Shouldnt Meningococcal B Vaccine Be Required
CDCs Advisory Committee on Immunization Practices has reviewed the available data regarding serogroup B meningococcal disease and the vaccines. At the current time, there is no routine recommendation and no statewide requirement for meningococcal B vaccination before going to college . As noted previously, adolescents and young adults may be vaccinated with a serogroup B meningococcal vaccine, preferably at 16 through 18 years of age, to provide short term protection against most strains of serogroup B meningococcal disease. This would be a decision between a healthcare provider and a patient. These policies may change as new information becomes available.
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.
Wherever The Vaccine Has Been Introduced Meningitis A Cases Have Virtually Disappeared
Steve Davis, PATH
Preziosi says the findings show that vaccination is cost-saving, prevents major disruption of health services when meningitis epidemics occur. She urges African governments to use the scientific data generated to make informed decisions about whether to include this vaccine in national childhood immunisation programmes. Steve Davis, President and CEO of PATH says wherever the vaccine has been introduced, meningitis A cases have virtually disappeared in contrast to previous years when the region was prone to meningitis A epidemics. During 1996 and 1997, he explains, the largest epidemic ever hit Africa, overwhelming health systems with 250,000 cases and 25,000 deaths. Ifedayo Adetifa, a consultant paediatrician and infectious diseases epidemiologist with Kenya-based Kilifi KEMRI-Wellcome Trust Research Programme, says development of a meningococcal vaccine for Africa is now a proven concept. The vaccine effectiveness, he tells SciDev.Net, is demonstrated through direct benefit to recipients and indirectly in unvaccinated populations through induction of herd immunity.
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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.
What Are The Symptoms Of Meningococcal Disease
Signs and symptoms of meningococcal disease include sudden onset of fever, stiff neck, headache, nausea, vomiting, sensitivity to light and/or mental confusion. A rash may also be present. Changes in behavior such as confusion, sleepiness, and unresponsiveness are important symptoms of illness. Anyone who has these symptoms should be seen by a healthcare provider immediately. In fatal cases, death can occur in as little as a few hours, even with appropriate medical treatment. Less common presentations include pneumonia and arthritis.
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How Is The Hib Vaccine Made
The Hib vaccine is made from the sugar coating of the bacteria. Antibodies directed against the Hib polysaccharide protect the child against an infection that could result in permanent disabilities or death.
Unfortunately, children less than 2 years old don’t develop very good immune responses to this polysaccharide, even if exposed to it through infection. For this reason, children less than 2 years old who catch Hib and survive the infection are still recommended to receive Hib vaccine.
Scientists have figured out that by taking the Hib polysaccharide and linking it to a harmless protein, young children are able to make a stronger immune response to the polysaccharide. This conjugated version of the Hib vaccine works extremely well. Before the vaccine, Hib caused about 20,000 cases of serious disease in the United States every year. In 2016, 30 cases of Hib in children 5 years of age and younger were reported to the Centers for Disease Control and Prevention .
All Infants Children And Adults
Any person from 6 weeks of age who wants to protect themselves against meningococcal disease is recommended to receive MenACWY vaccine and MenB vaccine
Any person who wants to protect themselves against invasive meningococcal disease can receive MenACWY and MenB vaccines from as early as 6 weeks of age.
A summary of the recommendations for use of meningococcal vaccines is shown in Table. Recommendations for meningococcal vaccines by age group. The table shows the type of vaccines that are strongly recommended for specific age groups and special risk groups. See below for brand and dosing recommendations.
Preferred vaccines
Infants aged < 9 months can receive 2 of the 3 MenACWY brands . Infants and children aged 9 months to 2 years can receive any of the 3 MenACWY vaccine brands, following the age-appropriate dosing schedule.
For all people aged 2 years, it is preferable to receive either Menveo or Nimenrix, rather than Menactra.
There is no preference for either Bexsero or Trumenba for people aged 10 years who wish to receive a MenB vaccine. For people aged < 10 years, Bexsero is the only registered MenB vaccine available in Australia.
Recommended dose schedules
For recommended dose schedules for healthy people aged 2 years who wish to receive meningococcal vaccine, see Table. Recommendations for meningococcal vaccines for healthy people aged 2 years, by age and vaccine brand.
For the recommended dose schedules for healthy infants and children aged < 2 years, see:
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Nature Of The Disease
Meningococcal disease is caused by the bacterium Neisseria meningitidis. The bacterium is commonly known as meningococcus.
There are 13 known meningococcal serogroups, distinguished by differences in surface polysaccharides of the bacteriums outer membrane capsule. Globally, serogroups A, B, C, W-135 and Y most commonly cause disease.
What Are The Common Side Effects
The most common side effects of the meningitis ACWY vaccine for young people are:
- redness
- hardening and itching at the injection site
- headache
- nausea
- fatigue
If you feel unwell at any time after getting immunised, you should contact your GP. If you’re worried, trust your instincts. Speak to your GP or phone the 111 service.
Phone your GP immediately if, at any time, you have a temperature of 39°C or above, or have a fit. If your GP practice is closed, phone the 111 service immediately.
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How Is Meningococcal Disease Spread And Who Is Most At Risk
Meningococcal disease is not as contagious as other illnesses, such as a cold or the flu. But it is spread by contact with infected respiratory and throat secretions. That can happen with coughing, kissing, or sneezing.
Because the risk increases with close or prolonged contact with an infected person, family members in the same household and caregivers are at an increased risk. For the same reason, so are college students who live in dormitories.
