Meningococcal Vaccine

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(MCV4 Vaccine)

What Is Meningococcal Disease?

Neisseria meningitidis is a bacteria that can cause infections in the body. One area this bacteria can infect is the meninges. The meninges is the membrane that surrounds the brain and spinal cord. A bacterial infection of the meninges, called bacterial meningitis , can cause death within hours. This bacteria can also cause infections in the blood.
The disease is usually spread by direct contact with discharge from the mouth or throat of an infected person (eg, kissing).
The disease is most common in:
  • Infants aged less than one year
  • People aged 16-21 years old
  • People with certain medical conditions (eg, lack of spleen)
  • College freshmen who live in dorms—increased risk
About 1,200 people in the US develop the disease each year. Approximately 10%-15% of these people die. Another 11%-19% lose their arms or legs, become deaf, have nervous system problems, become intellectual disabled , or suffer seizures or strokes .
Symptoms of meningitis include:
  • High fever
  • Headache
  • Very stiff, sore neck
  • Nausea
  • Vomiting
  • Photophobia (sensitivity to bright lights)
  • Sleepiness
  • Mental confusion
Symptoms in newborn and infants can be hard to notice. These may include:
  • Inactivity
  • Unexplained high fever or low body temperature
  • Irritability
  • Vomiting
  • Feeding poorly or refusing to eat
  • Tautness or bulging of soft spots between skull bones
  • Difficulty waking
Treatment may include:
  • Antibiotics
  • Corticosteroids
  • Fluid replacement

What Is the Meningococcal Vaccine?

There are two meningococcal vaccines available in the US:
  • Meningococcal conjugate vaccine (MCV4)—given as a shot into the muscle, preferred for people age 55 years or younger
  • Meningococcal polysaccharide vaccine (MPSV4)—given as a shot under the skin, preferred for adults age 56 years or older
Both vaccines are made from parts of the meningococcal bacteria. They do not contain live bacteria.

Who Should Get Vaccinated and When?

Routine Vaccination

The MCV4 vaccine is routinely given to children aged 11-12 years old with a booster dose given at age 16 years.
Three doses are given to teens (11-18 years old) who have HIV:
  • Two doses given two months apart at 11 or 12 years old
  • Booster dose at age 16
Teens who receive the vaccine late follow this schedule:
  • If the first dose is given between 13-15 years old, the booster dose is given between 16-18 years old.
  • If the first dose is given after 16 years old, then the booster dose is not needed.

Vaccination for People at Increased Risk

The following groups of people need to be vaccinated because they have an increased risk of meningitis:
  • College freshmen who live in dorms
  • People who work in labs who may be exposed to meningococcal bacteria
  • Military personnel
  • People who travel to or live in areas where meningococcal disease is common
  • People who have problems with spleen functioning or do not have a spleen
  • People who have a weakened immune system (eg, complement component deficiency)
  • People who have been exposed to meningitis during an outbreak
Young children aged 9-23 months and others who have certain conditions need to be given two doses in order to be fully protected.
People who are at high risk will need a booster dose every five years.

What Are the Risks Associated With the Meningococcal Vaccine?

The meningococcal vaccine, like all vaccines, has the potential to cause serious problems, such as severe allergic reactions. The risk of the vaccine causing serious harm or death is extremely small.
Mild problems associated with the vaccine include redness or pain at the injection site or a fever.

Who Should Not Get Vaccinated?

If you have the following conditions, you should not get the vaccine:
  • Have had a life-threatening allergic reaction to a previous dose of the vaccine or its components
  • Are moderately or severely ill—Wait until you recover before getting the vaccine.
  • Have ever had Guillain-Barre syndrome—Talk to your doctor.
The vaccines may be given to pregnant women. However, the MCV4 vaccine has not been extensively studied in pregnant women. It should be used only if it is clearly needed.

What Other Ways Can Meningococcal Disease Be Prevented Besides Vaccination?

Preventive antibiotics may be given to people in close contact with an infected person, such as:
  • Healthcare workers
  • Family members
Quitting smoking may also reduce the risk of meningococcal disease.

What Happens in the Event of an Outbreak?

In the event of an outbreak, close contacts of infected people and people at increased risk should get the vaccine. Antibiotics may be recommended for people in close contact.

WHERE CAN I GET MORE INFORMATION?

Immunization American Academy of Pediatrics http://www.cispimmunize.org/

Vaccines & Immunizations Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/

References

Bacterial meningitis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 15, 2012. Accessed November 29, 2012.

Bacterial meningitis in infants and children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 21, 2012. Accessed November 29, 2012.

Baker CJ, Pickerling LK, Chilton L, et al. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med. 2011;154(3):168-173.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2011. MMWR. 2011;60(5).

Deasy A, Read RC. Challenges for development of meningococcal vaccines in infants and children. Expert Rev Vaccines. 2011;10(3):335-343.

Honish L, Soskolne CL, Senthilselvan A, Houston S. Modifiable risk factors for invasive meningococcal disease during an Edmonton, Alberta outbreak, 1999-2002. Can J Public Health. 2008;99(1):46-51.

Huttunen R, Heikkinen T, Syrjänen J. Smoking and the outcome of infection. J Intern Med. 2011;269(3):258-269.

Menactra. DailyMed website. Available at: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=4d8781ff-9366-462c-8161-6e958f44fcb4#section-17 . Updated December 2011. Accessed November 29, 2012.

Meningitis questions and answers. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/meningococcal/about/index.html . Updated March 15, 2012. Accessed November 30, 2012.

Meningococcal disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/meningococcal/about/symptoms.html . Updated March 15, 2012. Accessed November 29, 2012.

Meningococcal disease. DermNet NZ website. Available at: http://dermnetnz.org/bacterial/meningococcal-disease.html . Updated June 29, 2011. Accessed November 30, 2012.

Meningococcal disease vaccine. Immunization Saves Lives website. Available at: http://www.vaccineinformation.org/menin/qandavax.asp . Accessed November 29, 2012.

Meningococcal vaccination. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/mening/default.htm . Accessed November 30, 2012.

Meningococcal vaccines: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf . Updated October 14, 2011. Accessed November 29, 2012.

Recommended immunization schedules for persons aged 0-6 years—United States, 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/child/0-6yrs-schedule-pr.pdf . Published December 23, 2011. Accessed November 30, 2012.

Recommended immunization schedules for persons aged 7-18 years—United States, 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/child/7-18yrs-schedule-pr.pdf . Accessed November 30, 2012.

Vaccine information statement: meningococcal vaccines. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf . Updated October 14, 2011. Accessed November 30, 2012.

Vaccine information statements. Immunization Action Coalition website. Available at: http://www.immunize.org/vis/ . Accessed November 30, 2012.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR . 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

10/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR . 2009;58(37):1042-1043. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm . Published September 25, 2009. Accessed October 2, 2009.

12/16/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention (CDC). Recommendation of the Advisory Committee on Immunization Practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MenACWY-D) among children aged 9 through 23 months at increased risk for invasive meningococcal disease. MMWR Morb Mortal Wkly Rep. 2011;60(40):1391-1392.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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