All babies are offered immunisation against group C meningococcus - the MenC vaccine. Also, if you go to certain countries, in particular Saudi Arabia and countries in sub-Saharan Africa, you should be immunised against various strains of the meningococcus before you travel. You should be immunised at least two weeks before you travel if you need this immunisation.
What is the meningococcus?
The meningococcus is a germ (bacterium) that can cause meningitis and blood infection (septicaemia). It can also cause other infections - for example, pneumonia, eye infection (conjunctivitis) and inflammation of the heart (myocarditis). It most commonly causes infections in babies under the age of 1 year. It also can cause infections in those aged 2-5 years and those aged 15-19 years.
Some of these infections are very serious and can be fatal if not treated quickly. There are different groups (strains or types) of meningococcal bacteria:
- Groups B and C are the common strains in the UK. Most cases of bacterial meningitis in the UK are caused by group B. Most of the rest are caused by group C (although the number of group C cases has fallen greatly due to immunisation introduced in 1999).
- Group A is rare in the UK, but more common in certain parts of the world. In particular, sub-Saharan Africa and parts of Saudi Arabia.
- Groups Y, W135, 29E and Z are rare in the UK but group W135 has been the cause of recent outbreaks in certain parts of the world.
Infection with the meningococcus can affect anyone, but those most at risk are: children aged under 5 years (especially babies under a year), teenagers and young adults under the age of 25.
Vaccines against the meningococcus
There are two types of vaccine against meningococcal infection:
- One type of vaccine protects against group C only - the MenC vaccine.
- One type of vaccine called the ACWY vaccine (Menveo®) protects against groups A, C, Y and W135.
The vaccine stimulates your immune system to protect you against meningococcal infection should you become infected with the germs (bacteria).
At present, there is no vaccine available in the UK that protects against group B.
Who should receive the different types of vaccine?
Children - the MenC vaccine
The vaccine against group C is offered to all babies as part of the childhood immunisation programme. It has been routine in the UK since 1999. It is given when children are 3 months, 12-13 months and around 14 years. It is thought to give lifelong immunity, so booster doses later in life are not needed. See separate leaflet called Meningococcal Group C Immunisation for more detail.
Older people and the MenC vaccine
Older children, teenagers, and young adults under the age of 25 were offered immunisation in a catch-up programme after the immunisation was first introduced in 1999. Most are now immunised. However, if you are under the age of 25 and have not been immunised - see your doctor or practice nurse to get immunised. Just one injection of vaccine is needed if you are over the age of 1 year. Once all people under the age of 25 are immunised with MenC, only the routine immunisations for new babies will need to continue.
People without a spleen or whose spleen does not work properly
If you do not have a spleen, or your spleen does not work properly or you have a weakened immune system then it is likely to be recommended to you that you will need to receive the MenC and the MenACWY vaccine. The timing of your vaccines will depend on your age. Your doctor will be able to advise you in more detail regarding this.
You should be immunised with the MenACWY vaccine if you intend to travel to areas where meningococcal infection is a risk. This includes areas of sub-Saharan Africa (particularly in the dry season), and areas of Saudi Arabia. The risk for meningococcal meningitis is extremely low for tourists but higher for those living or working within local areas in endemic or outbreak areas. Your doctor or practice nurse can advise if you should have this immunisation for your travel destination.
The MenACWY vaccine is thought to provide good protection within a couple of weeks or so of the injection. Patients should make an appointment at least 2-3 weeks before travel in order to have had the vaccination no less than 10 days before travel. You should receive the MenACWY vaccine if you are travelling and have only received the MenC vaccine in the past.
Immunity after the MenACWY vaccine does not last as long in children under 5 years old. For babies under 1 year of age, two doses one month apart are needed for protection, but older children and adults should receive a single dose.
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 last three years is now needed to get a new visa to visit Saudi Arabia.
Close contacts of a person with meningococcal infection may be offered immunisation. The vaccine used depends on the meningococcal group causing the illness. (Close contacts are likely to also be advised to take medicines called antibiotics for a few days.)
Are there any side-effects to the vaccines?
Most people have no side-effects. Sometimes a mild high temperature (fever) develops for a short time. Some babies cry more and become irritable for a short time after the injection. Occasionally they may be sick (vomit) or have diarrhoea. Slight swelling, pain and redness at the injection site may occur. Headache and muscle aches for a short time can occur in some older children.
None of the above side-effects is serious, and they soon settle. If necessary, you can give paracetamol or ibuprofen to children to ease pain and fever following immunisation. Serious reactions are rare.
Who should not be immunised?
- Immunisation should be postponed if a child has a high temperature (fever) or serious infection. Minor infections such as coughs, colds and snuffles are no reason to postpone immunisation.
- The vaccine should not be given if there has been a severe reaction to a previous dose of vaccine (which is extremely rare). Also, it should not be given if a person is known to be allergic to any of the ingredients in the vaccine.
The vaccines are safe if you are breast-feeding.
Are you still at risk of meningitis after the immunisation?
Yes. However, the MenC vaccine has greatly reduced the number of cases of meningitis and blood infection (septicaemia) since it was introduced in 1999.
Note: other groups of meningococcus, and other germs (bacteria) can still cause meningitis.
You should get medical help immediately if you suspect that your child, or someone you know, has meningitis or septicaemia. The earlier the treatment of meningitis or septicaemia, the better the chance of recovery and preventing complications or death. See separate leaflets called Meningitis and Septicaemia and Meningitis Symptoms Checklist for more details about the symptoms of meningitis and septicaemia.
Dr Tim Kenny
Dr Louise Newson
Prof Cathy Jackson