Global Public Health Response Elimination Of Meningococcal A Meningitis Epidemics In The African Meningitis Belt
In the African meningitis belt, meningococcus serogroup A accounted for 8085% of meningitis epidemics before the introduction of a meningococcal A conjugate vaccine through mass preventive campaigns and into routine immunization programmes . As of April 2021, 24 of the 26 countries in the meningitis belt have conducted mass preventive campaigns targeting 1-29 year olds , and half of them have introduced this vaccine into their national routine immunization schedules. Among vaccinated populations, incidence of serogroup A meningitis has declined by more than 99% no serogroup A case has been confirmed since 2017. Continuing introduction into routine immunization programmes and maintaining high coverage is critical to avoid the resurgence of epidemics.
Cases of meningitis and outbreaks due to other meningococcal serogroups, apart from serogroup B, continue to strike. The roll out of multivalent meningococcal conjugate vaccines is a public health priority to eliminate bacterial meningitis epidemics in the African Meningitis Belt.
Pneumococcus
The pneumococcus has over 97 serotypes, 23 causing most disease.
Haemophilus influenzae
Haemophilus influenzae has 6 serotypes, serotype b causing most meningitis.
- Conjugate vaccines protect specifically against Haemophilus influenzae serotype b . They are highly effective in preventing Hib disease and are recommended for routine use in infant vaccine schedules.
Group B streptococcus
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.
Is There Anyone Who Shouldnt Receive A Meningococcal Vaccine
If youre not in the recommended age range or have the specific risk factors, you likely dont need a meningococcal vaccine. But its always good to check with your healthcare provider if youre unsure.
There are a few other situations where you shouldnt get a meningococcal vaccine. This is the case if youve had a severe allergic reaction to a meningococcal vaccine in the past. Similarly, you shouldnt get it if you have a severe allergy to any of the vaccines ingredients.
Let your healthcare provider know if youre pregnant, nursing, or if youre sick before getting a meningococcal vaccine. Theyll determine if the benefits outweigh the risks.
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When To Get Vaccinations Against Bacterial Causes Of Meningitis
Meningitis is a disease thats defined by inflammation in membranes called meninges near your brain and spinal cord. It can have several different causes including viruses, bacteria, fungi, and some chemicals.
Different vaccines can protect you from the different causes of meningitis. Each has its own schedule for when you should receive it. Youll first get some of these vaccinations as an infant and others as a teenager or even as an adult. Many require boosters at various points throughout your life particularly if youre in a high-risk category for getting meningitis.
In general, vaccines are most helpful for protecting against bacterial meningitis, which is less common but more severe than viral meningitis.
Meningococcal vaccines protect against the meningitis-causing bacteria N. meningitidis. Two vaccines are currently approved for use in the U.S. Theyre called the MenACWY vaccine and the MenB vaccine.
The MenACWY vaccine is recommended for all young adults around the age of 11 or 12 years old plus a booster shot at 16 years. Another meningococcal vaccine called MenB is recommended between the ages of 16 to 18.
A good question to ask is: how long does the meningitis vaccine last? Even though both meningococcal vaccines produce an immune response, they lose effectiveness over time.
Healthy adults wont require another dose of this vaccine. But you should talk to your doctor about getting another pneumococcal vaccine if youre 65 years or older.
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.
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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.
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.
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Where Can Students Get The Bacterial Meningitis Vaccine
Students with insurance The bacterial meningitis vaccine is available at most doctors offices and private clinics, many large pharmacy chains, and some minor emergency centers or medi-clinics. It is recommended that the student call to schedule an appointment to confirm that the facility offers the vaccine and accepts their insurance. The UH Health Center offers the bacterial meningitis vaccine for a cost to admitted students, but the health care providers mentioned above may be able to provide the vaccine at a lower cost.
Students with Medicaid or CHIP The first option for students who have Medicaid or CHIP should be to contact his/her established healthcare provider to see if they offer the vaccine.
Students without insurance or whose insurance doesnt cover the bacterial meningitis vaccine
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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. In older children, adolescents and adults, protection is expected to last for around 5 years after vaccination.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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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 sequence and dosage depends 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 as long as 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.
