Meningitis is a term that describes inflammation of the tissues surrounding the brain and spinal cord. Several different organisms, including bacteria, viruses, fungi, and parasites, can cause it.
The disease can be neurologically devastating and cause long-term complications. It can be deadly in a matter of mere hours. Fortunately, a vaccine is available to help prevent meningitis caused by the bacterium Neisseria meningitidis.
When invasive infection occurs, prompt diagnosis and treatment are vitally important to prevent long-term complications, but given how quickly it progresses, this can be a difficult and daunting task.
The best way to prevent meningococcal disease is the meningococcal vaccine. This article covers what you need to know about this vaccine, which is widely regarded as safe and effective in reducing the risk of meningococcal disease.
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Understanding Meningococcal Disease
Several bacteria can cause bacterial meningitis, but N. meningitidis is among the most common and serious.
This bacteria has twelve serogroups, but six are known to cause most epidemics worldwide. These six subtypes (A, B, C, W, X, and Y) differ in their distribution globally. The bacteria are transmitted through respiratory droplets or throat secretion.
According to a study in the Lancet, there were 2.51 million cases of meningitis globally in 2019, more than half of which occurred in children under age 5.
In general, the mortality rate of bacterial meningitis is around 10%, but it may be higher in specific populations such as infants, teens, immunocompromised individuals, and travelers.
Of the people who survive, as many as 33-50% will end up with long-term health problems as a result. Some of these complications include:
- Hearing loss
- Seizures
- Memory or concentration problems
- Problems with movement and balance
- Learning or behavioral problems
- Vision loss
- Loss of limbs
- Arthritis or other joint problems
- Kidney disease
After exposure to N. meningitidis, it can take two to ten days for someone to develop symptoms of the disease. Symptoms of meningococcal disease include:
- Fever
- Headache
- Neck stiffness
- Confusion or altered mental status
- Sensitivity to light
- Nausea or vomiting
- Diarrhea
- Fatigue
- Rapid breathing
- A dark purple rash
In infants, symptoms include:
- Poor feeding
- Decreased activity
- Bulging soft spot
- Vomiting
- Irritability
- Abnormal reflexes
Meningococcal disease symptoms are usually flu-like initially and then rapidly worsen. If you suspect that you or someone you love has meningitis, it's imperative to seek immediate emergency medical evaluation.
Now that you know more about meningococcal disease, let's discuss how to protect yourself best and prevent it.
The Meningococcal Vaccine Explained
Several serotypes of N. meningitidis are responsible for the majority of invasive disease. Because of this, the vaccines available for meningitis target these subgroups.
There are three groups of meningitis vaccines used in the United States.
- Men ACWY vaccines (Menomune®, MenQuadfi®)
- Men B vaccines (Bexsero®, Trumenba®)
- MenABCWY (Penbraya™)
Meningitis vaccines work by introducing small proteins that mimic the proteins of the meningococcal bacteria. This causes the immune system to produce antibodies that will attack the bacteria if you are exposed to it in the future.
The vaccine is administered through an intramuscular injection. It is recommended for children and adults at increased risk for contracting the disease and all adolescents.
We've discussed the importance of the vaccine, but is it safe and effective?
Safety and Efficacy of Meningococcal Vaccines
The meningitis vaccine is highly regarded as both safe and effective.
One study on the MenB vaccine demonstrated 76% efficacy against invasive meningococcal disease from any subgroup with the full series and 54% efficacy from partial vaccination.
Another review that evaluated the meningococcal C conjugate vaccine in Latin America and the Caribbean found that the efficacy ranged from 65-83.7% for polysaccharide vaccines and 66-100% for conjugate vaccines.
Reviews of safety data for the MenACWY-D vaccine showed little to no risk of Guillain-Barre.
There may be a slight increase in the risk of Bell's palsy when the quadrivalent meningococcal vaccine Menveo is administered with other vaccines, but not when administered alone.
No significant safety issues have been identified in surveillance studies of the MenB vaccine.
Common side effects associated with both MenACWY and MenB include:
- Muscle or joint aches
- Local injection site reactions (soreness, redness, or swelling)
- Fatigue
- Headache
In addition, fever is common with the MenB vaccine. It is impossible to get meningitis from the vaccine, though you may feel mildly ill for a few days after vaccination.
Additionally, multiple studies continue to show that vaccines, including the vaccines for meningococcal disease, are not associated with autism spectrum disorder.
Due to their efficacy and safety, vaccines are recommended for routine use in certain groups. So, who should get vaccinated, and when?
Who Should Get the Meningococcal Vaccine
All adolescents in the 11-12 age group should get the MenACWY vaccine and a booster at age 16.
The MenB vaccine is recommended for people between the ages of 16 and 18 and is given in two doses six months apart.
If administered at age 16, the MenABCWY vaccine may be given in place of the 2nd MenACWY and first MenB vaccine.
Children at increased risk due to a medical condition may receive vaccination starting at age 10 or older and should be given as a three-dose series followed by boosters 1 year after the 3rd dose and every 2-3 years after that.
Many things put you at increased risk for meningococcal disease. These include:
- Age < 1 year old, 16-23 years old, and > 65 years old
- Complement component deficiencies (C3, C5-9, properdin, factor H, factor D)
- Functional lack of a spleen (like in sickle cell anemia)
- Anatomic lack of a spleen (after surgery)
- HIV infection (specifically with a low CD4 count or a high viral load)
- Being on medications that reduce complement levels
- Being in close or prolonged contact with someone with meningococcal disease (roommates, household members, intimate partners)
- Working, living, or traveling in certain conditions (microbiologists, college students, military recruits, travels to sub-Saharan Africa)
Travelers from the US who will be living or working in areas at high risk for exposure to meningitis should receive the MenACWY vaccine at least 2-3 weeks before leaving for their destination.
For people who have already received the primary series, a booster dose is recommended after 3 years and then every 5 years after that.
Vaccines are safe, effective, and life-saving, but vaccine hesitancy remains a significant concern. What can we do to promote access and awareness and improve vaccination rates?
Improving Vaccine Uptake and Awareness
Vaccine hesitancy has increased among both patients and healthcare providers over the past several years. The COVID pandemic has worsened this and has raised concern among local health departments, who have increasingly focused on addressing the problem.
To improve vaccine hesitancy, it's essential to understand why people are vaccine-hesitant. These may include cultural concerns, availability and affordability, perceived risk of the disease, or perceived risk of the vaccine.
Education and access are two of the more commonly deployed interventions.
Evidence suggests that strong recommendations and vaccine discussion, as well as presenting solid data supporting vaccine use, may be beneficial for addressing vaccine hesitancy in parents. The earlier the discussion is initiated, the better, including during prenatal appointments.
The United States Department of Health and Human Services has designed an initiative to improve vaccination rates in the United States. The objectives include:
- Fostering the development of innovative, safe, effective vaccines
- Maintain high levels of vaccine safety
- Increase knowledge and confidence in routinely recommended vaccines
- Increase access and use of routinely recommended vaccines
- Support global immunization efforts
Healthcare providers are at the forefront of vaccine uptake efforts as they are the first line and the resource that patients trust.
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Key Takeaways
- Meningitis is a deadly disease that can cause long-term health effects.
- The meningitis vaccine is safe, effective, and life-saving.
- There are three groups of vaccines for meningococcal disease.
- The meningitis vaccine is recommended for routine use in children and adolescents, travelers, and adults in high-risk professions.
- Meningitis is deadly, but you can protect yourself and your loved ones by getting vaccinated. Talk with your healthcare provider about meningococcal vaccination today.
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