Types Of Meningococcal Vaccines
The first category of vaccine is called the meningococcal conjugate vaccines or MenACWY vaccines. This vaccine protects against four strains of bacteria that fall into serogroups A, C, W, and Y.
Serogroups are closely related groups of bacteria that all present the same calling cards to the immune system. The MenACWY vaccine protects against meningitis-causing bacteria that present with the A, C, W, or Y calling cards.
Three types of MenACWY vaccines are currently available:
- Menactra
- Menveo
- MenQuadfi
The second category of meningococcal vaccines protects against bacteria that fall into serogroup B. These are called MenB vaccines and are sold under the brand names Bexsero and Trumenba.
The MenB vaccine is fairly new. The FDA approved Trumenba in 2014. Bexsero was approved in 2015. MenB vaccine is not currently part of the U.S. standard childhood vaccine immunization schedule. But in other countries, like the United Kingdom, Bexsero is routinely given during infancy.
Meningitis Outbreak In Nigeria
To confront the largest meningitis outbreak ever recorded in Nigeria, MSF mounts a massive response supported by international staff and several tons of medical equipment. Nearly three million people are vaccinated against the disease and more than 30,000 cases are treated. While the scale of the response is impressive, it also leads to a worldwide shortage of vaccine stocks and questions about effectiveness.
The Product Development Plan
In 2002, the Meningitis Vaccine Project found a way to produce a conjugate vaccine at less than the price point African countries had identified as affordable: By partnering with the Serum Institute of India Private Ltd., a developing-country vaccine manufacturer.
With the Serum Institute on board, the MVP team put together an innovative product development plan where the raw materials came from one source, the technology from another, and the manufacturing capability from a third. With this plan, they could produce a meningococcal A conjugate vaccine MenAfriVac® at less than US $0.50 per dose.
PATH team members turned to the Serum Institute and Synco BioPartners in Amsterdam, the Netherlands, to supply the raw materials . With the raw materials suppliers in place, the team next needed access to the conjugation technologyintellectual property that is valuable and highly protected. This was not easy to resolve early on, MVP director Dr. Marc LaForce said.
Everyone believed in the mission.
Up next was a partnership with the Center for Biologics Evaluation and Research at the US Food and Drug Administration. Dr. Robert Lee and Dr. Carl Frasch, two scientists at the center, had developed a new conjugation method that could be used to produce the vaccine. MVP acquired the technology and, with help from the National Institutes of Health, transferred the technology within months to the Serum Institute at almost no cost.
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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.
Is The Meningitis B Vaccine Safe
In the same 2021 study mentioned above, researchers found the vaccine demonstrated an acceptable level of safety. No safety concerns have been raised based on current data, which includes more than 3 million doses administered in the United Kingdom.
Data from Quebec revealed four cases of a kidney disorder called nephrotic syndrome in children age 2 to 5 within 13 months of receiving their vaccine. Researchers are still trying to understand if theres a link, but a lack of similar findings from other countries suggests these cases may have occurred by chance.
Side effects of meningitis B are usually mild and last for
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The History Of Meningitis: Causes Treatment And Vaccines
06 March 2019
Meningitis is a deadly disease that can kill in hours. Outbreaks occur all around the world particularly in the African Meningitis Belt where close to one million suspected meningitis cases were reported in the last 20 years, causing approximately 100 000 deaths.
Getting fast medical attention is important but, even with optimal medical care, infection can still kill or cause life changing after effects. This means that prevention through vaccination is the best tool of defense.
The World Health Organisation has launched a global plan to defeat meningitis by 2030. This month we consider the history of bacterial meningitis, the vaccines we depend on to defeat it and the people who created them.
Causes of meningitis
Meningitis symptoms have been described in ancient texts throughout history, even Hippocrates described brain inflammation in his work. The first outbreak of meningococcal meningitis was recorded in Geneva in 1805, the first recorded outbreak in Africa was in 1840. The popular miasma theory of the time attributed the spread of the disease to bad air and it was not believed to be contagious.
John Abercrombie played an important role in developing the understanding of meningitis. In his textbook of neuropathology, he was one of the first people to use the term meningitis and it was only after this work in 1828 that the term came into general usage.