How Are The Bacteria Spread
These bacteria are passed from person-to-person through saliva . You must be in close contact with an infected persons saliva in order for the bacteria to spread. Close contact includes activities such as kissing, sharing water bottles, sharing eating/drinking utensils or sharing cigarettes with someone who is infected or being within 3-6 feet of an infected person who is coughing or sneezing.
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Muslims Undergoing The Hajj Or Umrah Pilgrimage
Pilgrims to Saudi Arabia are especially at risk of contracting meningococcal infection. There have been outbreaks in recent years. A proof of immunisation is needed to obtain a visa to go to Saudi Arabia for this purpose.
Note: some pilgrims may have been immunised in the past with an older vaccine which only protected against groups A and C. If you travel to Saudi Arabia again you should have an injection of the newer MenACWY vaccine. Proof of immunisation with MenACWY vaccine given within the preceding three years is now needed to get a new visa to visit Saudi Arabia.
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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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.
Can The Meningococcal Vaccine Cause Meningococcal Disease
The short answer is no. There are actually four meningococcal vaccines licensed in the U.S. None of the vaccines contains live bacteria.
The vaccines contain antigens — substances that trigger the body’s immune system and cause it to make antibodies. These antibodies then protect the body by attacking and killing the bacteria if it should invade your system.
The first vaccine — meningococcal polysaccharide vaccine or MPSV4 — was approved in 1978. It’s made with the antigens contained in the outer polysaccharide or sugar capsule that surrounds the bacterium.
The meningococcal conjugate vaccine or MCV4 was approved in 2005. It uses antigens taken from the polysaccharide capsule and then bound to a separate protein that targets the body’s immune cells. This makes it easier for the body’s immune system to see and recognize the antigens.
One type of MCV4, Menveo, is licensed for use in people ages 2 to 55. Another version, Menactra, is approved for those 9 months to 55 years old. MPSV4 is the only vaccine licensed for use in people over 55 as well as people 2 to 55. Both vaccines protect against four types of meningococcal disease.
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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.
How Common Is Meningococcal Disease
Meningococcal disease is becoming much less common. Over the past 20 years, the overall incidence of meningococcal disease in the US has declined 10-fold. Twenty years ago in Massachusetts there were 80-100 cases of meningococcal disease per year. In contrast, for the past decade the average is approximately 12 cases per year. Declining rates of meningococcal disease may be due in part to the introduction of meningococcal vaccines as well as other factors such as the decline in cigarette smoking, which may impact susceptibility to this disease.
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Historic Dates And Events Related To Vaccines And Immunization
| It was not too many years ago when we celebrated the 200th anniversary of Edward Jenner’s first smallpox vaccination in 1796. The development of vaccines continued at a fairly slow rate until the last several decades when new scientific discoveries and technologies led to rapid advances in virology, molecular biology, and vaccinology. The chart which follows displays many of the vaccine- and immunization-related events that have occurred since Jenner’s critical discovery. This list is by no means exhaustive. If you know of an event that you would like us to add, contact us at . |
How To Get The Menb Vaccine
Your GP surgery or clinic will send you an appointment for your baby to have their MenB vaccination along with their other routine vaccinations.
Most surgeries and health centres run special immunisation or baby clinics.
If you cannot get to the clinic, contact the surgery to make another appointment.
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Does The Vaccine Work
The MenB vaccine has been tested on thousands of adults and children, and from these clinical trials it is thought that the new vaccine will prevent a high proportion of cases of group B meningococcal disease. However because the disease is rare, the exact number of cases that will be prevented will not be known until the vaccine has been used routinely.
In February 2016 Public Health England published research which showed that the MenB vaccine should help to provide protection against the aggressive strain of MenW disease circulating in the UK , as well as protecting against MenB disease.
In September 2016 Public Health England reported on research carried out on babies in the UK who were eligible to receive the new MenB vaccine. The research showed that the number of cases of meningitis and septicaemia caused by MenB infection in these babies had nearly halved over the previous year . See the research published in The Lancet in October 2016.
Public Health England estimates that the MenB programme prevented about 250 cases of invasive MenB disease in the first three years of the programme. In the second year of the programme, there was an estimated 72% reduction in the number of cases of invasive MenB disease in infants, and in the third year of the programme there was a further estimated 60% reduction in cases of invasive MenB disease in infants.
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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Meningitis Vaccine Project Introduces Meningococcal Vaccine For Africa
In the United States, meningitis is thought of as an extremely rare disease. It usually appears in the news when a college student has fallen ill, amid reminders by public health officials that a meningococcal vaccine can protect against diseases caused by Neisseria meningitidis bacteria, including meningitis. In 2008 only about 1,100 total cases of meningococcal disease were reported in the United States, and meningitis cases were only a fraction of that number.
In other parts of the world, however, meningitis takes a much larger toll. In Sub-Saharan Africa, an area that spans from Senegal to Ethiopia is called the meningitis belt because of the epidemic waves that occur there, some lasting as long as three years. The largest epidemic wave in history led to more than 25,000 meningitis deaths from 1996 to 1997. In 2009 alone, more than 88,000 cases were reported. Now, a new vaccine developed specifically for use in Africa offers hope that future epidemics may be prevented.
A region-specific challenge
Overcrowding, poor living conditions, and droughts all contribute to the rise of epidemics in the meningitis belt. Among the cases of meningitis in these epidemics, the vast majority80 to 85%are caused by a single group of meningococci bacteria: Group A.
Global collaboration
To call it a lofty goal would be charitable. But by 2002, the MVP had not only found a way to produce exactly the conjugate vaccine that Africa needed, but to do it for less than fifty cents per dose.