Meningococcal Vaccine: Protection, Risk, Schedule - Verywell Health
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Meningococcal vaccines protect against bacterial infections caused by Neisseria meningitidis. These bacteria are capable of causing meningococcal meningitis, a condition that causes inflammation of the brain and spinal cord.
Meningococcal disease isn't very common in the United States. A study conducted between 2011 and 2015 suggests that fewer than 1 in every 100,000 people contracted it.
The condition commonly strikes when children are less than age 1 or during adolescence (adolescents range from age 10 to 19). In some cases, this disease can become very serious and life-threatening.
Fortunately, a vaccine can protect against this disease and its more serious consequences. The meningococcal vaccine can help protect against different versions of disease caused by Neisseria meningitidis.
This article will discuss the meningococcal vaccine, side effects, dosing schedule, and more.
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Why the CDC Recommends Meningococcal Vaccination
Neisseria meningitidis can linger within the nasal cavity without causing disease in some people. Older estimates provided by the Centers for Disease Control and Prevention (CDC) suggest that about 10% of the general population carries the bacteria.
Generally, this bacteria can spread quickly when people are in close contact with one another. That's especially true in group living situations, or among people who are intimate (through contact with oral secretions, like kissing).
If someone is unprotected from the disease, it can go on to cause extremely severe illness or even death. About 10% to 15% of people with bacterial meningitis die. One in 5 may have permanent disabilities afterward, like hearing issues, brain and kidney damage, or limb amputation.
Protection and Effectiveness
There are two types of meningococcal vaccines: MenACWY vaccines and Meningitis B (MenB) vaccines. These vaccines protect against different bacterial subgroups that can cause meningitis. They are sold under different brand names.
Effectiveness of the MenACWY Vaccine
The type of meningococcal vaccine that most young adults get is generally called the MenACWY vaccine, which protects against four strains of the Neisseria meningitidis bacteria.
Since the CDC recommended vaccination for adolescents in 2005, cases of meningococcal disease fell by 90%. Similar declines weren't seen in groups that didn't have this vaccine recommendation.
Other studies also noted a large drop in meningococcal disease since the vaccine was introduced. One 2020 paper in JAMA Pediatrics analyzed the national rates of meningococcal disease between 2000 and 2005 (pre-vaccine recommendation) and compared it to 2011 to 2017 (after the CDC implemented a vaccination recommendation).
The annual incidence rates of three strains (C, W, and Y) of meningococcal disease were already dropping in the pre-vaccine period by about 14.6% among adolescents 16 to 22 years old. But that drop accelerated after vaccine introduction. Between 2011 and 2017, the incidence of meningitis due to these strains dropped by 35.6% per year.
This suggests that MenACWY vaccination is related to the drop in meningococcal disease among adolescents, though vaccination alone can't explain this decline. But other studies have replicated these results in other populations.
A study compared meningococcal disease cases and deaths in the Republic of Korea Armed Forces between 2008 and 2013 (before a meningococcal vaccine became obligatory) and 2013 to 2016 (after an obligatory vaccine). Data showed the MenACWY vaccine is 88% effective in protecting against meningococcal disease.
The CDC currently estimates that one dose of the MenACWY vaccine is about 79% effective one year after vaccination. Its effectiveness declines slightly over time but is still 61% eight years after vaccination.
Effectiveness of the MenB Vaccine
Another type of meningococcal vaccine is the MenB vaccine, which protects against a fifth strain of Neisseria meningitidis. In the U.S., parents can opt to give their children a MenB vaccine once they're in their teens.
The CDC's analysis of the efficacy of the MenB vaccines in the real world comes from studies done in other countries. In Canada, a study followed a mass vaccination campaign in a region with a meningitis B outbreak and found that a MenB vaccine was 79% effective in the four years after vaccination.
In the UK, MenB vaccines have become part of the childhood immunization schedule. By 2018 as many as 92% of eligible infants in the UK completed a MenB vaccination by their first birthday, according to a 2020 study in The New England Journal of Medicine.
That study estimated that the vaccine was about 53% effective. This policy has also resulted in a large drop in meningitis B cases. The study noted a 75% drop in cases among vaccine-eligible age groups, compared to the expected numbers.
Who Shouldn't Get Vaccinated
According to the CDC, some people should speak to their healthcare provider before receiving a meningococcal vaccine. Specifically, people who have had life-threatening allergic reactions to meningococcal vaccines or their ingredients should not receive it.
Growing evidence suggests that it is safe for pregnant people to receive a MenACWY vaccine. The CDC notes that pregnancy shouldn't preclude a person from seeking a MenACWY vaccine and that they should contact a healthcare provider for more information.
As for MenB vaccines, the CDC notes that there have been no randomized controlled trials evaluating this vaccine's safety for pregnant or lactating people. The agency suggests that vaccination can wait until after this period. But if the person is at increased risk of meningococcal disease, a vaccine should still be considered.
Parental Hesitancy
One reason parents may express hesitancy over this vaccine is that meningitis cases are rare. Fewer than 1 out of every 100,000 people have gotten meningococcal disease between 2011 and 2017.
However, the consequences of meningitis can be very severe. Even with antibiotics, 10% to 15% of people who contract the infection die. And there have been meningitis outbreaks in recent years, particularly meningitis B (MenB), a specific subtype of bacteria.
One 2019 study in Emerging Infectious Diseases noted that from 2013 to 2018, 10 MenB outbreaks (between 1 and 4 per year) occurred on large college campuses. During those outbreaks, the colleges implemented MenB vaccine campaigns to contain the spread.
