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Meningococcal Immunisation

The following information is sourced from NCIRS, June 2018.

What is meningococcal disease?

Meningococcal disease is a rare but severe bacterial infection that can cause lifelong disability or death and can affect people at any age.

Meningococcal bacteria (Neisseria meningitidis) are carried in the nose and throat of some healthy people and are spread through close prolonged contact. The bacteria are more commonly found in teenagers and young adults.

Meningococcal disease is a rare but serious infection caused by the bacterium Neisseria meningitidis (N. meningitidis). There are 13 serogroups. Meningococcal disease is most commonly caused by serogroups A, B, C, W and Y.

Septicaemia and/or meningitis are the most common clinical manifestations of invasive meningococcal disease (IMD). The highest incidence of meningococcal disease is in children aged <2 years and adolescents aged 15–19 years. Carriage rates of the bacteria are highest in older adolescents and young adults.

The incidence of meningococcal disease fluctuates naturally over time.

Meningococcal B disease has been dominant until recently, but has been naturally declining in most states and territories, even in the absence of widespread vaccination against this serogroup. The incidence of meningococcal W disease has increased since 2013. In 2017, serogroups B and W caused similar numbers of meningococcal disease cases in Australia (37.5% and 38.1%, respectively, of cases with an identified serogroup). Meningococcal B disease remains the most common cause of IMD in children, adolescents and young adults. Meningococcal W and Y disease occurs over a more diverse age range and may present with less typical clinical manifestations than disease due to other serogroups.

Meningococcal Vaccines

Three types of meningococcal vaccines are available in Australia:

  1. Meningococcal C conjugate vaccines (MenCCV), available as a single vaccine, NeisVac-C®, or in a combination formulation with the Haemophilus influenzae type b (Hib) vaccine (Hib–MenCCV): Menitorix®
  2. Multicomponent meningococcal B vaccines (MenBV): Bexsero® , Trumenba® 
  3. Quadrivalent (A, C, W, Y) meningococcal conjugate vaccines (4vMenCV): Menactra®, Menveo®, Nimenrix®.

Currently the National Immunisation Program Schedule includes routine Meningococcal ACWY vaccination for children aged 12 months.

The Tasmanian Government is currently (as of 26/7/18) funding a free meningococcal ACWY vaccine for all Tasmanians aged between 6 weeks up to 21 years (ie. born after 1 August 1997).

Glebe Hill Family Practice stocks private Meningococcal B vaccine (Bexsero), and Meningococcal ACWY vaccines. The cost for the vaccine differs depending on the vaccine required (or available), and that information is available by speaking with one of our team members.

Who should be vaccinated?

  • People in age groups with increased incidence of IMD or high carriage rates of N. meningitidis:

    • Infants and young children aged <2 years: All infants and children aged <2 years are recommended to receive MenACWY vaccine. A routine single dose of MenACWY vaccine at 12 months of age is recommended and funded under the National Immunisation Program (NIP). MenACWY vaccine is available for infants <12 months of age through private prescription from 6 weeks of age, and requires more doses. MenB vaccine (Bexsero® only for this age group) is also recommended but not funded under the NIP for children aged <2 years.
    • Adolescents and some young adults: All adolescents aged 15–19 years are recommended to receive MenB and MenACWY vaccines. Some young adults aged 20–24 years who live in close quarters (such as new military recruits and students living in residential accommodation) or who are current smokers are also recommended to receive vaccination. In some Australian states, vaccines are funded for certain age groups in response to locally predominant meningococcal B or W disease.
  • Aboriginal and/or Torres Strait Islander people:

    • Aboriginal and Torres Strait Islander people aged 2 months to 19 years are recommended to receive MenB and MenACWY vaccines.
  • People with medical conditions associated with an increased risk of IMD:

    • People with complement disorders, asplenia and other immunocompromising conditions are recommended to receive MenB and MenACWY vaccines.
  • Travellers:

    • People travelling to certain destinations where there is an increased risk of exposure to serogroups A, C, W or Y (including, but not limited to, the ‘meningitis belt’ of sub-Saharan Africa) are recommended to receive MenACWY vaccine. Vaccination is required for pilgrims attending the annual Hajj in Mecca, Saudi Arabia.
  • People who have occupational risk:

    • Laboratory personnel who frequently handle Neisseria meningitidis should be vaccinated with MenB and MenACWY vaccines.
  • Anyone wishing to reduce their risk of IMD:

    • Vaccination with MenB and MenACWY vaccines may be offered to anyone aged >6 weeks 

Meningococcal ACWY Vaccination

 