What Is Meningitis
The meninges are a membrane that covers and protects the brain and spinal cord. When that membrane gets inflamed, its called meningitis. One of the ways this inflammation can happen is from infection. Common symptoms of an infection of the meninges are fever, headache, and a stiff neck.
There are many different germs that can infect the meninges. Viruses cause most cases, and while this can be serious, most people with viral meningitis get better without treatment. Some may not even realize theyve had meningitis.
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Are Free Or Low
Yes, if you dont have insurance or your insurance does not cover the cost of the meningococcal vaccines, you may be able to find free or low-cost meningococcal shots.
- Talk to your doctor or clinic to see if they participate in the Minnesota Vaccines for Children Program. If the person in need of vaccination is 18 years old or younger, they may be eligible for no-cost vaccines. However, there may be an administration fee of up to $21.22 per shot.
- Talk to your city or county health department. They may be able to provide low-cost meningococcal shots.
You Got Meningitis Vaccination As A Child
You might have had a meningococcal group C vaccination as a child, however, due to an increase in type W across the UK you are now recommended to have the MenACWY vaccine.
This will boost your protection against Men C and also protect you against the types A, W and Y. It wont protect you against all the types of meningococcal disease which is why it is also important to know the signs and symptoms.
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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
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.
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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.
Who Gets Bacterial Meningitis
Children between the ages of 1 month and 2 years are the most susceptible to bacterial meningitis.
Adults with certain risk factors are also susceptible. You are at higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia.
You are also at higher risk if you have a weakened immune system, have had your spleen removed, are on corticosteroids because of kidney failure or have a sickle cell disease.
Additionally, if you have had brain or spinal surgery or have had a widespread blood infection you are also a higher risk for bacterial meningitis.
Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks.
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Im Not A College Student Do I Still Need This Vaccine
The meningitis vaccine âis also a good idea for travelers who go to certain parts of sub-Saharan Africa, the so-called meningitis belt,â Schaffner says. Itâs also recommended for anyone with a damaged spleen, people whose spleen has been removed, people with terminal complement component deficiency , anyone who might have been exposed to meningitis during an outbreak, and microbiologists who routinely work with meningococcal bacteria.
Show Sources
William Schaffner, MD, president, National Foundation for Infectious Diseases professor, chairman, department of preventive medicine, professor of medicine, division of infectious diseases, Vanderbilt University School of Medicine.
CDC: âMeningococcal Vaccines: What You Need to Know.â
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.
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Where And When Can I Get The Vaccine
Talk to your doctor or local public health clinic to find out where and when your child should get vaccinated.
- The cost of Men-C-C is covered everywhere in Canada.
- Many provinces currently cover the cost of MCV-4 vaccine.
- Currently, no provinces or territories cover the cost of Men-B vaccine for all children. Some provide it for children at high risk of getting meningococcal disease.
Measles Mumps And Rubella Vaccine
The MMR vaccine offers protection against measles, mumps and rubella infections. Meningitis can sometimes occur as a complication of mumps. Measles and rubella can cause encephalitis . In New Zealand, the MMR vaccine is free as part of the childhood immunisation schedule, for children at 15 months and 4 years of age. Read more about MMR vaccine.
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What Are The Risks From Meningococcal Vaccines
- Redness or soreness where the shot is given can happen after meningococcal ACWY vaccination
- A small percentage of people who receive meningococcal ACWY vaccine experience muscle pain, headache, or tiredness.
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or 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.
Who Should Get The Meningococcal Vaccines
All children ages 11 through 12 years should receive meningococcal vaccine followed by a booster dose at age 16 years. Vaccination is also recommended for all adolescents ages 13 through 18 years who did not receive a dose at age 11-12 years.
Individuals ages 2 months and older who have certain conditions that weaken their immune system should receive meningococcal vaccine, including teens who are HIV positive. These persons should also receive booster shots every three to five years depending on their age. Talk to your health care provider if your preteen or teen has a condition that makes it harder for their body to fight off infection.
The MenB vaccine may also be given at age 16 years along with the MenACWY booster dose. MenB vaccine is also recommended for children age 10 years and older with certain high-risk conditions. The number of doses needed depends on the product used and if your child has a high-risk condition. Talk to your health care provider about this additional vaccine.
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