Types of Meningococcal Vaccines
The first category of vaccine is called the meningococcal conjugate vaccines or MenACWY vaccines. This vaccine protects against four strains of bacteria that fall into serogroups A, C, W, and Y.
Serogroups are closely related groups of bacteria that all present the same calling cards to the immune system. The MenACWY vaccine protects against meningitis-causing bacteria that present with the A, C, W, or Y calling cards.
Three types of MenACWY vaccines are currently available:
- Menactra
- Menveo
- MenQuadfi
The second category of meningococcal vaccines protects against bacteria that fall into serogroup B. These are called MenB vaccines and are sold under the brand names Bexsero and Trumenba.
The MenB vaccine is fairly new. The FDA approved Trumenba in 2014. Bexsero was approved in 2015. MenB vaccine is not currently part of the U.S. standard childhood vaccine immunization schedule. But in other countries, like the United Kingdom, Bexsero is routinely given during infancy.
Meningitis Vaccine Schedule
The CDC's meningococcal vaccine recommendations differ depending on age, and other risk factors.
Adolescents
Generally, the CDC recommends kids age 11 and 12 get their first dose of a MenACWY meningococcal vaccine. Then, they receive a booster around the age of 16.
Young adults aged 16 through 23 may receive a MenB vaccine. The preferred age of administration is between 16 and 18. The CDC does not routinely recommend this vaccine but instead suggests talking to your child's healthcare provider about receiving this vaccine.
Bexsero is a two-dose vaccine. Doses are given at least one month apart. Trumenba is a two-dose vaccine (doses are six months apart) for healthy teens not at risk for meningitis B. If a teen is at risk, a third shot may be given.
However, unlike the MenACWY meningococcal vaccines, the MenB vaccines (Bexsero and Trumenba) are not interchangeable, and the person getting the MenB vaccine should get the same product for all doses.
You can get the MenACWY vaccine and the MenB vaccine at the same time (usually when a teen comes in for a booster shot at 16). Also, both MenACWY and MenB vaccines can be given at the same time as other vaccines such as Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) and human papillomavirus (HPV).
Children
There are some cases in which the CDC recommends that children as young as 2 months get a MenACWY vaccine. Young children may receive this vaccine if they:
- Have a rare immune disorder called complement component deficiency
- Are taking a complement inhibitor medication like Soliris (eculizumab) or Ultomiris (ravulizumab)
- Have a damaged spleen or have had their spleen removed (including having sickle cell disease)
- Are traveling to a country where meningococcal disease is more common
- Have HIV (a virus that suppresses the immune response)
- Are in a population deemed at-risk due to a local meningococcal disease outbreak
Depending on what condition you or your child may have, your doctor may recommend a specific brand of MenACWY or MenB vaccine.
Adults
Adults can also opt to get a meningococcal vaccine. The CDC particularly recommends doing so for the following groups:
- People with an immune disorder called complement component deficiency
- People who take a complement inhibitor medication
- People with damaged spleens or who have had spleens removed
- Microbiologists who work around or near Neisseria meningitidis
- People who are traveling to places where meningococcal disease is more common
- People experiencing a meningococcal outbreak and deemed at-risk
- Military members
- Those who did not receive this vaccine as an adolescent and are first-year residential college students
Meningitis Vaccine Ingredients
The ingredients of the meningococcal vaccines depend on the brand and type of vaccine.
Ingredients in MenACWY Vaccines
Menactra, MenQuadfi, and Menveo are all made through a process which chemically links a protein recognized by the immune system with a sugar molecule (polysaccharide) found on the surface of certain types of Neisseria meningitidis.
Usually, those polysaccharides are hard for the immune system to spot, but when they're linked to proteins the immune system recognizes, your body learns to mount a response to it. These vaccines are called conjugate vaccines.
Importantly, each one of these vaccines contains polysaccharides from four different serogroups of Neisseria meningitidis. That allows the vaccine to protect you against four different subgroups of bacteria.
These vaccines do not contain preservatives or adjuvants (additives that enhance the immune response).
Ingredients in MenB Vaccines
Meningitis B vaccines, like Bexero and Trumenba, are made up of three proteins found on the surface of one subtype of the Neisseria meningitidis bacteria. The specific proteins differ, depending on whether you receive Bexsero or Trumenba.
These vaccine contains very small amounts of other ingredients, like aluminum hydroxide, sucrose (sugar), histidine (an amino acid), and sodium chloride (salt).
Side Effects
The side effects of meningococcal vaccines are similar to those normally seen with vaccines. They include redness at the injection site, soreness, muscle pain, headaches, and feeling tired. The MenB vaccine may also be accompanied by a feeling of nausea and diarrhea or fever and chills.
These symptoms usually last between one and two days for the MenACWY vaccine, and between three and five days for the MenB vaccine.
Where to Get Vaccinated
The meningococcal vaccines should be available with your local healthcare provider or public health clinic.
Summary
Meningococcal disease is rare in the U.S., but it can be very dangerous. The meningococcal vaccines are safe and effective but not iron-clad ways to protect your child or yourself. The quadrivalent MenACWY vaccine is recommended at age 11 or 12, with a booster at age 16.
The MenB vaccine protects against an additional type, but it is optional. It is often given between ages 16 and 18, and may be given at the time of the booster for MenACWY. Young children who are at greater risk may also be immunized, as may be adults who are at greater risk.
A Word From Verywell
You may have read headlines about meningitis outbreaks on college campuses or in other group living situations. These outbreaks are rare, but it's still important to protect yourself. Receiving a meningococcal vaccine, particularly if you fall into a risk group, is the best way to protect yourself from this condition.
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