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MenC vaccine

MenB vaccine

Quadrivalent (ACWY)
meningococcal vaccines

Description

The MenC vaccine was listed on the National Immunisation Program Schedule in 2003. In 2013, the original MenC vaccine formulation was replaced by a combination of Haemophilus influenza type b (Hib) and MenC vaccine (Menitorix; GlaxoSmithKline).

The MenB vaccine (Bexsero; Novartis Vaccines and Diagnostics Pty. Ltd.) is recommended for babies and young children less than 2 years of age, and for adolescents and young adults. Although MenB vaccine is safe and protective against MenB type disease, it is not provided for free. The Pharmaceutical Benefits Advisory Committee (PBAC) determined that the large cost of routine MenB vaccination was not justified due to the rarity of MenB disease.

The ACWY vaccine provides protection against four meningococcal serotypes - MenA, MenC, MenW and MenY. The ACWY vaccine has been shown to be safe, and is able to stimulate the production of antibodies against MenA, MenC, MenW and MenY in babies, children and adults at levels high enough to provide protection. A single dose of ACWY vaccine, which has been in use in the US for several years, is estimated to reduce the risk of infection with these types by 80-85%.

An older vaccine targeting these serotypes is also available, produced using a different method. The 4vMenPV polysaccharide vaccine stimulates the immune system in a different way to the other vaccines but is not as effective as ACWY, especially in children less than 2 years old.

Effectiveness

The estimated effectiveness against MenC disease is 83-99%. There is evidence that immunity of vaccinated infants prevents the bacteria being transmitted to older age groups who are not eligible to receive the vaccine. This indirect immunity has contributed to the decline in the proportion of MenC serotypes circulating in Australia.

Because meningococcal disease is now rare, it has not been possible to conclusively prove the effectiveness of MenB vaccine in clinical trials – such a trial would require millions of participants over many years. However, when this vaccine is given as part of a recommended dose schedule it has been shown to stimulate protective antibodies against MenB at levels high enough to prevent disease.

 

Dose schedule

A single dose at 12 months of age. Children who missed vaccination at 12 months, or received the vaccine younger than 12 months are recommended to have a single catch-up MenC dose at 12 months of age, or 8 weeks after their last dose. Otherwise, booster doses of the MenC vaccine are not recommended.

The dose schedule depends on the age of the child when the first dose is given: if the vaccine is given to babies less than 3 months of age, 3 doses are required; for babies and children older than 6 months, only 2 doses are required. For more information on dose schedules, check with your GP or see the Immunise Australia Program website.

For babies less than 6 months of age, 3 doses are required, followed by a booster dose at 12-18 months and then again 3 years later.

For babies and children older than 6 months, 2 doses are required, with a booster dose 3 years after the first dose.

Additional booster doses are needed every 5 years after the 3-year booster dose.

For more information on dose schedules, check with your GP or see the Immunise Australia Program website.

Safety

Side effects from the HiB-MenC vaccine are similar to those from other childhood vaccines, with redness and irritability the most commonly reported.

The MenB vaccine often causes fever in the 24 hours after dosing, especially if given at the same time as other routine vaccines. While this fever is not dangerous, paracetamol (at an appropriate dose for age) is recommended with each vaccine dose. This is an exception to the recommendation that paracetamol should not be given routinely at the time of infant vaccinations.

Other common side effects include tenderness, swelling and redness at the injection site, as well as irritability, sleepiness, unusual crying and change in appetite. The frequency of fever is two times higher if the MenB vaccine is given with other childhood vaccines.

Common side effects are similar to those experienced with other vaccinations, such as pain, redness and swelling at the injection site, fever, irritability, drowsiness, decreased appetite and headaches. Rash and nausea are also sometimes reported after ACWY.

Cost

The vaccine is provided for free to babies at 12 months of age, but you may need to pay for the GP consultation.

Approximately AU$125 to AU$135 per dose, not including the cost of the GP consultation.

The cost per dose of ACWY varies depending on the vaccine, but approximately AU$80 to AU$100 per dose. The cost does not include the GP consultation.

A free vaccination program is being provided by the WA government for children aged 0-4 and teenagers aged 15-19. Speak to your GP for more information.