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Vaccinations: Meningococcal

©iStockphoto.com/lovleah

©iStockphoto.com/lovleah

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by Katie Porterfield
November 29, 2011

What is meningococcal disease?
Meningococcal disease is a rare but serious disease. The term refers to any illness caused by meningococcus bacteria. Septicemia (a bloodstream infection) and bacterial meningitis (an infection of the fluid surrounding the brain and spinal cord) are the most serious meningococcal infections, both of which can turn deadly in 48 hours. Symptoms of meningococcal disease include high fever, headache, stiff neck, nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. Infants with meningococcal disease can appear sluggish, inactive, and irritable, and may vomit or feed poorly, but the classic meningococcal symptoms (fever, headache, and neck stiffness) can be difficult to detect. While meningococcal disease is not as contagious as the common cold or flu, it spreads from person to person via respiratory secretions during close or lengthy contact (kissing, sharing utensils or cups, coughing and sneezing), especially among people in the same household or school dormitory.

Why should I vaccinate my child?
Every year, meningococcal disease infects about 1,000 to 2,600 people in the U.S., according to the Centers for Disease Control and Prevention (CDC). Despite antibiotic treatment, about 10 to 15 percent of those infected suffer fatal complications and about 15 percent of those who survive have long-term disabilities, including loss of limbs, deafness, nervous system problems, or brain damage. The meningococcal conjugate vaccine, also known as MCV4, was licensed in 2005. It is the preferred vaccine for people 2 through 55 years of age. (Another vaccine, the meningococcal polysaccharide vaccine known as MPSV4 was licensed for people older than 55 and may be used for certain individuals under age 55 if MCV4 is not available). Both vaccines, according to the CDC protect against four types of meningococcal disease, including two of the three types most common in the U.S. and a type that causes epidemics in Africa. Unfortunately, there isn’t a vaccine to protect against subtype B, which causes about one-third of all meningococcal disease cases in the U.S.

Meningococcal disease is most common in people with certain medical conditions (people who do not have a spleen, for example, are considered high risk) and infants under 1 year of age. However, there isn’t a vaccine to (routinely) protect children under the age of 2. Under special circumstances (consult your child’s health care provider for details) in which short-term protection is needed from a strain of meningococcal disease known as subtype A (one of the four types protected by the vaccines), children under 2 may receive MPSV4, according to the Immunization Action Coalition. However, the majority of meningococcal cases in infants are caused by subtype B, which no vaccine protects against.

Parents, then, should focus on what they can control. It seems every year, a meningococcal meningitis case, or death from the disease, at a college in the U.S. makes headlines. Indeed, according to the CDC, teenagers 15–19 and college students living in close quarters in dormitories have an increased risk of getting meningococcal disease. As a result, the CDC recommends (and many colleges require) that this age group be up-to-date on their meningococcal vaccinations. If an infant or any child younger than 15 years of age is considered a “close contact” of someone who has been infected with meningococcal meningitis, he should receive antibiotics to prevent him from getting the disease.

When is the vaccine given?
The meningococcal vaccine is recommended for children and adolescents 11 through 18 years old, according to the CDC. The vaccine is typically given to 11–12 year olds during their routine pre-adolescent immunization visit. If your child did not get the vaccine at this visit, he should get it at the earliest opportunity.

The vaccine is also recommended for certain high-risk children ages 2 through 10. This includes U.S. children who travel to or live in countries where meningococcal meningitis is hyperendemic (meaning the area has a high and continued incidence of the illness) or epidemic (meaning an atypically large number of people in the area have the illness at the same time). For more information and recommendations regarding high-risk children, click here.

How many doses will my child receive?
The CDC recommends that your child receive one dose of the meningococcal vaccine. Depending on the age of your child when he receives the vaccine, he may also need a booster dose when he is 16 years old. If your child receives his first dose at 13 through 15 years old, he should receive the booster dose at 16 through 18 years old. If he doesn’t receive his first dose until he is 16 years or older, he will not require a booster dose.

What are the possible side effects?
As many as 50 percent of those who receive meningococcal vaccines have mild side effects, including redness or pain where the shot was given, according to the CDC. If this occurs, it usually lasts 1–2 days. A small percentage of people who get the vaccine exhibit fever. Parents may wish to apply a cool, wet washcloth to the sore area and give acetaminophen or ibuprofen (as directed by the child’s health care provider) for pain and fever.

In addition, some people who receive the MCV4 vaccine reporte a serious nervous system disorder known as Guillain-Barre Syndrome (GBS), in which the body’s immune system attacks its nerves. The CDC, however, states that this occurs so rarely that it is difficult to determine whether the vaccine is linked to GBS, and even if it is, the risk is extremely small.

When should I call a doctor?
Parents should immediately alert their child’s health care provider if their child experiences difficulty breathing, hoarseness, wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. Such side effects, indicative of an allergic reaction, are rare, but would likely occur within a few minutes to a few hours of receiving the vaccination. Parents should also contact their child’s health care provider if the child has a high fever, feels weak, or displays unusual behavior.

Katie Porterfield is a freelance writer and former magazine editor in Nashville, Tennessee. She is mom to twin boys.