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.
Who Should Get Which Meningococcal Vaccine And When
Although MCV4 is the preferred vaccine for most people, if it is not available when it’s time for the vaccination, MPSV4 can be used.
Routine immunization with the meningococcal vaccine MCV4 is recommended for children ages 11 or 12, with a booster to be given between ages 16 and 18. Vaccinations are also recommended for the following groups:
- College freshmen living in a dorm
- Military recruits
- Someone who has a damaged spleen
- Someone whose spleen has been removed
- Someone with terminal complement component deficiency
- Microbiologists who are routinely exposed to meningococcal bacteria
- Someone traveling to or residing in a country where the disease is common
- Someone who has been exposed to meningitis
Preteens who are 11 and 12 usually have the shot at their 11- or 12-year-old checkup. An appointment should be made to get the shot for teenagers who did not have it when they were 11 or 12.
The vaccine may be given to pregnant women. However, since MCV4 and MenB are newer vaccines, there is limited data about their effect on pregnant women. They should only be used if clearly needed.
Anyone who is allergic to any component used in the vaccine should not get the vaccine. It’s important to tell your doctor about all your allergies.
People with mild illness such as a cold or congestion can usually get the vaccine. But people who are moderately or severely ill at the time of vaccine administration should wait until they recover.
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.
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.
How Many Children Are In The Usa In School
In Americas public schools, there are over 50.7 million students, based on federal projections for the fall of 2022. How many students attend charter schools? According to data from four years earlier , almost 3.3 million students, or 6.5 percent of all public school students, attend charter schools.
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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. Check with your insurance provider for details on whether there is any cost to you for this vaccine.
The Vaccines for Children, or VFC, program provides vaccines for children 18 years old and younger who are
- Not insured
- 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
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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Special Considerations For Use Of Menactra For People With Functional Or Anatomic Asplenia Or Hiv
Children with functional or anatomic asplenia or HIV should not receive Menactra® before the age of 2 years. This timing avoids interference with the immunologic response to the infant series of pneumococcal conjugate vaccine . CDC recommends infants 2 through 23 months of age with functional or anatomic asplenia or HIV receive Menveo®.
People 2 years of age or older with functional or anatomic asplenia or HIV should not receive Menactra® at the same time as PCV. They should either receive Menveo® or MenQuadfi® when they get PCV or wait and receive Menactra® 4 weeks after completion of all PCV doses.
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.
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Administration With Other Vaccines
Vaccine providers may administer MenACWY and MenB vaccines during the same visit, but at a different injection site, if feasible. Providers can also administer meningococcal and other vaccines during the same visit, but at a different injection site, if feasible. Administer each vaccine with a separate syringe.
Menb Vaccination Of Adults At Increased Risk
MenB vaccines are not approved for use in people under 10 years old. Adults should receive a MenB vaccine if they are at increased risk for serogroup B meningococcal disease due to
- Having certain medical conditions
- Complement component deficiency
- Functional or anatomic asplenia
Those who remain at increased risk need regular booster doses.
- Administer a booster dose of MenB vaccine 1 year after series completion and then every 2 to 3 years thereafter.
- For those at increased risk due to an outbreak who previously received the MenB vaccine series, CDC recommends a booster dose if a year or more has passed since primary series completion.
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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.
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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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.
How Is Menactra Given
Menactra is given as an injection into a muscle. You will receive this injection in a doctor’s office or clinic setting.
Menactra is recommended if:
you’ve been exposed to an outbreak of meningococcal disease
you are in the military
you work in a laboratory and are exposed to meningococcal bacteria
you live in a dormitory or other group housing
you live in or travel to an area where meningococcal disease is common
you have a medical problem affecting your spleen, or your spleen has been removed
you use a medicine called eculizumab or ravulizumab or
you have an immune system disorder called “complement component deficiency.”
Menactra 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 doses.
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 Menactra or you may not be fully protected against disease.
There are other types of meningococcal vaccine available. When you receive a booster dose, make sure you are receiving a vaccine for meningococcal serogroups A, C, W, or Y and not for serogroup B.
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There Are Three Types Of Meningococcal Vaccines:
- The meningococcal C vaccine that protects against infection from one of the most common types of meningococcal bacteria, type C.
- The meningococcal quadrivalent vaccine that protects against 4 types of meningococcal bacteria: types A, C, Y and W-135.
- The meningococcal B vaccine that protects against infection by one of the most common types of meningococcal bacteria, type B.
The type of vaccine recommended depends on a person’s age and risk factors.
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 MenACWY vaccine is also especially important for students who live in college dorms and for military recruits.
The sequence and dosage depend 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 if 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.
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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.
When Should My Child Get The Meningococcal Vaccine
The vaccine comes in 2 forms. Your child’s healthcare provider will tell you which kind your child should get. He or she will also tell you how many doses your child needs and when to get each dose.
- Children usually get the first dose at 11 or 12 years. If your child does not get the first dose by age 12, he or she should get it between 13 and 18 years. If the first dose is given between 13 and 15 years, a booster dose is given between 16 and 18 years. The booster will be given at least 8 weeks after the first dose. Your child will not need a booster if he or she gets the first dose between 16 and 18 years. Your child can get the vaccine when he or she is 16 to 23 years old for short-term protection against infection. This works best if your child gets the vaccine by age 18.
- Children at high risk may need multiple vaccine doses starting as early as 6 weeks old. Ask your child’s healthcare provider when your child should get the vaccine. Any of the following can increase your child’s risk for meningococcal disease:
- A condition that causes a weakened immune system
- A damaged or removed spleen, or sickle cell disease
- Persistent complement component deficiency
- Use of eculizumab or ravulizumab
- Living in or traveling to areas where meningococcal infection is common
- Exposure to the infection during an outbreak of the disease
- HIV infection
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Routine Menacwy Vaccination Of Adolescents
All 11 to 12 year olds should receive a meningococcal conjugate vaccine. Since protection wanes, CDC recommends a booster dose at age 16 years. The booster dose provides protection during the ages when adolescents are at highest risk of meningococcal disease.
- For adolescents who receive the first dose at age 13 through 15 years, administer a booster dose at age 16 through 18 years, before the period of increased risk.
- Adolescents who receive their first dose of MenACWY vaccine at or after age 16 years do not need a booster dose.
- Adolescents who are at increased risk due to medical conditions need a 2-dose primary series of MenACWY vaccine administered 8 weeks apart, as well as regular booster doses every 5 years.
- CDC also recommends a booster dose for those at increased risk due to an outbreak if 5 or more years have passed since receiving MenACWY.