisVac-C vaccine is funded for children aged under 9 months with a medical condition that increases their risk of invasive meningococcal disease AND is listed on the Pharmaceutical Schedule. Refer to the Immunisation Handbookfor more details.
NeisVac-C is also available as a purchased vaccine through your family doctor. The cost is approximately $98 per dose.
For more advice on vaccines and their availability, talk to your family doctor, call the free Immunisation Advisory Centre helpline 0800 IMMUNE , or see the Immunisation Handbook.
What Are Neisseria Meningitidis
Neisseria meningitidis are bacteria that may be found normally in peoples throats and noses. About 5 to 15% of people carry these bacteria and do not get sick from them. These people may be referred to as colonized. Colonized people only have bacteria for a short time. Usually, the bacteria go away and these people may have increased resistance to infection in the future. In rare cases, the bacteria may get into the blood and go to the tissue surrounding the spinal cord and brain, causing severe illness. It is not known why this occurs in certain people and not in others. A recent upper respiratory illness may be a contributing factor.
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How Can I Protect My Child
There are three kinds of meningococcal vaccine available in Canada. Each vaccine provides different protection:
- Meningococcal C vaccine is usually given to babies and young children. It protects against type C of the meningococcus germ, which used to be very common before this vaccine was available.
- MCV-4 protects against 4 types of the meningococcal germ . This vaccine is usually only given to people at higher risk of getting meningococcal disease . In some provinces it is given to all teenagers.
- Meningococcal B vaccine protects children against type B. This vaccine is not given routinely but is usually given to children at higher risk of getting meningococcal disease.
Your doctor will know which vaccine is best for your child, and at what age.
Shouldnt Meningococcal B Vaccine Be Required
CDCs Advisory Committee on Immunization Practices has reviewed the available data regarding serogroup B meningococcal disease and the vaccines. At the current time, there is no routine recommendation and no statewide requirement for meningococcal B vaccination before going to college . As noted previously, adolescents and young adults may be vaccinated with a serogroup B meningococcal vaccine, preferably at 16 through 18 years of age, to provide short term protection against most strains of serogroup B meningococcal disease. This would be a decision between a healthcare provider and a patient. These policies may change as new information becomes available.
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