Meningococcal disease is any infection caused by bacteria called Neisseria meningitidis (also known as meningococcal bacteria). Although meningococcal disease is uncommon, it is very serious. About 10 per cent of the population carry meningococcal bacteria in their throat without becoming unwell. These people are known as ‘carriers’.
Invasive meningococcal disease occurs when these bacteria, which usually live in the throat, enter the blood stream to cause septicaemia (infection in the blood, also known as ‘bacteremia’) or meningitis, (inflammation of the membrane covering of the brain). Occasionally, severe infection can also occur in the joints, throat, lungs or intestines.
There are different strains (serogroups) of meningococcal bacteria designated by letters of the alphabet, including meningococcal serogroups A, B, C, W and Y. The strains that are most common in the population fluctuate over time, but in 2016, serogroups B and W cause most cases of invasive meningococcal disease in Victoria.
The meningococcal C vaccine provides good protection against serogroup C strains. The number of cases caused by the C serogroup bacteria has decreased following the introduction of the serogroup C meningococcal immunisation program in Australia in 2003.
A meningococcal serogroup B vaccine that protects against about 76 per cent of serogroup B meningococcal strains is available to purchase on prescription. Children aged less than five years, particularly infants aged less than two years, have the highest numbers of meningococcal disease caused by meningococcal B strains. Another smaller peak in numbers occurs in late adolescence and early adulthood.
A four-in-one combined vaccine against meningococcal serogroups A, C, W, and Y is also available for people to purchase on private prescription who wish to protect themselves and their family from disease. People at high risk include travellers to countries where epidemics of meningococcal disease occur, and for people with poor functioning or no spleen, or who have a complement component disorder (a rare immune deficiency disorder).
Immunisation against meningococcal disease
Immunisation against meningococcal bacteria is the best protection against meningococcal disease. It is important to know that even if you have had meningococcal disease, you do not have immunity and should still be immunised.
Immunisation against meningococcal serogroup C disease is available for free in Victoria as part of the National Immunisation Program schedule for:
- children at 12 months – immunisation against meningococcal serogroup C is given in combination with the booster dose of vaccine against Haemophilus influenza type b (Hib)
- children from 13 months up to and including nine years to catch-up (ongoing program)
- children from 10 years up to and including 19 years to catch-up (until the end of 2017).
Immunisation against meningococcal serogroup B disease is available on private prescription, but is not available free under the National Immunisation Program schedule. This vaccine is recommended for high risk groups, including:
- infants and young children, particularly those aged less than two years
- adolescents aged 15 to 19 years
- children and adults with medical conditions that place them at a high risk of meningococcal disease, such as a poor functioning or no spleen, a complement component disorder or a haematopoietic stem cell transplant
- laboratory personnel who frequently handle meningococcal bacteria.
Meningococcal serogroup B vaccine commonly causes fever in children younger than two years of age and skin reactions at the injection site. Paracetamol is recommended 30 minutes before or as soon as practicable after meningococcal B vaccine for children younger than two years of age. Two further doses of paracetamol are recommended six hours apart, regardless of whether fever is present.
Immunisation against meningococcal serogroups A, C, W and Y is available in a four-in one combined vaccine for purchase by anyone wishing to protect themselves or their family. It is recommended for high risk groups including:
- travellers to countries where epidemics of meningococcal disease occur
- people with poor functioning or no spleen, a complement component disorder or a haematopoietic stem cell transplant
- laboratory personnel who frequently handle meningococcal bacteria.
Speak to your doctor about which vaccine you should have (and how long protection will last) if you are in one of these high-risk groups, including:
- people who have close household contact with those who have meningococcal disease and who have not been immunised
- people who are travelling to places, such as Africa, that have epidemics caused by serogroups A, C, W and Y
- pilgrims to the annual Hajj in Saudi Arabia – Saudi Arabian authorities require a valid certificate of vaccination to enter the country
- people who work in a laboratory and who handle the meningococcal bacteria
- children aged from six weeks and over, and adults who have high-risk conditions, such as a poor functioning or no spleen, a complement component disorder or a haematopoietic stem cell transplant.
