Meningococcal Meningitis Outbreak During The Hajj
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Neisseria meningitidus W135 is a very infectious and lethal strain of Meningococcal Meningitis if it is not treated early on. It is easily transmissible from one person to another and is ever developing into different subtypes, making vaccination quite difficult. Attempting to keep this bacterium at bay is not easy and will require more examination overtime to evaluate the rate of evolution that occurs to properly create a vaccine that will be effective long termly. Investigators recommend that in order to prevent oneself from this disease, individuals must avoid contact with people and areas that are at high risk of the infectious disease and practice good hygiene as much as possible. Saudi Arabias outbreak was devastating and is still under watch to make sure that the disease does not cause another epidemic. Technology is ever advancing and soon enough, this disease will be eliminated with patience.
Older Children And The Menacwy Vaccine
From September 2015 MenACWY began being routinely offered to schoolchildren aged 14-15. . It is also offered to those aged 17-18 and young adults under the age of 25. This is because of a rise in infection with group W meningococcus in this age group.
If you are under the age of 25 and have not been immunised, see your doctor or practice nurse to get immunised. This is particularly important if you are about to start university for the first time, as the risk of infection with group W meningococcus is highest in first-year university students. Just one injection of vaccine is needed if you are over the age of 1 year.
Why Do Teens Need A Meningococcal Vaccine
Of the 1,000-2,600 people who get meningococcal disease each year, one-third are teens and young adults. Ten percent to 15% of those who get sick with the disease will die, even with antibiotic treatment. As many as 20% of the survivorswill have permanent side effects, such as hearing loss or brain damage.
The immunization can help prevent this serious disease.
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How Is Meningococcal Disease Spread And Who Is Most At Risk
Meningococcal disease is not as contagious as other illnesses, such as a cold or the flu. But it is spread by contact with infected respiratory and throat secretions. That can happen with coughing, kissing, or sneezing.
Because the risk increases with close or prolonged contact with an infected person, family members in the same household and caregivers are at an increased risk. For the same reason, so are college students who live in dormitories.
What Are The Three Meningitis Vaccines
In the U. As well as meningococcal polysaccharide vaccines, there are other types available: Menomune is the only meningococcal vaccine available. There are three types of Meningococcal conjugate vaccine that are on offer, Menactra, MenHibrix, and Menveo. Trumenba or Bexsero are two variants of the serogroup b b vaccines.
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Aboriginal And Torres Strait Islander People
Aboriginal and Torres Strait Islander people aged 2 months to 19 years are strongly recommended to receive MenACWY vaccine
Aboriginal and Torres Strait Islander people aged 2 months to 19 years are strongly recommended to receive MenACWY vaccine.
The dose schedule for MenACWY vaccine depends on the vaccine brand and the persons age when they start the vaccine course.
Infants aged < 9 months can receive 2 of the 3 MenACWY brands .
Infants and children aged 9 months to 2 years can receive any of the 3 MenACWY vaccine brands, following the age-appropriate dosing schedule.
For all people aged 2 years, a single dose of MenACWY vaccine is recommended. In this age group, it is preferable to receive either Menveo or Nimenrix, rather than Menactra. If Menveo and Nimenrix are unavailable, Menactra can be given.
Aboriginal and Torres Strait Islander people aged 2 months to 19 years are strongly recommended to receive a course of MenB vaccine.
The dose schedule for MenB vaccine depends on the brand and the persons age when they start the vaccine course.
People aged 29 years should receive 2 doses of Bexsero, 8 weeks apart.
People aged 10 years can receive 2 doses of either MenB vaccine:
- 2 doses of Bexsero, with 8 weeks between doses, or
- 2 doses of Trumenba, with 6 months between doses
Common And Local Adverse Events
Conjugate meningococcal vaccines
Men-C-ACYW vaccines
Injection site reactions occur in up to 59% of vaccinees. Fever is reported in up to 5% of recipients and systemic reactions, such as headache and malaise, are reported in up to 60% of recipients.
Men-C-C vaccines
Mild reactions, including injection site reactions , occur in up to 50% of vaccine recipients. Irritability occurs in up to 80% of infants and fever in up to 9% when other vaccines were administered. Headaches and malaise occur in up to 10% of older children and adults. These reactions last no more than a few days.
Serogroup B Meningococcal vaccines
4CMenB vaccine
Solicited local and systemic reactions have been commonly reported in clinical trials and include injection site tenderness, induration, sleepiness and irritability. Higher rates of fever have been observed with simultaneous administration of 4CMenB vaccine and routine infant vaccines therefore, routine prophylactic administration of acetaminophen or separating 4CMenB vaccination from routine vaccination schedule has been proposed for preventing fever in infants and children up to three years of age.
