How Common Is Meningococcal Disease
Meningococcal disease is becoming much less common. Over the past 20 years, the overall incidence of meningococcal disease in the US has declined 10-fold. Twenty years ago in Massachusetts there were 80-100 cases of meningococcal disease per year. In contrast, for the past decade the average is approximately 12 cases per year. Declining rates of meningococcal disease may be due in part to the introduction of meningococcal vaccines as well as other factors such as the decline in cigarette smoking, which may impact susceptibility to this disease.
Most Health Insurance Plans Pay For Menb Vaccination For Teens And Young Adults
Most health plans must cover CDC-recommended vaccines with no out-of-pocket costs if an in-network healthcare provider administers the vaccine. Patients should check with their insurance provider for details on whether there is any cost to them for this vaccine.
The Vaccines for Children, or VFC, program provides vaccines for children 18 and younger who are
- Not insured
- Medicaid-eligible
- American Indian or Alaska Native
Parents can find a VFC provider by contacting their local health department. VFC will cover the cost of MenB vaccination for those
- 16 through 18 years old
- 10 through 18 years old at increased risk due to a medical condition
- 10 through 18 years old identified as being at increased risk due to a serogroup B meningococcal disease outbreak
Many Colleges Require Proof Of Menacwy Vaccination Within 5 Years Before Starting School
Regardless of school requirements, CDC recommends a booster dose for all teens who received the first dose before their 16th birthday. The booster dose provides the best protection during the ages when teens are at highest risk. Teens who receive their first MenACWY vaccine dose at or after age 16 years do not need a booster dose.
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Meningococcal Acwy Vaccine Side Effects
The meningococcal ACWY vaccine is effective and safe, although all medications can have unwanted side effects.
Side effects from this vaccine are uncommon and are usually mild, but may include:
- localised pain, redness and swelling at the injection site
- occasionally, an injection-site lump that may last many weeks
- low-grade temperature
- children being unsettled, irritable, tearful, or generally unhappy, drowsy and tired.
Which Meningococcal Vaccines Are Available
In the U.S., three meningococcal vaccines are available:
- Meningococcal polysaccharide vaccine , sold as Menomune
- Meningococcal conjugate vaccine , sold as Menactra, MenHibrix, and Menveo.
- Serogroup B meningococcal vaccine, sold as Trumenba and Bexsero.
MPSV4 and MCV4 can prevent four types of meningococcal disease, which make up about 70% of the cases in the U.S.
The MenB vaccines prevent the Meningococcal B strain.
MCV4 is preferred for people age 55 and younger. The recommendation for teens is one dose at age 11 and one dose at age 16. The doctor or nurse injects one dose into the muscle. If MCV4 is not available, you can use MPSV4. The doctor or nurse injects one dose beneath the skin.
MPSV4 is the only meningococcal vaccine approved for use in people over 55.
The MenB vaccines are recommended for ages 10-24, by the CDC for high risk patients, but can also be used in older adults. Trumenba is administered in three doses while Bexsero requires two doses.
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Why Are Meningococcal Vaccines Recommended
Meningococcal disease is caused by a type of bacteria. It can lead to an infection of the bloodstream or meningitis, or both, and can be life-threatening if not quickly treated. The MenACWY vaccine is very effective at protecting against four strains of the bacteria, while the MenB vaccine protects against a fifth strain.
How Effective Is Meningococcal Vaccine
Having the meningococcal vaccine does not give you lifelong protection against meningococcal disease. When you get the vaccine, it causes your body’s defence system to produce antibodies to fight against the infection if you come into contact with someone who has the illness. But, over time, the antibody levels decrease. The number and quality of antibodies and how long they last depend on what type of vaccine is used, the meningococcal group covered by the vaccine and the age of the person receiving the vaccine.
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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
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.
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What Is Meningitis B
While its not very common, if you get meningococcal B, it is a nasty disease, Litjen Tan, MD, chief strategy officer at the Immunization Action Coalition , tells Health. The IAC is a national nonprofit authority on vaccination policies that aims to increase immunization rates.
Meningitis B is more prevalent among 18 to 24-year-old college students than kids and adults in other age groups that’s because it’s easier for infections to spread among young adults living in cramped living quarters, such as dorms. Symptoms of the disease include sudden high fever, stiff neck, severe headache, nausea, and vomiting, as well as convulsions, rapid breathing, and confusion. A dark purple rash will usually appear on the arms, legs, or torso, too.
