What is the efficacy of vaccination against meningococcal meningitis?

Updated: Jul 16, 2018
  • Author: Francisco de Assis Aquino Gondim, MD, PhD, MSc, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Vaccination is used for close contacts of patients with meningococcal disease due to A, C, Y, or W135 serogroups, to prevent secondary cases. [17] Current meningococcal vaccines are indicated for active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis. MenHibrix, a combination vaccine, is a 4-dose sequence approved for use in children as young as 6 weeks old and is indicated for active immunity against invasive disease caused by Neisseria meningitides serogroups C and Y, and Haemophilus influenzae type b.

In October 2014, the FDA approved the first meningococcal vaccine for serogroup B (Trumenba) under the breakthrough therapy designation and accelerated approval regulatory pathways. Recent outbreaks of serogroup B meningococcal disease on a few college campuses have heightened concerns for this potentially deadly disease.

Approval was based on 3 randomized trials conducted in the United States and Europe in about 2800 adolescents. Among participants who were given 3 doses of the vaccine, 82% developed antibodies against 4 different N meningitidis serogroup B strains representative of those that cause serogroup B meningococcal disease in the United States compared with less than 1% before vaccination. [18]

In January 2015, a second meningococcal serogroup B vaccine was approved (Bexsero). [26]

According to the Centers for Disease Control and Prevention, in 2012, approximately 500 cases of meningococcal disease were reported; of those, 160 resulted from serogroup B.

Epidemics usually spread rapidly to a peak within weeks but may last for several months in the absence of vaccination.

Mass immunization of selected communities, using polyvalent A and C polysaccharide vaccine, is a useful control measure.

Vaccines against meningococcus A, C, W, and Y are available. ACIP guidelines include a recommendation for primary immunization for children aged 11-12 years, with a booster dose at age 16 years. [19] The vaccine is also recommended for adults and children at high risk (aged 2 months or older). [20, 21] High-risk persons include military recruits, contacts to index cases, individuals travelling to areas of high incidence or areas affected by outbreaks, patients with asplenia, adolescents with HIV infection, and persons with terminal complement disorders. Serogroup B vaccine is indicated as a 3-dose series in adolescents and young adults aged 10 through 25 years. College students also benefit from vaccination.


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