People With Medical Conditions That Increase Their Risk Of Invasive Meningococcal Disease
People with medical conditions specified in List. Specified medical conditions associated with increased risk of invasive meningococcal disease are strongly recommended to receive MenACWY and MenB vaccines.
This includes:
- a full primary course of MenACWY vaccine, with ongoing booster doses
- a full primary course of MenB vaccine
People with these specific medical conditions have a higher risk of invasive meningococcal disease. They are recommended to receive extra doses compared with people who do not have these conditions.
The number of doses needed depends on the vaccine brand used and the persons age when they start the vaccine course.
For people aged 2 years receiving MenACWY vaccine, it is preferable to receive either Menveo or Nimenrix, rather than Menactra. If Menveo and Nimenrix are unavailable, Menactra can be given.
There is no preference for either Bexsero or Trumenba for people aged 10 years. For people aged < 10 years, Bexsero is the only registered MenB vaccine available in Australia.
Bexsero and Trumenba are not interchangeable. The same vaccine should be used for both vaccine doses.
Regular booster doses are required for MenACWY vaccines, but not for MenB vaccines.
For more details see:
People who have previously received a meningococcal polysaccharide vaccine
They should receive the 1st dose of MenACWY conjugate vaccine about 2 years after the most recent dose of 4vMenPV, with a recommended minimum interval of 6 months.1-3
Booster doses
Meningococcal Conjugate Or Menacwy Vaccines
Sanofi Pasteur formulates each 0.5-milliliter dose of Menactra® in sodium phosphate buffered isotonic sodium chloride solution. Each dose contains 4 micrograms each of meningococcal A, C, W, and Y polysaccharides conjugated to approximately 48 µg of diphtheria toxoid protein carrier. It does not contain a preservative or an adjuvant. The manufacturer supplies it as a liquid in a single-dose vial.
GlaxoSmithKline formulates each 0.5-mL dose of Menveo® to consist of 2 portions:
- 10 µg of lyophilized meningococcal serogroup A capsular polysaccharide conjugated to CRM197
- 5 g each of capsular polysaccharide of serogroup C, W, and Y conjugated to CRM197 in 0.5 mL of phosphate buffered saline
Clinicians reconstitute the lyophilized MenA component with the MenCWY liquid component before injection. It does not contain a preservative or an adjuvant.
Where Can I Get Vaccinated
The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if youve already had a particular vaccination. Either your doctor or a nurse can give the vaccination. If you dont have a family doctor , you can go to one of the after-hour medical clinics. phone them first to make sure they can help you with the vaccination you need. You can find a clinic near you on the Healthpoint website. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.Vaccines on the National Immunisation Schedule are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.
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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.
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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Why Do I Need To Get The Vaccine
You’ve a higher risk of getting meningococcal disease because of your age. You need to get immunised to protect yourself as well as to protect others around you.
You may have previously had a MenC vaccine to protect you against meningococcal C infection, but this won’t protect you against MenW. Having the MenACWY vaccine after getting the MenC vaccine won’t only give you better protection against MenC infection, but will also protect you against the other 3 meningococcal groups .
What If There Is A Severe Reaction
What should I look for?
Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness– usually within a few minutes to a few hours after the vaccination.
What should I do?
If you think it is a severe allergic reaction or other emergency that can’t wait, call 9-1-1 or get to the nearest hospital. Otherwise, call your doctor.
Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System . Your doctor should file this report, or you can do it yourself through the VAERS web site at , or by calling .
VAERS does not give medical advice.
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Young People Starting University Aged 25 Or Under
Various sub groups of meningococcal disease can spread quickly in areas where people live closely to each other:
- in university halls of residence
- in shared accommodation
If youre aged 25 or under, about to start university for the first time and havent yet had the MenACWY vaccination, you should ask your GP for the vaccine. Even if you have previously received the Men C vaccine you should still now ask for the MenACWY vaccine.
Ideally, you should get the vaccine at least two weeks before you start university. If you dont get the vaccine before going to university you should contact a GP in the university health centre and arrange to get the vaccine.
You can ask your GP, practice nurse or university health centre for more information about the vaccine.
How Do We Know The Vaccine’s Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once they’re in use, the safety of vaccines continues to be monitored by the MHRA.
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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.
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.
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Meningococcal B Vaccine For Children Less Than Two Years Of Age
Fever is common in children aged two or under two years of age when meningococcal B vaccine is given.
It is recommended to use paracetamol 30 minutes before every dose of meningococcal B vaccine given to children under two years of age or as soon as practicable. Follow this with two more doses of paracetamol given 6 hours apart, even if the children do not have a fever.
This is to:
- reduce the chance of fever occurring
- reduce the severity of fever that does occur.
Be sure to give the paracetamol dose that is written on the bottle according to your child’s weight.
Talk With Your Health Care Provider
Tell your vaccination provider if the person getting the vaccine:
- Has had an allergic reaction after a previous dose of meningococcal ACWY vaccine, or has any severe, life-threatening allergies
In some cases, your health care provider may decide to postpone meningococcal ACWY vaccination until a future visit.
There is limited information on the risks of this vaccine for pregnant or breastfeeding people, but no safety concerns have been identified. A pregnant or breastfeeding person should be vaccinated if indicated.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting meningococcal ACWY vaccine.
Your health care provider can give you more information.
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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
Menacwy Vaccine Side Effects
Like all vaccines, the MenACWY vaccine can cause side effects, but they are generally mild and soon pass.