Treating meningitis
Preventing meningitis
The future of meningitis
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.
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More Information About The Vaccine
The MenB vaccine was introduced into the UK schedule on 1st September 2015. The UK is the first country in the world to introduce a MenB vaccine into its routine vaccination schedule. It is expected that results from the UK programme will influence other countries’ decisions about including the MenB vaccine as part of routine vaccination.
There is a useful list of FAQs about the MenB vaccine on the Meningitis Research Foundation website .
Before 1999, most cases of meningococcal disease in the UK were caused by MenC infection. A MenC vaccination programme was successfully introduced in the UK in 1999. Since then, cases of MenC disease have fallen dramatically in the UK. In the last 10 years, about 90% of the cases of meningococcal disease in the UK have been caused by group B infections. Before the MenB vaccine was introduced around 600 people a year in the UK were infected by MenB, mainly babies and children. About 10% of those who get the disease will die .
Charlotte Nott developed septicaemia through type B meningococcal disease infection. In the short film below, her mother, Jenny Daniels, talks about the impact on Charlotte and the rest of her family.
See also our blog posts on the MenB vaccine in the UK:
The 1970s Vaccine Success
During the 1970s, one vaccine was eliminated. Because of successful eradication efforts, the smallpox vaccine was no longer recommended for use after 1972. While vaccine research continued, new vaccines were not introduced during the 1970s.
Late 1970s | Recommended Vaccines
* Given in combination as DTP** Given in combination as MMR
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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.
Contraindications And Precautions Of Meningococcal Vaccine
The main contraindication for meningococcal vaccines is
For children with functional or anatomic asplenia, MenACWY and pneumococcal conjugate vaccine is caused by some of the > 90 serotypes of Streptococcus pneumoniae . Vaccines are directed against many of… read more ) should not be given during the same visit but should be separated by 4 weeks.
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What Are The Risks Of Gbs With The Mcv4 Vaccine
Between 2005 and 2012, more than 18 million doses of MCV4 were distributed. It’s uncertain how many of those have actually been given. In that same time period, there have been 99 confirmed cases of GBS, a serious nervous system disorder, reported within six weeks of the vaccine being taken. There is not enough data at this time to tell whether or not the vaccine was a factor. But analysis of the data suggests that the incidence of GBS is no higher for people receiving the vaccine than the incidence of GBS in the general population.
Still, the timing of the onset of symptoms has raised concern. The CDC is continuing to study the issue and has recommended that people be told about the study when they are considering the vaccine. The current opinion is that even if there is a slight increase in the risk of GBS, it’s significantly outweighed by the risk of meningococcal disease without the vaccine.
Talk to your doctor if you have any further concerns about the vaccine and GBS.
Show Sources
Pediatrics, published online Feb. 1, 2011. CDC web site: “Meningitis Questions & Answers,” “Meningococcal Vaccines: What You Need to Know,” “Meningococcal Vaccination,” “Vaccines and Preventable Diseases: Meningococcal: Who Needs to Be Vaccinated?” “Meningococcal vaccine side-effects,” “GBS and Menactra Meningococcal Vaccine.”
VaccineInformation.org: “Meningococcal Disease Vaccine.”
False Claims About Autism
In 1998 Andrew Wakefieldet al. about twelve children, reportedly with bowel symptoms and autism or other disorders acquired soon after administration of MMR vaccine, while supporting a competing vaccine. In 2010, Wakefield’s research was found by the General Medical Council to have been “dishonest”, and The Lancet fully retracted the paper. Three months following The Lancet’s retraction, Wakefield was struck off the UK medical register, with a statement identifying deliberate falsification in the research published in The Lancet, and was barred from practising medicine in the UK. The research was declared fraudulent in 2011 by the British Medical Journal.
Since Wakefield’s publication, multiple peer-reviewed studies have failed to show any association between the vaccine and autism. The Centers for Disease Control and Prevention, the Institute of Medicine of the National Academy of Sciences, the UK National Health Service and the Cochrane Library review have all concluded that there is no evidence of a link.
In Japan, the MMR triplet is not used. Immunity is achieved by a combination vaccine for measles and rubella, followed up later with a mumps only vaccine. This has had no effect on autism rates in the country, further disproving the MMR autism hypothesis.