MenB-fHBP vaccine
Solicited local and systemic reactions have been commonly reported in clinical trials and include injection site tenderness, induration and irritability.
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What Are The Meningococcal Vaccine Side Effects
As with any other vaccine, you may have side effects after getting a meningococcal vaccine. The most common reactions are mild and go away after a few days without any problems.
Mild reactions to MenB vaccines seem to last slightly longer than mild reactions to MenACWY vaccines .
Common side effects of the MenACWY vaccines include:
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Skin irritation at the location of the shot
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Headache
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Chills or fever
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Diarrhea or nausea
Serious but rare side effects from any injected vaccine include severe allergic reactions and fainting. Sit or lay down for about 15 minutes after receiving a vaccine if youre feeling dizzy or lightheaded.
Submitting Proof Of Vaccination
Do not submit your vaccination proof to Undergraduate Admissions or the Student Health Center.
Texas State uses Magnus Health SMR for managing compliance with the meningitis vaccination requirement. New students planning to enroll at Texas State must submit proof of meningitis vaccination directly to Magnus Health SMR. Students subject to the bacterial meningitis requirement will receive an email from Magnus Health SMR with instructions. Students will be charged $10 by Magnus Health SMR for processing the documents and verifying compliance with the vaccination requirement. Acceptable evidence of vaccination may include any of the following:
- An official immunization record from a government health authority .
- An official immunization record received from school officials, including a record from another state .
- Students using a pharmacy should download and provide the pharmacist with the generic immunization form available on the Magnus website, once they have paid their processing fee, to ensure they receive an approvable document from the pharmacist . H-E-B customers should request their Vaccine Administration Consent Form for submission to Magnus.
- All records must be in English to be approved.
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Who Should Not Get A Meningococcal Vaccine
Your preteen or teen shouldn’t get the meningococcal vaccine if they:
- Has had a severe, life-threatening allergic reaction to a meningococcal vaccine before or to any vaccine component
- Is moderately or severely ill
- Has ever had Guillain-Barre syndrome
Pregnant women can get the meningococcal vaccine, but it’s only recommended for those with certain immune problems or those likely to be exposed to meningitis. With the newer MCV4 and MenB vaccines, there hasn’t been as much study in pregnant women compared to the MPSV4 vaccine.
Effectiveness Of The Menb Vaccine
Another type of meningococcal vaccine is the MenB vaccine, which protects against a fifth strain of Neisseria meningitidis. In the U.S., parents can opt to give their children a MenB vaccine once theyre in their teens.
The CDC’s analysis of the efficacy of the MenB vaccines in the real world comes from studies done in other countries. In Canada, a study followed a mass vaccination campaign in a region with a meningitis B outbreak and found that a MenB vaccine was 79% effective in the four years after vaccination.
In the UK, MenB vaccines have become part of the childhood immunization schedule. By 2018 as many as 92% of eligible infants in the UK completed a MenB vaccination by their first birthday, according to a 2020 study in The New England Journal of Medicine.
That study estimated that the vaccine was about 53% effective. This policy has also resulted in a large drop in meningitis B cases. The study noted a 75% drop in cases among vaccine-eligible age groups, compared to the expected numbers.
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Interchangeability Of Meningococcal Vaccines
MenACWY vaccines
If possible, complete the primary course of MenACWY vaccination with the same vaccine brand. If this is not possible, use an alternative brand following the dose recommendations by age. See Recommended dose schedules.
People can receive booster doses of MenACWY vaccine using any brand. Menveo or Nimenrix are preferred to Menactra in people aged 2 years.
MenB vaccines
Bexsero and Trumenba are not interchangeable. Use the same vaccine to complete the vaccination course.
The only absolute contraindications to meningococcal vaccines are:
- anaphylaxis after a previous dose of any meningococcal vaccine
- anaphylaxis after any component of a meningococcal vaccine
Previous meningococcal disease, regardless of the serogroup, is not a contraindication to receiving any meningococcal vaccine.
Previous vaccination with the strain-specific MenB vaccine used in New Zealand is not a contraindication to receiving either Bexsero or Trumenba.
Previous vaccination with a quadrivalent polysaccharide meningococcal vaccine is not a contraindication to receiving any MenACWY vaccine. See People who have previously received a meningococcal polysaccharide vaccine in Laboratory workers or Travellers.
Who Needs A Meningococcal Vaccine
The CDC recommends a meningococcal vaccine for:
- All children ages 11-18 or certain younger high-risk children
- Anyone who has been exposed to meningitis during an outbreak
- Anyone traveling to or living where meningitis is common, such as in sub-Saharan Africa
- Military recruits
- People with certain immune system disorders or a damaged or missing spleen
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Are Both Meningococcal Vaccines Equally Effective
The MCV4, MPSV4 and MenB vaccines are about 85-90% effective in preventing meningococcal disease. There are actually several types of N meningitidis — the bacterium that causes meningococcal disease, five of which are common in the U.S. These vaccines together protect against all five of these strains.
