Other Vaccines Against Meningococcal Disease
Several bacteria can cause meningitis and septicaemia, some of which can be prevented through vaccination.
The Hib/MenC vaccine is offered as part of the NHS vaccination programme to all babies after their 1st birthday.
The MenB vaccine is offered as part of the NHS childhood vaccination programme to all babies at 8 and 16 weeks, with a booster after their 1st birthday.
Page last reviewed: 2 April 2020 Next review due: 2 April 2023
Who Should Get The Men
The Men-C vaccine is given to infants as a series of 2 doses. The first is given at 2 months of age, and the second at 12 months. The vaccine is given at the same time as other childhood immunizations.
The vaccine may also be given to people:
- born before 2002 who are 24 years of age and under who did not get a dose of vaccine on or after their 10th birthday
- 18 years of age and older who have had a stem cell transplant and
- who have been in close contact with someone with meningococcal type C disease.
It is important to keep a record of all immunizations received.
Are There Times You Shouldn’t Get The Vaccine
Typically, you want to avoid getting it if you:
- Are very sick. A mild cold is OK, but for anything more than that, it’s better to hold off.
- Had a severe, life-threatening allergy to a meningitis vaccine or some part of it. Your doctor can tell you what’s in the vaccine.
- Had a severe reaction to the DTap vaccine or latex
- Have Guillain-Barre syndrome. Ask your doctor if the vaccine is safe for you.
- Have a latex allergy
May be pregnant or are breastfeeding. It’s typically best to avoid the vaccine in this case, but if it’s needed, your doctor can help weigh the pros and cons.
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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 asTrumenba 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.
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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Route Site And Needle Size
Administer meningococcal conjugate and serogroup B meningococcal vaccines by the intramuscular route. The preferred site for infants and young children is the vastus lateralis muscle in the anterolateral thigh. The preferred injection site in older children and adults is the deltoid muscle. Use a needle length appropriate for the age and size of the person receiving the vaccine.
Where Can I Find These Vaccines
Your doctor is usually the best place to receive recommended vaccines for you or your child. These vaccines are part of the routine childhood immunization schedule. Therefore, vaccines for children and teens are regularly available at
- Pediatric and family practice offices
- Community health clinics
If your doctor does not have these vaccines for adults, ask for a referral.
Vaccines may also be available at
- Health departments
- Other community locations, such as schools and religious centers
You can also contact your state health department to learn more about where to get vaccines in your community.
When receiving any vaccine, ask the provider to record the vaccine in the state or local vaccine registry, if available. This helps providers at future visits know what vaccines you or your child have already received.
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What Is Meningococcal C Infection
Meningococcal C infection is caused by bacteria called meningococcal type C. It can cause serious and life-threatening infections including meningitis, an infection of the lining that covers the brain, and septicemia, an infection of the blood. For every 100 people who get sick, up to 15 will die, even if they receive treatment. Permanent complications of infection include brain damage and deafness.
Meningococcal infection is spread from person to person by coughing, sneezing, or close face-to-face contact. It can also be spread through saliva. Babies and young children can become sick through sharing soothers, bottles or toys used by other children. Older children and adults can become sick through activities such as kissing, or sharing food, drinks, cigarettes, lipstick, water bottles, and mouth guards used for sports or mouthpieces of musical instruments.
Meningococcal type C disease is now rare in B.C. because of routine childhood immunization programs.
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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What Is Meningococcal Disease
Meningococcal disease is a serious illness caused by a bacterium. It can cause meningitis, which is an infection of the brain and spinal cord, and it can also cause blood infections. The infection can cause death or lifelong disability.
About 375 people get the disease each year, and about 10 to 15 out of 100 people infected with meningococcal disease die. Of those who survive, up to one out of five will have permanent disabilities, such as deafness, brain damage, loss of limbs, or seizures.
A person with meningococcal disease may become seriously ill very quickly. Antibiotics can treat meningococcal infections, but often cant be given soon enough to help.
Anyone can get meningococcal disease, but it is most common in infants less than 1 year of age. Teens are less likely to be infected than infants, but disease levels increase in adolescence starting around age 11, and peak around age 19 years.
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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When Should My Child Get The Vaccine
- Your child should be immunized with Men-C-C at 12 months of age. Your child may get earlier doses, started anytime between 2 and 12 months of age, depending on your province or territorys immunization program.
- Teens should get a dose of MCV-4 or Men-C-C, usually at about 12 years of age.
- Children at higher risk for meningococcal disease should receive MCV-4 and Men-B vaccine starting as early as 2 months of age. If you are unsure, talk to your doctor.
Acwy Vaccination Is Free For Some People
In Victoria, immunisation against meningococcal serogroups A, C, W and Y is available for free as part of the National Immunisation Program schedule for:
- children aged 12 months
- children from 13 months to under 20 years of age, who did not have their meningococcal C vaccine at 12 months
- young people in Year 10 of secondary school
- young people not in secondary school, aged 15 to 19 years.
