meningitis vaccine

The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: “Why not self-medicate?”. Contrary to popular belief, meningococcal meningitis is not a cold. That is, you can not protect yourself from the disease by wearing a warm hat. Inflammation of the meninges, which actually is meningococcal meningitis, is an infectious disease that is easily transmitted by airborne droplets. But it is quite possible to prevent the disease. The best way to prevent it is to get vaccinated against meningococcal disease.

Vaccine types

The meningococcal meningitis vaccine is a drug that forms strong immunity against the meningococcal bacteria Neisseria meningitidis. The bacterium Neisseria meningitidis has 13 serogroups, but only six of them (A, B, C, Y, W135, X) can cause disease in humans. The disease caused by these bacteria ends in death in about 16% of cases. And what is most dangerous, death most often occurs during the first two days of the development of the disease, even if it was diagnosed on time.

The first meningococcal vaccine was developed in 1970. It was a polysaccharide preparation. Currently, three types of special vaccines are used to protect against meningococcal infection: polysaccharide; protein; conjugated.

As a rule, the meningococcal vaccine is given once. The drug is administered by injection into a muscle or under the skin. Vaccination is effective in 9 out of 10 cases. The necessary immunity is formed within 5 days after the injection and lasts for 3-5 years.

Along with vaccinations against meningococcus, a pneumococcal vaccine is used to protect against pneumococcal meningitis. In this case, Prevenar and Pneumo-23 vaccines are often used to immunize children. To protect babies from a hemophilic infection, which can also provoke meningitis, they resort to the help of Pentaxim, Hiberix, Act-HIB and others.

Polysaccharide

The polysaccharide vaccine is an immunostimulatory drug for the prevention of meningococcal infection, which contains inactivated bacterial strains that do not cause the disease. Vaccinations of this kind are not included in the list of mandatory for children or adults in the CIS countries, however, they are desirable in order to prevent the risk of infection during an epidemic.

Three types of polysaccharide vaccines are currently in use:

• divalent (contain serogroups A, C);
• trivalent (serogroups A, C, W);
• tetravalent (serogroups A, C, Y, W135).

Meningitis caused by serogroup X bacteria, although it has been recorded in North America, Australia, West Africa, and some European countries, today there is no vaccine against this strain.

When choosing a vaccine, it is important to understand that it only induces immunity against meningococcal meningitis caused by certain serogroups. After an injection of a polysaccharide vaccine, the amount of antibodies needed to resist the disease rises sharply in the body. The effect of vaccination in adults can last for 3-5 years, in children – about 2 years. But for more reliable protection, experts advise revaccinating every 3 years.

Type A and C polysaccharide vaccines are suitable for children over 2 years of age and for adults at increased risk of the disease. These drugs are also used for mass vaccination during the epidemic, as they allow you to create not only individual, but also the so-called collective immunity. Vaccines of type “A + C” are recommended to be re-administered no earlier than after 2-4 years.

For vaccination of children under 2 years of age, the quadrivalent preparation Menjugate is suitable (administered once – 1 dose). For children under 18 months of age, polysaccharide vaccines of groups A, A + C are administered only in case of an epidemic or if someone in the family is sick. To create a strong immunity for the child, vaccination must be repeated after 18 months.

Polysaccharide vaccines are generally well tolerated. A minor post-vaccination reaction occurs in about 1/4 of cases. It is expressed in the form of redness and soreness at the injection site. In some people, after vaccination, body temperature may rise, which returns to normal after 24-36 hours. Serious complications from vaccination are extremely rare. Approximately one patient out of 1 million may have a reaction in the form of urticaria or bronchospasm, and even less often – anaphylactic shock.

Like any vaccination, meningococcal vaccination should only be given to healthy people. It is forbidden to administer the drug against meningococci during the period of exacerbation of the course of a chronic disease, as well as to persons allergic to the vaccine, pregnant and lactating mothers.

Popular polysaccharide vaccines:

• dry polysaccharide (meningococcal group A);
• polysaccharide meningococcal vaccine A + C;
• Meningo A + C (French drug, used from 18 months);
• Mencevax ACWY (Belgian and English vaccine, administered to children from 2 years old and adults);
• Menactra (American ACWY vaccine, suitable for children 2 years of age and older and adults up to 55 years of age).

Protein

It turned out that polysaccharide vaccines are ineffective for the prevention of meningococcal infection caused by group B bacteria. Therefore, experts have developed a different type of vaccine – protein, which is the outer protein of the pathogen’s membrane. Its creation was prompted by the epidemic of the disease in Cuba, which was recorded in the 80s of the last century. This is how the first protein vaccine VA-Mengoc-BC appeared.