The most common side effects seen in teenagers and young people are redness, hardening and itching at the injection site, a high temperature , headache, feeling sick and tiredness . These symptoms should last no longer than 24 hours.
Sometimes a small, painless lump develops, but this usually disappears after a few weeks.
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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.
Concerns About Immunisation Side Effects
If a side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your childs condition after an immunisation, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.
It is important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.
In Victoria you can report immunisation side effects to SAEFVIC, the vaccine safety and central reporting service on Tel. 1300 882 924 #1. Ask your immunisation provider how to report adverse events in other states or territories.
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Which Meningococcal Vaccines Are Available In New Zealand
Meningococcal disease is caused by a bug called Neisseria meningitidis. At least 12 groups of N. meningitidis have been identified, including groups A, B, C, X, Y and W. The pattern of disease caused by each group varies by time and country or geographical area. There is no single vaccine that offers protection against all groups. There are different meningococcal vaccines registered in New Zealand to cover different groups:
- Menactra covers groups A, C, W, Y
- NeisVac-C covers group C
- Nimenrix covers groups A, C, W, Y
- Bexsero covers group B.
For best protection against all meningococcal disease in New Zealand, separate vaccinations against group B disease and groups A, C, Y and W disease are recommended.
Serogroup B Meningococcal Or Menb Vaccines
GlaxoSmithKline formulates each 0.5-mL dose of Bexsero® to contain:
- 50 µg each of recombinant proteins Neisserial adhesin A , Neisserial Heparin Binding Antigen , and factor H binding protein
- 25 µg of Outer Membrane Vesicles
- 5 milligrams aluminum hydroxide
- 125 mg sodium chloride
- 10 mg sucrose at pH 6.4 6.7
Each dose contains less than 0.01 µg kanamycin .
Pfizer formulates each 0.5-mL dose of Trumenba® to contain:
- 60 µg each of 2 lipidated fHBP variants
- 0.018 mg of polysorbate 80
- 0.25 mg of Al³+
- 10 millimolar histidine buffered saline at pH 6.0
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How To Spot Meningococcal Disease
Symptoms of meningococcal disease can start like a bad case of flu but they get worse very quickly. Early treatment can be lifesaving.
Other symptoms of meningococcal disease can include:
- a headache
- cold hands and feet
- drowsiness or difficulty waking up
A rash may also appear that can develop into a purple, bruise-like rash that does not fade under pressure for instance, when gently pressing a glass against it .
If you, or a child or adult you know, has any of these symptoms, get urgent medical help. Do not wait for the rash to develop. Early diagnosis and treatment with antibiotics are vital.
Although meningococcal disease commonly causes meningitis and septicaemia, which can trigger sepsis, it can also more rarely cause other illnesses. These include pneumonia and joint infections .
Find out more about meningitis.
Meningococcal Disease In Australia
Meningococcal disease can occur sporadically or in epidemics. In Australia, most cases occur during winter and early spring. Other countries with temperate climates also have this seasonal trend.95
The meningococcal serogroups that cause meningococcal disease have been changing. A meningococcal C vaccine was introduced on the National Immunisation Program in 2003 and has resulted in a large reduction in meningococcal C disease incidence.95,96
Meningococcal B has historically caused most meningococcal disease in Australia.96 Meningococcal B continues to cause around half of all reported cases of meningococcal disease in Australia.98
Meningococcal B is most common in South Australia, where a state-funded MenB vaccination program was introduced from 2018. Refer to the South Australian Health Department website for further details.
Because of substantial declines in invasive meningococcal disease caused by serogroups B and C, overall IMD incidence in Australia declined between 2003 and 2013.96
Since 2013, the incidence of meningococcal W disease has rapidly increased.98,99 Incidence of meningococcal Y disease has also been steadily increasing since 2016.98 Several states and territories implemented vaccination programs with MenACWY vaccine in 2017 to manage this disease. In 2018, MenACWY vaccine was introduced on the National Immunisation Program for toddlers aged 12 months. Adolescents are able to receive MenACWY vaccine on the National Immunisation Program from 2019.
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What Other Meningitis Vaccines Are Available
The Men C vaccine is given as part of the NHS vaccination programme to babies, teenagers and university students.
A Men B vaccine was licensed in early 2014. This vaccine is currently not part of the NHS vaccination programme, but may be offered to all babies in the near future if the vaccine can be obtained at a cost-effective price.
Why Get Vaccinated
Meningococcal ACWY vaccine can help protect against meningococcal disease caused by serogroups A, C, W, and Y. A different meningococcal vaccine is available that can help protect against serogroup B.
Meningococcal disease can cause meningitis and infections of the blood. Even when it is treated, meningococcal disease kills 10 to 15 infected people out of 100. And of those who survive, about 10 to 20 out of every 100 will suffer disabilities such as hearing loss, brain damage, kidney damage, loss of limbs, nervous system problems, or severe scars from skin grafts.
Meningococcal disease is rare and has declined in the United States since the 1990s. However, it is a severe disease with a significant risk of death or lasting disabilities in people who get it.
Anyone can get meningococcal disease. Certain people are at increased risk, including:
- Infants younger than one year old
- Adolescents and young adults 16 through 23 years old
- People with certain medical conditions that affect the immune system
- Microbiologists who routinely work with isolates of N. meningitidis, the bacteria that cause meningococcal disease
- People at risk because of an outbreak in their community
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