Meningococcal Meningitis Vaccine
Meningococcal disease, or meningococcemia, isa leading cause of meningitis in children, and then disease can also lead to infections of the blood. People who acquire the disease can become very ill, especially the young children. Meningococcal disease is treated with antibiotics, and the vaccine is not routinely recommended for most people in the United States. Particularly, it is not for children under age two, except under special circumstances.
Meningococcal meningitis is different from the meningitis in infants for which vaccination is routinely given. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis. However, vaccines given to all children as part of their routine immunization have reduced the frequency of the invasive diseases caused by H. influenzae and Streptococcus pneumonia, leaving neisseria meningitis as one of the leading causes of bacterial meningitis.
The meningococcal vaccine contains inactivated bacteria and cannot cause the disease. It is effective against four of the five subtypes of meningococcal meningitis. It is a one-time injection (except for the very young), and the effects last for four to five years. Adverse reactions are uncommon with this vaccine. Localized redness at the injection site lasting one or two days may occur. Less likely is an allergic reaction to the vaccine.
Meningococcal vaccine is recommended for children and young adults as follows:
- children two years old and older in a population where an outbreak has occurred
- college students who live in close quarters (dormitories), who consume alcohol, smoke, or are regularly around smokers
- those with certain chronic conditions, including those with spleen damage or immune disease
- anyone traveling to or living in a part of the world where meningococcal disease is common, such as West Africa
- household or institutional members who have contact with anyone with meningococcal disease (The same individuals should also receive prophylaxis antibiotic therapy.)
- medical and laboratory personnel at risk of exposure to meningococcal disease
Children who are mildly ill at the time the shot is due can still get meningococcal vaccine. Children with moderately severe illnesses should wait until they recover. Children two years old and over receive one dose, while children three months to two years old need two doses, three months apart. Immunizations should be deferred during any acute illness. Pregnant women should not receive the vaccine because it may affect the fetus.
Children who get the meningitis vaccine may have mild side effects, such as tenderness, redness, or a painful lump on the skin at the injection site; symptoms usually last one to two days. A small percentage of the patients who receive the vaccine develop a slight fever. The meningitis vaccine, like any other injection, may in rare cases lead to a serious allergic reaction. Symptoms of allergic reaction include swelling in the mouth or throat, trouble breathing, weakness, hoarseness or wheezing, a fast heart beat, hives, dizziness, paleness, and a high fever. If a serious allergic reaction occurs the symptoms will start within a few minutes to a few hours after the shot. The child should be seen immediately by a doctor. The doctor will need to know the date of the vaccination and when exactly the symptoms started. A health-care provider should file a report using the vaccine adverse events reporting system (VAERS) form.
Acute—Refers to a disease or symptom that has a sudden onset and lasts a relatively short period of time.
Antibody—A special protein made by the body's immune system as a defense against foreign material (bacteria, viruses, etc.) that enters the body. It is uniquely designed to attack and neutralize the specific antigen that triggered the immune response.
Antigen—A substance (usually a protein) identified as foreign by the body's immune system, triggering the release of antibodies as part of the body's immune response.
Efficacy—The effectiveness of a drug in treating a disease or condition.
Immunity—Ability to resist the effects of agents, such as bacteria and viruses, that cause disease.
If the vaccine is given to children receiving immunosuppressive therapy, as in chemotherapy for cancer or HIV/AIDs, the immune response may not take place. Moreover, the meningitis vaccine should not be given to
Meningitis passes from person to person, mainly by coughing and sneezing. The risk of contracting the disease increases if the child spends time in close contact with the local population at schools, crowded markets, or public buildings. In addition, young adults living in close quarters on college campuses are at risk for contracting the disease. Vaccines are available at student health services on campuses.
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Meningitis Foundation of America. 6610 North Shadeland Ave., Suite 200, Indianapolis, IN 46220–4393. Web site: <www.musa.org/>.
"Meningitis." MedlinePlus, January 6, 2004. Available online at <www.nlm.nih.gov/medlineplus/ency/article/000680.htm> (accessed December 18, 2004).
Aliene Linwood, RN, DPA, FACHE