Meningococcal Group A, B, C, Y and W-135 Vaccines

What is meningococcal disease and what are the complications of this disease?

Invasive meningococcal disease is caused by a bacteria called Neisseria meningitidis (N. meningitidis). There are many different groups or types of this bacteria that can cause disease and each type is identified by a letter. The majority of invasive meningococcal disease (IMD) is associated with Neisseria meningitidis serogroups A, B, C, Y and W-135.

The bacteria can cause infection of joints (septic arthritis), blood (bacteremia or septicemia), the lining of the heart (pericarditis), the lung (pneumonia), or the brain (meningitis).

The most common illness caused by this bacteria is meningitis and there have been outbreaks of meningococcal meningitis in several Canadian provinces since 1989. Meningocococcus Group C was responsible for an outbreak of bacterial meningitis in PEI during 1990 to 1992. There were deaths among young adults during that outbreak.

Approximately 10 per cent of people who get meningococcal disease will die and 10-20 per cent of survivors have long term effects including hearing loss, digit or limb amputations, and neurological disabilities.

What are the contents of the vaccines?

Meningococcal A,C,Y and W135
This is an inactivated vaccine containing portions of the N. meningitidis antigens of serogroups A, C, Y, and W-135 bacteria conjugated to a carrier protein from diphtheria. This component of the vaccine is responsible for stimulating the body to make antibodies to meningococcal A, C, Y, and W-135 strains of the bacteria, which results in protection for the vaccinated person.

As well, the vaccine contains traces of medicinal ingredients that keep the vaccine stable, sterile, and help the body be more effective in producing antibodies. There is no preservative and no mercury in the vaccine. The product is latex free.

Meningococcal C
This is an inactivated vaccine containing portions of the N. meningitidis bacteria of serogroup C conjugated to a carrier protein, which stimulates the body to make antibodies to the Meningococcal C strain. This results in protection for the vaccinated person.

As well, the vaccine contains traces of non-medicinal ingredients that keep the vaccine stable, sterile, and help the body be more effective in producing antibodies. There is no preservative and no mercury in the vaccine.

Meningococcal B
This is an inactivated recombinant vaccine containing protein from the N. meningitidis bacteria of serogroup B  which then stimulates the body to make antibodies. This results in protection for the vaccinated person. As well, the vaccine contains traces of non-medicinal ingredients that keep the vaccine stable, sterile, and help the body be more effective in producing antibodies. There is no preservative and no mercury in the vaccine.

All vaccine contents are licensed for use in Canada by the Biologics and Genetics Therapies Directorate within Health Canada. A complete listing of contents is included in the product insert which is available from the immunizer.

What are the possible reactions to the vaccine?

The most serious but rare side effect is a severe allergic reaction (anaphylaxis), which can be life threatening and which usually occurs within 15-20 minutes of receiving the vaccine. Procedures are in place for the immuizer to quickly respond to anaphylaxis by administering adrenaline.

The most common side effects after receiving the vaccine are tenderness, redness, and swelling at the site where the vaccine is given. Headache and mild flu-like symptoms including malaise, tiredness, nausea, and muscle aches and pains have been reported. These symptoms generally last one to two days.

It is not necessary to give acetaminophen after immunization. If discomfort or fever occur acetaminophen can relieve the symptoms.

• Please remain in the waiting room for 15 minutes after immunization.
• See a doctor or seek medical attention if any serious side effect occurs.
• Report serious reaction(s) to the immunizer.

What are the situations in which Meningococcal vaccine should not be given?

Meningococcal vaccine is contraindicated in persons with a history of anaphylaxis after previous administration of the vaccine and in persons with proven immediate or anaphylactic hypersensitivity to any component of the vaccine or its container.

In situations of suspected hypersensitivity or non-anaphylactic allergy to vaccine components, investigation is indicated, which may involve immunization in a controlled setting.

Administration of meningococcal vaccine should be postponed in persons with moderate or severe acute illness. Persons with minor acute illness, with or without fever, may be vaccinated.

What are the risks if the vaccine is not received?

The chance of getting invasive meningococcal disease varies greatly from time to time and an outbreak can occur without warning. There had been on average over 100 cases of meningococcal disease caused by groups A, B, C, Y, and W-135 meningococcus in Canada each year, with an increased number of cases when an outbreak occurred.

Illness due to Meningococcus group C has decreased due to immunization programs, and the corresponding decline in serogroup C IMD, serogroup B has become the leading cause of IMD in Canada.

IMD mortality is approximately 10% and of IMD survivors, 10% to 20% have long term sequelae which may include hearing loss, neurologic disabilities, and digit or limb amputations.

Who is eligible for publicly funded meningococcal vaccines in PEI?

Men- C vaccine is provided to individuals at 12 months of age, and Men A,C,Y, W-135 is given to children as part of the school-based program in Grade 9.

Men-B vaccine is provided during outbreaks and for individuals that are at higher risk of developing Men-B IMD, including; PEI residents attending post-secondary school who are living in residence in PEI or out-of-province; individuals with asplenia; persons with congenital complement, properdin, factor D or primary antibody deficiencies; individuals with HIV; and, persons with acquired complement deficiency due to receipt of the terminal complement inhibitor eculizumab).