Pregnancy and meningococcal disease immunisation
Meningococcal vaccines are not usually recommended for women who are pregnant or breastfeeding, but they might be given if your doctor thinks your situation puts you at risk of the disease.
Before immunisation, tell your doctor or nurse if you (or your child):
- are unwell on the day of immunisation (have temperature over 38.5 °C)
- have ever had a serious reaction to any vaccine
- have had a serious reaction to any component of the vaccine
- have had a severe allergy to anything
- are pregnant or breastfeeding.
Side effects of the meningococcal vaccines
Vaccines against meningococcal bacteria are effective and safe, although all medications can have unwanted side effects.
Side effects from these vaccines are uncommon and are usually mild, but may include:
- localised pain, redness and swelling at the injection site
- occasionally, an injection-site lump that may last many weeks, but treatment is not needed
- low-grade temperature (fever)
- children can be unsettled, irritable, may cry, or be generally unhappy, drowsy and tired
- meningococcal B vaccine commonly causes fever, localised pain, redness and swelling at the injection site
- Fever and high fever is common in children aged two to 12 months when meningococcal B vaccine is given (see below).
Managing fever after immunisation
Common side effects following immunisation are usually mild and temporary (occurring in the first few days after immunisation). Specific treatment is not usually required.
There are a number of treatment options that can reduce the side effects of the vaccine, including:
- drinking extra fluids and not overdressing if there is a fever
- although routine use of paracetamol after vaccination is not recommended (meningococcal B vaccine is the exception), if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).
Fever is common in children aged two to 12 months when meningococcal B vaccine is given on the same day with other vaccines commonly given to infants, compared to when meningococcal B and other routine vaccines are given on separate days.
It is recommended to use paracetamol with every dose of meningococcal B vaccine administered to children less than two years of age, to reduce the chance and severity of fever that may develop following immunisation with meningococcal B vaccine.The first dose of paracetamol (15 mg/kg per dose) is recommended 30 minutes before immunisation. This should be followed by two more doses of paracetamol given six hours apart, regardless of whether fever is present.
Managing injection site discomfort
Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to two days. Paracetamol might be required to ease the discomfort.
Concerns about side effects
If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after an immunisation, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and central reporting service on Tel. 1300 882 924 #1.
You can discuss with your immunisation provider how to report adverse events in other states or territories. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.
Rare side effects
There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation in case further treatment is required. If any other reactions are severe and persistent, or if you are worried, contact your doctor for further information.
Immunisation and HALO
The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic (pdf)
Where to get help
- Your GP
- In an emergency, always call triple zero (000)
- Emergency department of your nearest hospital
- Your local government immunisation service
- Maternal and Child Health Line (24 hours) Tel. 132 229
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- Immunisation Program, Department of Health & Human Services, Victorian Government Tel. 1300 882 008
- National Immunisation Information Line Tel. 1800 671 811
- SAEFVIC, the Victorian vaccine safety service Tel. 1300 882 924 #1
Things to remember
- Meningococcal vaccines are available and provide good protection against serogroups A, B, C, W and Y strains of meningococcal bacteria.
- The National Immunisation Program provides free immunisations for children at 12 months of age against meningococcal disease caused by the C serogroup.
- Vaccines against menignococcal serogroup B, and a four-in-one combined vaccine against meningococcal serogroups A, C, W and Y are available on private prescription and are recommended for certain groups. Speak with your doctor if you want these vaccines for yourself or a family member.
- Common immunisation side effects are usually mild and temporary (occurring in the first few days after immunisation).
- Meningococcal serogroup B vaccine commonly causes fever in children less than two years of age and injection site reactions. Paracetamol is recommended 30 minutes before meningococcal B vaccine for children less than four years of age followed by two further doses six hours apart, regardless of the presence of fever.