Meningococcal Immunisation

What is the meningococcus?

The meningococcus is a bacterium (germ) that can cause meningitis and septicaemia (blood infection). 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 and W135 are rare in the UK but group W135 has been the cause of recent outbreaks in certain parts of the world.

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 vax vaccine (or the quadrivalent meningococcal meningitis vaccine) protects against groups A, C, Y and W135.
• At present, there is no vaccine that protects against Group B meningococcal infection.

The vaccines stimulate your body to make antibodies against the meningococcal bacteria. These antibodies protect you from illness should you become infected with the bacteria.

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 thought to give lifelong immunity, so booster doses later in life are not needed. A separate leaflet describes this in 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 you doctor or practice nurse to get immunised. Just one injection of vaccine is needed if you are over the age of one year. Once all people under the age of 25 are immunised with MenC, only the routine immunisations for new babies will need to continue.

Travellers
You should be immunised with the ACWY vax 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. Your doctor or practice nurse can advise if you should have this immunisation for your travel destination.

The ACWY vax vaccine is thought to provide good protection within a week or so of the injection. However, ideally you should be immunised at least two weeks before travel. Protection is thought to last about five years. If needed, a booster is recommended after five years.

Note: the ACWY vax vaccine is not very effective against Group C infection if given to children under the age of 18 months. (The MenC vaccine is a different type of vaccine and is effective in babies. This is why the MenC vaccine is routinely given to babies and not the ACWY vaccine.)

Moslem's 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 ACWY vax vaccine. Proof of immunisation with ACWY vax vaccine given within the last two years is now needed to get a new visa to visit Saudia Arabia.

Contacts
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 may also be advised to take antibiotics for a few days.)

Are there any side-effects from meningococcus vaccines?

Pain and redness at the site of injection occur in about 1 in 10 people and lasts 1-2 days before subsiding. A mild fever sometimes occurs. This is more common in young children but it soon goes. Severe reactions are rare.

Who should not be immunised against the meningococcus?

• You should not have a booster if you have had a severe reaction to a vaccine in the past.
• Pregnant women. The risks are thought to be very small, but as with any other vaccine it is wise to play safe and not have the vaccine. However, if your risk of exposure to the meningococcus is high, it may be advisable to be immunised even if you are pregnant.
• If you have a feverish illness it is best to wait until the illness goes before being immunised.

Further information

Health Advice for Travellers - From the Department of Health
All travellers going abroad are advised to get this booklet. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Immunisation Against Infectious Disease (The Green Book)
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/GreenBook/fs/en
From the Department of Health. Aimed at health professionals but of interest to all.

© EMIS and PIP 2006   Updated: October 2006   PRODIGY Validated