Dose schedule for Men ACWY vaccines, by age and vaccine brand, for healthy individuals (sourced from NCIRS Fact Sheet: June 2018)
Age at commencement of vaccine courseBrands registered for use in AustraliaNumber of doses required Healthy individualsInterval between doses
6 weeks-5 months

Menveo

or

Nimenrix

3 doses8 weeks between 1st & 2nd doses;m 3rd dose at 12 months of age 
6-8 months

Menveo

or

Nimenrix

22nd dose at 12 months of age
9-11 months

Menveo, Nimenrix or Menactra

2 doses for Menveo or Menactra, 1 dose for Nimenrix8 weeks between doses for Menveo or Menacra. 2nd dose not required for Nimenrix
2 years and overMenveo, Nimenrix or Menactra1 doseN/A

For individuals with any specified medical conditions associated with increased risk of meningococcal disease, extra doses may be required - please ask your GP or Practice Nurse about your individual situation.

Is the meningococcal ACWY vaccine safe?

The meningococcal ACWY vaccine is safe and effective.  We know this because the vaccine has been used safely to prevent the spread of disease in the United Kingdom and United States of America for many years. Side effects are mostly mild and don’t last long. The most common side effects are fever or redness, pain or swelling at the injection site. Serious side effects are very rare.

Vaccines used in Australia must pass strict safety testing before being approved by the Therapeutic Goods Administration (TGA). In addition, the TGA monitors the safety of vaccines once they are in use.

Can people of other ages access meningococcal ACWY vaccine?

People of all ages who wish to protect themselves against Meningococcal ACWY disease can access the vaccine privately through their GP. The vaccine is available for purchase at Glebe Hill Family Practice, or can be purchased at a pharmacy with a prescription from a GP.

What does it cost?

The fee for private Meningococcal ACWY vaccine at Glebe Hill Family Practice is usually $69 - $120 (depending on the brand required).

For existing patients, appointments solely for vaccination (excluding travel vaccination) are bulk-billed at Glebe Hill Family Practice (excluding Saturdays). New patients will require a normal appointment with a GP and will be privately billed.

Meningococcal B Vaccination

 

Recommended number of doses of Men B Vaccine for healthy individuals (sourced from NCIRS Fact Sheet: June 2018)
Age at commencement of vaccine courseBrands registered for use in AustraliaNumber of doses requiredRecommended interval between dosesNotes
6 weeks-5 monthsBexsero48 weeks8 weeks between doses; 4th dose at 12 months
6-11 monthsBexsero38 weeks8 weeks between 1st & 2nd doses; 3rd dose at 12 months or 8 weeks after 2nd dose, whichever is later
12 months-9 yearsBexsero28 weeks 
10 years and overBexsero or Trumenba2 or 3 (see note)6 months (2 doses); see note for 3 dose scheduleFor those with specified medical conditions, 3 doses are required (at least 4 weeks between 1st and 2nd doses; 3rd dose at least 4 months after 2nd dose and at least 6 months after 1st dose)

The requirement for booster doses of Men B Vaccine has not yet been determined, and at present not recommended.

Risks of Meningococcal B vaccination

The most common side effect is high fever, especially for children under 12 months. About 1 in 4 children will have a temperature ≥38°C and 1 in 10 have a temperature of ≥39°C. This is highest within 6 hours of vaccination, and resolves within 3 days. Trials suggest the risk of fever is higher if the meningococcal B (Bexsero) vaccination is given with other infant vaccines. Other common adverse events associated with vaccination include tenderness, swelling and redness at the injection site, irritability, sleepiness or crying. For adolescents and adults the most common reported adverse events are pain at the injection site, malaise and headache.

Precautions

Due to the risk of high fever following meningococcal B (Bexsero) vaccination it is recommended to give children under 2 years of age a dose of paracetamol about 30 minutes prior to the vaccination. A further 2 doses can be given 6 hours apart following vaccination, regardless of fever. This does not affect the effectiveness of the vaccination but does halve the risk of high grade fever. This is an exception to the general recommendation not to routinely give paracetamol with vaccinations unless it is for relief of fever or pain following immunisation.

What does it cost?

The cost of Bexsero is currently $118 per dose. It may be available slightly cheaper from a pharmacy with a prescription.

Glebe Hill Family Practice stocks Bexsero for purchase. If our vaccine stocks have run out your GP will provide a prescription for the vaccine.

For existing patients, appointments solely for vaccination (excluding travel vaccination) are bulk-billed at Glebe Hill Family Practice (excluding Saturdays). New patients will require a normal appointment with a GP and will be privately billed.