The component viral strains of MMR vaccine were developed by propagation in animal and human cells as all viruses require a living host cell to replicate.
| Disease immunized |
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| MEM |
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Meningococcus B: The Last Frontier
The development of a vaccine against meningococcus B represents one of the milestones of modern medicine . Meningococcus B is a major cause of disease in the Americas, Canada, Europe, Asia, and many other countries. The stumbling block was that the B capsule does not cause antibodies to be produced, not even with the conjugation technology. The sneaky meningococcus B uses a sophisticated strategy: its capsule mimics the sugars presents on our cells, so that it can go under-cover as a harmless human cell. As a result, by attacking the meningococcus B capsule, the body could also damage its own cells, and that is why the immune system does not react to it. Many scientists concluded that using the capsule to fight meningococcus B could be too risky. A new technology was needed to overcome this challenge.
An Ounce Of Prevention Is Worth A Pound Of Cure
In the 1940s all of the strains of pneumococcus could be treated with the antibiotic, penicillin. However, over time many pneumococcal strains have become resistant not only to penicillin, but also to other antibiotics developed to combat bacterial infections. Resistance means that bacteria have changed, or evolved, so that they are no longer killed by one or more antibiotics. As a result, treatment with those antibiotics is not effective against those resistant strains.
Strains of pneumococcus have now been identified that are highly resistant to most antibiotics. Our reliance on and overuse of antibiotics have led to this resistance, backing us into a corner when treating infections caused by these and other types of bacteria. Unfortunately, we have taken our first steps into a post-antibiotic era. This makes the use of vaccines all the more important.
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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.
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
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Vaccines For Adults Increasing Opportunities For Health
Historically, vaccines were deemed to be only for children. However, vaccines for adults are becoming increasingly common and necessary. Most adults think only of the tetanus booster recommended every 10 years and even then, many adults only get the vaccine if they injure themselves. In 2005, the Tdap vaccine was licensed as an improved version of the typical tetanus booster, Td. The newer version also contains a component to protect against pertussis . All adults, especially those who are going to be around young infants, should get the Tdap vaccine. Adults often unwittingly pass pertussis to young infants for whom the disease can be fatal. In 2012, the CDC recommended that pregnant women get a dose of Tdap during each pregnancy between 27 and 36 weeks gestation. In 2019, the CDC recommended that Tdap or Td vaccine could be used for booster dosing every 10 years.
Influenza vaccines, available since the 1940s, are now recommended for most adults. Vaccines like MMR and chickenpox are recommended for adults who have not had the diseases, and vaccines including hepatitis A, hepatitis B, pneumococcus, and meningococcus are recommended for sub-groups of the adult population. The HPV vaccine became available in 2006. In 2018, the license was expanded to include people up to 45 years of age.
The first formal adult immunization schedule was published in 2002 and is updated annually.
How Is The Pneumococcal Vaccine Made
Like the Hib vaccine, the pneumococcal vaccine is made from the sugar coating of the bacteria. Antibodies directed against the pneumococcal polysaccharide protect the child without having to take the risk that their first encounter with natural pneumococcus will result in permanent disabilities or death.
Unfortunately, children less than 2 years old don’t develop very good immune responses to this polysaccharide alone. So the pneumococcal vaccine was made in a manner similar to the Hib vaccine . The pneumococcal polysaccharide is linked to a harmless protein. This version of the vaccine is referred to as the pneumococcal conjugate vaccine. Once linked, young children are able to make an immune response to the polysaccharide. The big difference between the pneumococcal vaccine and the Hib vaccine is the number of different types of polysaccharides that need to be included in the vaccine. Whereas, there is really only one strain of Hib that causes disease in children, there are about 90 different strains of pneumococcus. Fortunately, most of the serious disease in young children is caused by the 13 strains of pneumococcus contained in the vaccine.
The pneumococcal vaccine was found to be highly effective in preventing severe pneumococcal infection in a large trial of children injected with the vaccine. About 40,000 children were included in the initial trial of the vaccine. Since its licensure, the pneumococcal vaccine has been given to millions of children safely.
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