Young people in the 15 to 19 years age group are more likely to spread the disease to others. One in five people in this age group carry the bacteria that cause meningococcal disease. Immunisation experts have advised that immunising this age group can prevent spread to other age groups and protect the wider community.
Eligible young people who are away from school on the day the vaccine was given, or who do not attend secondary school, can attend either a local government community immunisation session, or a general practitioner to receive the free meningococcal ACWY vaccine. The GP may charge a consultation fee.
Contact your local government to find out when and where immunisation sessions are held.
- People with specified medical risk conditions can also receive free meningococcal ACWY vaccine. This includes people with:
- a poorly functioning spleen or no spleen, including sickle cell disease or other haemoglobinopathies
- defects in, or a deficiency of, a complement component, including factor H, factor D or properdin deficiency
- current or future treatment with eculizumab .
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What Happens After The Immunization
Your child might have a fever, soreness, and some swelling and redness at the injection area. Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever and to find out the right dose.
A warm, damp cloth or a heating pad on the injection site may help reduce soreness, as can moving or using the arm.
Quadrivalent Meningococcal Conjugate Vaccine
Potential adverse reactions after meningococcal conjugate vaccines include localised pain, irritability, headache and fatigue. Fever is reported by 25 percent of adolescents who receive MenACWY-D.
The safety of two doses of MenACWY-D was assessed in a phase III trial of infants: dose one was administered at age 9 months and dose two was administered at age 12 months, with or without routine childhood vaccines. The percentage of participants with solicited systemic reactions after MenACWY-D administration alone at age 12 months was lower than after the vaccination at age 9 months , lower than the control groups at age 12 months and lower than when MenACWY-D was administered concurrently with the routine childhood vaccines .
The safety profile of MenACWY-T is very similar to other meningococcal conjugate vaccines.
There is no evidence of an association between meningococcal conjugate vaccines and GBS. An early report in the US of a suspected temporal association between MenACWY-D and GBS was followed by a large retrospective cohort study in the US that found no evidence of an increased risk of GBS following administration of MenACWY-D. If indicated, meningococcal conjugate vaccines may be administered to individuals with a history of GBS.
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Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals. Review of meningococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present as persons with sickle cell disease are at risk of serious meningococcal infections. In many countries outside of Canada, conjugate meningococcal vaccines are in limited use. Information on vaccination schedules in other countries can be found on the World Health Organization website. Refer to Immunization of Persons New to Canada in Part 3 for additional general information.
Symptoms Of Meningococcal Disease
Neisseria meningitidis can cause invasive meningococcal disease , which usually presents as meningitis and septicaemia. Septicaemia, either on its own or with meningitis, can be particularly severe. N. meningitidis can also cause other localised infections, although these are less common, including:74,84
The clinical manifestations of meningococcal septicaemia and meningitis may be non-specific.
They can include:85
Not all symptoms or signs may be present at disease onset.
The characteristic rash of meningococcal disease does not disappear with gentle pressure on the skin, but the rash is not always present.
IMD can also present atypically as:
These atypical presentations are more common among certain serogroups, especially serogroup W.
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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.
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.
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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.
Use Of Saliva Testing Of Antibody Levels Against Meningococcal Serogroups For Monitoring Meningococcal Vaccine Responses
The authors stated that a drawback of this study was that only samples of children aged 10 to 15years were used here to identify the salivary thresholds. Thus, these salivary thresholds as surrogate of protection have to be validated in other large meningococcal vaccine trials, preferably studies that include participants with a wide age range. furthermore, samples were collected only up to 1 year after vaccination. Whether saliva samples could be used as a surrogate of protection in the long-term after vaccination has to be examined as well.
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Risk By Age Group And By Aboriginal And Torres Strait Islander Status
Children aged < 2 years
Children aged < 2 years have the highest incidence of meningococcal cases. The disease occurs most often in infants aged 35 months.
Adolescents aged 1519 years
A high number of meningococcal disease cases occurs among adolescents and young adults aged 1524 years, with peak rates of disease occurring in 1820-year-olds. Adolescents and young adults have the highest rate of meningococcal carriage and are thought to play an important role in transmitting the bacteria in a community.4
Adolescents and young adults in this age bracket who have a higher risk of acquiring the meningococcal bacteria are:
- people who live in close quarters, such as new military recruits and students living in residential accommodation
- people who have prolonged contact with a person who is carrying meningococcal bacteria5-7
- people who are smokers8-10
Aboriginal and/or Torres Strait Islander people
Aboriginal and Torres Strait Islander people have much higher incidence rates of meningococcal disease than non-Indigenous Australians.96 This is particularly among children aged < 15 years for the 2 most common meningococcal serogroups: B and W.
Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors. Conjugate meningococcal vaccine, as appropriate for age, may be given regardless of possible previous receipt of the vaccine, as adverse events associated with repeated immunization have not been demonstrated. Refer to Immunization of persons with inadequate immunization records in Part 3 for additional general information.
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Problems That Could Happen After Getting Any Injected Vaccine
- People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell the provider if you or your child feel dizzy, have vision changes, or have ringing in the ears.
- As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.