Around the same time, another protein-based antimeningococcal drug was developed in Norway. With its help, the Norwegians tried to stop the rapid spread of the disease among children and adolescents. But it soon turned out that this drug was effective only in half of the cases, so its further use was abandoned.

In 2010, another protein-based vaccine against type B bacteria, MenB, appeared. It was created to vaccinate residents of New Zealand, and in 2013 received approval in Europe. In the same year, the Swiss company Novartis received a license to manufacture Bexsero, a protein vaccine that is suitable for all ages, including children from 2 months. Laboratory studies conducted in England confirmed the effectiveness of the drug in 88 cases out of 100. A protein drug, like a polysaccharide drug, is administered in 2-4 doses (with an interval), after which antibodies to type B meningococcal bacteria are produced in the body. It is more advisable to do such immunizations during infancy, so the serogroup B vaccine is often viewed as a childhood vaccine.

As a rule, protein vaccination is well tolerated. But in order to avoid an allergic reaction, within 2 weeks before and after taking the vaccine, the child should not be vaccinated with another type of vaccine. Contraindications to vaccination of children and adults: allergies, the presence of an infectious disease accompanied by fever, pregnancy (or planning a pregnancy in the near future), lactation.

A post-vaccination reaction can manifest itself in the form of redness and hyperemia at the injection site, a short-term increase in body temperature up to 38 degrees (rarely up to 40), headache, irritability, convulsions, vomiting, rash, lymphadenopathy.

conjugated

Conjugate vaccines are similar in principle to polysaccharide vaccines. They also counteract meningococcal infections caused by four serotypes of bacteria.

The conjugate vaccine against group C has been used in medicine since 1999, and in 2005 a quadrivalent vaccine against groups A, C, Y, W135 was created. This type of vaccination is given to children and adults in Europe, Canada and the United States. In 2010, an improved vaccine was created to fight group A meningococcus. Compared to polysaccharide preparations, the conjugated one creates a more stable barrier against bacteria. This vaccine, unlike the polysaccharide vaccine, can be used for children under 2 years of age (starting at 2 months). In addition, it is great for vaccinating teenagers and adults. After the conjugate vaccine, immunological memory is produced in the human body. This means that the effectiveness of the procedure is maintained for the next 10 years. The use of the conjugate vaccine in Europe has resulted in a significant decrease in cases of meningococcal disease in the region.

Children from 9 months of age are suitable for the Menactra vaccine. The vaccine is given twice with an interval of more than 3 months, and after 2 years it is repeated once.

NeisVac-C is also suitable for infants and adults, but it only provides protection against serogroup C meningococcus bacteria. During the year, children from 2 months old can receive 2 doses of the drug (with an interval of more than 2 months). For children over 1 year of age and adults, one dose of the vaccine is enough to protect against the disease.

The drug, called Menveo, is suitable for vaccinating adults and children over 2 years of age. The injection is done once. Revaccination is possible after 5 years. According to the same scheme, the Nimenrix conjugate vaccine is used, which is recommended for vaccination of adults and babies from 1 year old.

For and against vaccinations

Vaccination against meningococcal disease as a preventive measure is essential for everyone. But there are groups of the population for which vaccination against this infection, without exaggeration, is vital. These are people in contact with the patient, people with severely weakened immunity, travelers planning to visit Africa, laboratory workers working with meningococcal bacteria. As well as students living in dormitories, schoolchildren studying in boarding schools, and conscripts. Vaccination against meningococcus is mandatory for these populations.

Despite the seemingly obvious benefits of vaccination against meningococcal infection, opinions differ about whether it is necessary to get vaccinated. Some, citing possible side effects, negative reviews on the Internet, or the absence of an epidemic in the region, refuse to be vaccinated. The fact that even the most expensive vaccine does not provide a 100% guarantee of protection against the disease is often cited as an argument against vaccination. However, experts say that even if after vaccination a child or an adult gets sick with bacterial meningitis (which happens extremely rarely), the disease will proceed much easier than in unvaccinated people. After the vaccine, complications are much less common. By the way, statistics show that it is thanks to vaccinations that mortality from meningococcal infection has significantly decreased over the past 20 years. But vaccination should be carried out only after consulting a doctor. He will select the necessary drug, and also determine when it is best to vaccinate an adult or child, taking into account the medical history and the state of the patient’s immune system.

Sources of