What are Meningococcal Vaccines?
Meningococcal vaccines help protect against infection caused by Neisseria meningitidis bacteria, more commonly known as meningococcus. There are 13 different serogroups (or strains) that can cause invasive meningococcal disease which includes meningitis (infection of the lining of the brain and spinal cord) and sepsis (infection of the bloodstream). The most common serogroups that cause disease worldwide are A, B, C, W and Y. Vaccines are available to help prevent infection from some of these serogroups.
Meningococcal Vaccines in the United States
In the United States, there are currently three main types of Meningococcal Vaccines recommended routinely for certain age groups:
- Meningococcal conjugate vaccine (MenACWY) helps protect against serogroups A, C, W, and Y. It is routinely recommended at age 11-12 years with a booster at 16 years old. Students entering college for the first time are also required to have received this vaccine or have a booster within the previous 5 years.
- Meningococcal serogroup B vaccine (MenB) helps protect against serogroup B which causes the majority of cases in the U.S. The two MenB vaccines approved for use in the U.S. are Bexsero and Trumenba. They are recommended for those at increased risk aged 10 or older.
- Meningococcal polysaccharide vaccine (MPSV4) also helps protect against serogroups A, C, W, and Y but is only recommended in certain circumstances like for previously unvaccinated adults at high risk.
Meningococcal Vaccines in Other Countries
Vaccination recommendations differ around the world depending on the predominant disease-causing serogroups seen in each country or region. Some examples include:
- Countries in South America’s “Meningitis Belt” of sub-Saharan Africa routinely recommend an meningococcal serogroup A conjugate vaccine (MenAfriVac) for children as young as 9 months old due to recurrent large epidemics caused by this serogroup.
- Many European countries recommend routine meningococcal conjugate vaccination against serogroups A, C, W and Y similarly to the U.S. but some may include serogroup B or C vaccination as well depending on local epidemiology.
- Countries like Australia, New Zealand and Canada have also moved towards routine meningococcal B vaccination programs for infants and children in response to increasing B serogroup cases.
- Some Asian and Middle Eastern countries may focus vaccination efforts on polysaccharide vaccines against the dominant local serogroup such as serogroup C in China or serogroup W in Saudi Arabia.
Vaccine Effectiveness and Level of Protection Provided
Clinical trial data and real-world effectiveness studies have shown that meningococcal vaccines can provide good to excellent levels of direct protection against the vaccine serogroups:
- Conjugate vaccines against serogroups A, C, W, and Y have been shown to be 85-100% effective at preventing invasive meningococcal disease from these serogroups. Protection lasts for 3-5 years on average requiring a booster.
- The two approved MenB vaccines Trumenba and Bexsero have efficacy ranging from 50-84% depending on age and vaccine schedule used. Protection may be slightly lower than other conjugate vaccines but lasts longer, potentially up to 10 years or more for Trumenba.
- Vaccinated individuals are also less likely to carry the bacteria in their nose/throat and less able to spread it to other close contacts providing some "herd immunity" even for non-vaccinated individuals.
- Protection is thought to be lower for polysaccharide vaccines alone, around 70-80% effective for 3-5 years against the targeted serogroup when used alone without a booster.
Ongoing Research into New Vaccines
Research continues globally to develop improved meningococcal vaccines that can provide broader protection against multiple serogroups including new emerging strains. Some areas of ongoing study include:
- Investigating multicomponent MenA, C, W, Y vaccines that may boost immune responses and duration of protection compared to existing conjugate vaccines.
- Development of large-scale combination MenABCWY conjugate vaccines allowing broader protection with fewer doses.
- Additional clinical testing of MenB vaccines to determine long term effectiveness as more countries adopt routine use.
- Surveillance for new emerging serogroups like serogroup X and development of targeted polysaccharide or conjugate vaccines as needed.
Safe and effective vaccines exist to help protect against some of the most common disease-causing meningococcal sero- groups globally. Ongoing research aims to expand vaccine coverage further. Routine vaccination as recommended according to age and risk factors provide the best possible protection against this serious infectious disease.
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