MCV4 has not been available long enough to compare the long-term effectiveness of the two vaccines. But most experts think that MCV4 provides better, longer-lasting protection.
Meningococcal B Vaccine: Frequently Asked Questions
In June 2015, the U. S. Advisory Committee on Immunizations Practices provided a category B recommendation for both Men B vaccines, making the vaccine appropriate for individual clinical decision-making:
A serogroup B meningococcal vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short term protection against most strains of serogroup B meningococcal disease. The preferred age for Men B vaccination is 16 through 18 years of age.3,4
This is not a category A or âroutineâ recommendation, so many health care providers and patients have questions about the vaccine. Below is a list of frequently asked questions that may assist with decision-making:
Should low risk patients aged 16 to 23 be advised to get one of the new Men B vaccines? There is no clear answer to that question. Persons aged 16 to 23 are at an increased risk of contracting meningococcal infections. However, the incidence of Men B disease is low and seems to be getting lower. There is limited information about the clinical efficacy and safety of the vaccines. This is one of the reasons the ACIP gave this recommendation a B rather than an A rating.3,4
Will immunizing populations decrease carriage of the meningococcal B bacteria? So far, limited studies have not shown a decrease of asymptomatic carriage in immunized populations. More studies are planned.4
Where can I get more information? More information is available at the CDC/ACIP website.
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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.
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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Are Students Required To Get Meningococcal Vaccine Before College
Yes. Massachusetts law requires the following students receive quadrivalent meningococcal conjugate vaccine :
- Secondary School : newly enrolled full-time students who will be living in a dormitory or other congregate housing licensed or approved by the secondary school must provide documentation of having received a dose of meningococcal conjugate vaccine at any time in the past.
- Postsecondary Institutions : newly enrolled full-time students 21 years of age and younger must provide documentation of having received a dose of quadrivalent meningococcal conjugate vaccine on or after their 16th birthday, regardless of housing status.
Immunizations should be obtained prior to enrollment or registration however, students may be enrolled or registered provided that the required immunizations are obtained within 30 days of registration. There is no requirement for meningococcal B vaccination. However, adolescents and young adults may also be vaccinated with a serogroup B meningococcal vaccine, preferably at 16 through 18 years of age, to provide short term protection for most strains of serogroup B meningococcal disease.
More information about requirements and exemptions may be found in the MDPH document Information about Meningococcal Disease, Meningococcal Vaccines, Vaccination Requirements and the Waiver for Students at Colleges and Residential Schools.
What Are The Symptoms Of Meningococcal Disease
Signs and symptoms of meningococcal disease include sudden onset of fever, stiff neck, headache, nausea, vomiting, sensitivity to light and/or mental confusion. A rash may also be present. Changes in behavior such as confusion, sleepiness, and unresponsiveness are important symptoms of illness. Anyone who has these symptoms should be seen by a healthcare provider immediately. In fatal cases, death can occur in as little as a few hours, even with appropriate medical treatment. Less common presentations include pneumonia and arthritis.
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How Long Do Meningococcal Vaccines Last
Like many vaccines, the protective effects of meningococcal vaccines lessen over time. Thats why booster doses are important for teens and other people at high risk for meningococcal disease.
Experts believe that within 5 years, the effects of MenACWY vaccines in teens begin to wear off. For the MenB vaccines, its suggested that protection goes down within 1 to 2 years after getting the vaccine series.
How Is This Vaccine Given
This vaccine is given as an injection into a muscle. You will receive this injection in a doctor’s office or clinic setting.
Meningococcal conjugate vaccine is recommended if:
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you’ve been exposed to an outbreak of meningococcal disease
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you are in the military
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you work in a laboratory and are exposed to meningococcal bacteria
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you live in a dormitory or other group housing
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you live in or travel to an area where meningococcal disease is common
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you have a medical problem affecting your spleen, or your spleen has been removed
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you use a medicine called eculizumab or ravulizumab or
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you have an immune system disorder called “complement component deficiency.”
Meningococcal conjugate vaccine is usually given only once to adults and children 2 years and older. You may need a booster dose if you have a high risk of meningococcal infection and it has been at least 4 years since you last received this vaccine. Younger children will need to receive 2 to 4 doses.
The Centers for Disease Control recommends that all teens ages 11 to 12 years be vaccinated with a single dose of meningococcal conjugate vaccine. A booster dose should be given at age 16 for continued protection when teens are at highest risk of meningococcal disease.
Your booster schedule may be different. Follow the guidelines provided by your doctor or local health department.
Be sure to receive all recommended doses of this vaccine or you may not be fully protected against disease.
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