Vaccination against meningitis
There are two categories of meningococcal vaccines: polysaccharide vaccines with specific capsule serogroup antigens and polysaccharide-protein conjugate vaccines, which have serogroup antigens attached to the protein that helps enhance the immune system's response to the vaccine. Conjugate vaccines are preferred over polysaccharide vaccines because of their potential for herd protection and their enhanced ability to generate immunity, especially in children under two years of age (this is similar for pneumococcal conjugate vaccines, see section 10 of this module).
Meningococcal vaccines should be stored between +2 °C and +8 °C. Polysaccharide vaccines are generally given as a 0.5 ml subcutaneous dose. Conjugated vaccines are administered in a dose of 0.5 ml intramuscularly.
Meningococcal vaccines have excellent safety records. Serious side effects with polysaccharide vaccines include rare anaphylaxis (one in a million doses of vaccine administered) and rare neurological reactions, such as seizures. Mild effects include local injection site reactions in up to 56% and fever in less than 5% of them (most commonly in infants).
Conjugate vaccines have excellent safety profiles. No serious negative side effects have been associated with them. Mild side effects include local reactions at the injection site, fever and restlessness in children.
Both conjugate and polysaccharide vaccines are safe and effective when used in pregnant women.
Quadrivalent conjugate vaccines (A,C,W135,Y) should be administered as a single intramuscular dose to individuals over two years of age.
A,C,W135,Y-D is also licensed for children aged 9 to 23 months and is given as a two-dose series at three-month intervals starting at nine months of age.
Polysaccharide vaccines should be administered to individuals over two years of age as a single dose. In us A booster dose may be given to persons who travel to endemic countries and are considered to be at high risk of exposure three to five years after the primary dose.