Meningococcal Vaccines

Vaxopedia

The expanded use of Menactra will hopefully cut down on lining up for meningitis shots like this.
The expanded use of Menactra will hopefully cut down on meningococcal outbreaks and kids in high school and college lining up for meningitis shots like this. Photo by Mike Simons/Getty Images

Although there has been a meningococcal vaccine available since the 1970s (Menomune), it was not very popular because its protection did not last very long. Fortunately, new meningococcal vaccines are now available that offer better and more long lasting protection.

Why do we need a meningococcal vaccine?

Neisseria meningitidis, the meningococcal bacteria, is not well known by most parents, but it is an important cause of serious infections in children.

In fact, meningococcal disease is one of the leading causes of bacterial meningitis and can lead to outbreaks and epidemics. It can also cause meningococcemia, a serious and life-threatening blood infection.

Ever wonder why your pediatrician gets so concerned when your child has a fever and a rash?

It is mostly because of meningococcemia. Children with this infection can develop a fever and red or purple spots on their skin. These children can then quickly worsen, often over just 12-24 hours, and become critically ill, with about 10-15% of them dying, even with proper treatment.

The fact that invasive meningococcal disease so often strikes previously healthy children, the majority of whom were perfectly fine less than 24 hours of ending up in the hospital, and worsens so quickly (making it hard to diagnose), makes this infection even scarier.

Even children who survive can have serious sequela, including becoming deaf, having seizures and strokes, or amputation of their arms, legs, fingers, and/or toes.

So a meningococcal infection is clearly something that you don't want your kids to get...

Who gets meningococcal disease?

Infants under 12 months old are most likely to get meningococcal disease. There is then another peak in the rate of meningococcal disease among teens and young adults, with the highest rates being among freshman college students who are living in dormitories.

Keep in mind that meningococcal disease is not very common, though, only affecting about 700 people in the United States each year.

New Meningococcal Vaccines

The new meningococcal vaccines include:

  • Menactra - MCV4 vaccine covering serogroups A, C, W, Y
  • Menveo - MCV4 vaccine covering serogroups A, C, W, Y
  • MenHibrix - covers Hib plus serogroups C and Y only
  • Bexsero - MenB vaccine covering serogroup B only
  • Trumenba - MenB vaccine covering serogroup B only

While Menactra isn't really that 'new' anymore, having been approved in 2011, the latest serogroup B meningococcal vaccines were just approved in 2015.

Who Needs the New Meningococcal Vaccines?

It is currently recommended that either Menactra or Menveo be given to all children at their routine well child visit to their doctor when they are 11 or 12 years old. Teens should also get it when they start high school or if they are going to be living in a dorm at college and haven't gotten a meningococcal vaccine yet.

According to the CDC, Menactra or Menveo are also recommended for older teenagers, other people who simply want to decrease their risk of meningococcal disease, and:

  • U.S. military recruits
  • anyone traveling to, or living in, a part of the world where meningococcal disease is common, such as parts of Africa
  • anyone who has a damaged spleen, or whose spleen has been removed
  • anyone who has terminal complement component deficiency (an immune system disorder)
  • people who might have been exposed to meningitis during an outbreak
  • microbiologists who are routinely exposed to meningococcal bacteria

Menactra and Menveo can also be given to certain high-risk children between the ages of 2 and 10 years, such as children with a persistent complement component deficiency and anatomic or functional asplenia.

Teens also need a booster dose of Menactra and Menveo when they are 16 to 18 years old.

The Advisory Committee on Immunization Practices also states that "Young adults aged 16 through 23 years (preferred age range is 16 through 18 years) may be vaccinated with either a 2-dose series of Bexsero or a 3-dose series of Trumenba vaccine to provide short-term protection against most strains of serogroup B meningococcal disease."

The MenB vaccines are also recommended during outbreaks.

Meningococcal Vaccines for Younger Kids

Although younger children do get meningococcal disease, it is most commonly caused by MenB, and the MenB vaccines are not yet approved for children under age 10 years.

About 40 percent of cases among young children are vaccine preventable though and certain high-risk children can get:

  • MenHibrix beginning at 6 weeks
  • Menveo beginning at 2 months
  • Menactra beginning at 9 months
  • Bexsero or Trumenba beginning at 10 years

Most younger children will not get a meningococcal vaccine, though. Talk to your pediatrician or pediatric specialist if you think that your child is in a high-risk group and hasn't been offered a meningococcal vaccine yet.

What To Know About Meningococcal Vaccines

Other things to know about the meningococcal vaccines include that:

  • Like most vaccines currently given to children, Menactra, Menveo, Bexsero, and Trumenba are all free of thimerosal and other preservatives. Although there is no proven link between thimerosal, mercury, and autism, that these new vaccines have no preservatives is likely welcome news to most parents.
  • There are 13 different serogroups of meningococcal bacteria, but only five typically cause invasive disease, with most caused by just three - serogroups B, C, and Y.
  • There have been several small MenB outbreaks over the past few years, including outbreaks at UC, Santa Barbara, Princeton University, and Santa Clara University in California.

Get educated and get your kids vaccinated and protected against meningococcal disease.

Sources:

MMWR, October 23, 2015, Vol 64 #41 Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015

MMWR, June 20, 2014, Vol 63 #24 Use of MenACWY-CRM Vaccine in Children Aged 2 Through 23 Months at Increased Risk, 2013

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