Part of what makes meningitis B so deadly is that many students and parents dont know about it, and many symptoms mimic those of more common illnesses, such as the flu. It wouldnt be unreasonable for a college student to assume they had the flu and then try to sleep off some of the symptoms. But if they actually have meningitis B and try that approach, theres a good chance the illness will overcome them and turn fatal.
Kimberly was perfectly healthy. Sitting in her classroom. Next day shes in the ICU fighting for her life, Wukovits recalls.
Stillman echos her heartbreak. People think so rare. But when its your child, 100% of that child just died. It doesnt matter what the statistics are, she says.
Rare Side Effects Of Meningococcal Immunisation
There is a very small risk of a serious allergic reaction to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation in case further treatment is required.
If any other reactions are severe and persistent, or if you are worried, contact your doctor for further information.
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Why Is The Meningitis B Vaccine Not Recommended As Strongly As The Ac W Y Vaccine
In short: cost. Dr. Tan says theres a problem with formally recommending a meningitis B vaccination for every young person in the US. Were not infinitely rich. The resources to vaccinate every adolescent in our countryits immense. Its just not practical, he explains.
That said, the current recommendation isnt working either.
Weve got to figure out a way to manage this. Were depriving people of a very good vaccine who might want to get protected, Dr. Tan says. He places the blame on doctors who dont bring up the disease or the vaccine when they meet with their patients. Thats an implementation problem. If you fail to talk about B vaccine, youre failing your patients. need to have an internal policy where everybody agrees youre going to talk about the vaccine, Dr. Tan says.
Is It Possible To Get The Vaccine And Still Get Meningitis
Because the vaccines do not protect against all causes of meningitis, it is still possible that someone could receive the vaccine and still get meningitis from a different strain not protected by the vaccine. But the risk of contracting meningococcal meningitis is significantly lower after the vaccine.
There are other causes of meningitis that are preventable. Vaccines like the Hib vaccine and the pneumococcal vaccine are also very effective at protecting against other causes of meningitis and should be included as part of a routine childhood vaccination schedule. Check with your doctor and your children’s doctor to make sure that you and your family are protected against meningitis, as well as other serious illnesses.
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Guidance On Reporting Adverse Events Following Immunization
To ensure the ongoing safety of vaccines in Canada, reporting of AEFIs by vaccine providers and other clinicians is critical, and in some jurisdictions, reporting is mandatory under the law.
Vaccine providers are asked to report AEFIs, through local public health officials, and to check for specific AEFI reporting requirements in their province or territory. In general, any serious or unexpected adverse event felt to be temporally related to vaccination should be reported.
For additional information about AEFI reporting, please refer to Adverse events following immunization. For general vaccine safety information, refer to Vaccine safety and pharmacovigilance in Part 2.
Does The Vaccine Work
The MenB vaccine has been tested on thousands of adults and children, and from these clinical trials it is thought that the new vaccine will prevent a high proportion of cases of group B meningococcal disease. However because the disease is rare, the exact number of cases that will be prevented will not be known until the vaccine has been used routinely.
In February 2016 Public Health England published research which showed that the MenB vaccine should help to provide protection against the aggressive strain of MenW disease circulating in the UK , as well as protecting against MenB disease.
In September 2016 Public Health England reported on research carried out on babies in the UK who were eligible to receive the new MenB vaccine. The research showed that the number of cases of meningitis and septicaemia caused by MenB infection in these babies had nearly halved over the previous year . See the research published in The Lancet in October 2016.
Public Health England estimates that the MenB programme prevented about 250 cases of invasive MenB disease in the first three years of the programme. In the second year of the programme, there was an estimated 72% reduction in the number of cases of invasive MenB disease in infants, and in the third year of the programme there was a further estimated 60% reduction in cases of invasive MenB disease in infants.
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Potential Serious Side Effect
Very rarely, serious side effects can occur with any vaccine. Speak with your healthcare provider immediately if you or your child experience:
- Dizziness, ringing in the ears, or vision changes after the vaccine is administered. This could indicate that you are going to faint.
- Severe pain in your shoulder or trouble moving your arm where the shot was administered.
- Symptoms of an allergic reaction, including changes to breathing. This can happen even hours after a shot is given.
Your Child Can Get Menacwy And Menb Vaccine At The Same Time
Your childs clinician can give both types of meningococcal vaccines during the same visit, but preferably in different arms. If you choose for your child to get a MenB vaccine, the preferred timing is between 16 and 18 years old. So its possible your child will get this vaccine and the MenACWY booster dose at the same visit.
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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.
Preteens And Teens Are At Increased Risk For Meningococcal Disease An Uncommon But Serious Illness
Meningococcal disease can be devastating and oftenand unexpectedlystrikes otherwise healthy people. Although meningococcal disease is uncommon, teens and young adults 16 through 23 years old are at increased risk. Meningococcal bacteria can cause severe, even deadly, infections like
- Meningitis
- Bacteremia or septicemia
About 1 in 5 people who survive their meningococcal infection have permanent disabilities.
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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.
Are Students In College At Risk For Meningococcal Disease
In the 1990s, college freshmen living in residence halls were identified as being at increased risk for meningococcal disease. Meningococcal disease and outbreaks in young adults were primarily due to serogroup C. However, following many years of routine vaccination of young people with quadrivalent meningococcal conjugate vaccine , serogroup B is now the primary cause of meningococcal disease and outbreaks in young adults. Among the approximately 9 million students aged 18-21 years enrolled in college, there are an average of 20 cases and 2-4 outbreaks due to serogroup B reported annually.
Although incidence of serogroup B meningococcal disease in college students is low, college students aged 18-21 years are at increased risk compared to non-college students. The close contact in college residence halls, combined with certain behaviors , may put college students at increased risk.
Is there a vaccine against meningococcal disease?
Yes, there are 2 different meningococcal vaccines.
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Who Should Get Meningococcal Vaccines
CDC recommends meningococcal vaccination for all preteens and teens. In certain situations, CDC also recommends other children and adults get meningococcal vaccines. Below is more information about which meningococcal vaccines, including booster shots, CDC recommends for people by age.
Talk to your or your childs clinician about what is best for your specific situation.
Simultaneous Administration With Other Vaccines
Men-C-C and 4CMenB vaccine may be administered concomitantly with routine childhood vaccines, and Men-C-ACYW vaccine may be administered concomitantly with adolescent and adult age appropriate vaccines. MenB-fHBP can be given concomitantly with quadrivalent human papillomavirus vaccine meningococcal serogroup A, C, Y, W conjugate vaccine and tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine adsorbed. The concomitant administration of MenB-fHBP has not been studied with other vaccines.
Men-C-ACYW-CRM can be administered with routine paediatric vaccines however, further studies are needed with regard to concomitant administration with pneumococcal 13-valent conjugate vaccine. Co-administration of Men-C-ACYW-CRM and combined tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine may result in a lower immune response to the pertussis antigens than when Tdap vaccine is given alone however, the clinical significance of this is unknown. Tdap vaccine given one month after Men-C-ACYW-CRM induces the strongest immunologic response to pertussis antigens.
If vaccines are to be administered concomitantly with another vaccine, a separate injection site and a different syringe must be used for each injection.
Refer to Timing of Vaccine Administration in Part 1 for additional general information.
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You Are Pregnant Or Breastfeeding
- Pregnant women who are at increased risk for serogroup A, C, W, or Y meningococcal disease may get MenACWY vaccines.
- Pregnant or breastfeeding women who are at increased risk for serogroup B meningococcal disease may get MenB vaccines. However, they should talk with a clinician to decide if the benefits of getting the vaccine outweigh the risk.
Persons With Chronic Diseases
Asplenia
Two doses of Men-C-ACYW vaccine are recommended for persons with anatomic or functional asplenia, including sickle cell disease. When elective splenectomy is planned, all recommended vaccines should ideally be completed at least 2 weeks before surgery if only one dose can be given before surgery, the second dose should be given 8 weeks after the first dose, with a minimum interval of 4 weeks. In the case of an emergency splenectomy, two doses of vaccine should ideally be given beginning 2 weeks after surgery but can be given earlier, before discharge, if the person might not return for vaccination after discharge. Persons one year of age and older with asplenia who have not received Men-C-ACYW vaccine should receive two doses administered 8 weeks apart, with a minimum interval of 4 weeks. In addition, 4CMenB or MenB-fHBP vaccine should be offered. Periodic booster doses with Men-C-ACYW vaccine are also recommended.
Refer to Table 1 for vaccination recommendations of high risk individuals due to underlying conditions. Refer to Booster doses and re-immunization for additional information and Immunization of Persons with Chronic Diseases in Part 3 for additional general information.
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