Meningococcal polysaccharide Vaccine
It is used for active immunisation against Neisseria meningitidis infection which includes meningitis and septicaemia. It is a bivalent vaccine containing antigens of sero types group A & C of N. meningitidis. Each 0.5ml dose contains purified polysaccharide of N.
meningitidis group A 50mcg and group C 50mcg. Minimum recommended age of administration is usually 2 years because of possible poor
immune response in younger infants.
Adverse Effects: Low grade fever. Pain at injection site.
Contraindications: Acute infectious diseases. Evolving diseases.
Special Precautions: Meningitis caused by other meningococcal
groups. Children below two years.
Indications: Prophylaxis against cerebrospinal meningitis due to meningococcal A & C
groups in persons at risk in epidemic and endemic areas. It is given as an adjunct to chemoprophylaxis in close contacts of persons with the disease.
It should also be considered for people travelling to countries where the disease is endemic.
Dosage: Single 0.5ml S.C. or 1. M. injection.
Meningococcal group C conjugate vaccine in patients with asplenia or splenic dysfunction
Meningococcal group C conjugate vaccine is recommended for patients with asplenia or splenic dysfunction. Children under 1 year should be vaccinated according to the Immunisation Schedule (section 14.1 <38311.htm>). Unimmunised adults and children over 1 year should be given 2 doses of meningococcal group C conjugate vaccine (usually combined with haemophilus influenzae type b vaccine) with an interval of 2 months between doses. Immunised adults and children who develop splenic dysfunction should be given 1 additional dose of meningococcal group C conjugate vaccine (usually combined with haemophilus influenzae type b vaccine).
Immunisation for travellers
Individuals travelling to countries of risk (see below) should be immunised with a meningococcal polysaccharide vaccine that covers serotypes A, C, W135 and Y. Vaccination is particularly important for those living or working with local people or visiting an area of risk during outbreaks.
Countries with risk in Africa are listed below but outbreaks may also occur in countries not listed:
Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, CΓ΄te d'Ivoire, Democratic Republic of Congo, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Kenya, Mali, Niger, Nigeria, Rwanda, Senegal, Somalia, Sudan, Tanzania, Togo, Uganda, and Zambia
Proof of vaccination with the tetravalent (A, C, W135 and Y) meningococcal vaccine is required for those travelling to Saudi Arabia during the Hajj and Umrah pilgrimages (where outbreaks of the W135 strain have occurred).
Travellers should be immunised with the meningococcal polysaccharide vaccine that covers serogroups A, C, W135 and Y, even if they have already received meningococcal group C conjugate vaccine. The response to serotype C in unconjugated meningococcal polysaccharide vaccines given to children aged under 18 months is not as good as in adults.
Contacts of infected individuals and laboratory workers
For advice on the immunisation of close contacts of cases of meningococcal disease in the UK and on the role of the vaccine in the control of local outbreaks, consult Guidance for Public Health Management of Meningococcal Disease in the UK at www.hpa.org.uk <../../../../www.hpa.org.uk/default.htm>. See section 5.1 <3705.htm> Table 2 for antibacterial prophylaxis to prevent a secondary case of meningococcal meningitis
The need for immunisation of laboratory staff who work directly with Neisseria meningitidis should be considered.
Side-effects
Side-effects of meningococcal group C conjugate vaccine include redness, swelling, and pain at the site of the injection, mild fever, irritability, drowsiness, dizziness, nausea, vomiting, diarrhoea, anorexia in children, headache, myalgia, rash, urticaria, pruritus, malaise, lymphadenopathy, hypotonia, paraesthesia, hypoaesthesia, and syncope. Hypersensitivity reactions (including anaphylaxis, bronchospasm, and angioedema) and seizures have been reported rarely. Symptoms of meningism have also been reported rarely, but there is no evidence that the vaccine causes meningococcal C meningitis. There have been very rare reports of Stevens-Johnson syndrome.
Meningococcal polysaccharide A, C, W135 and Y vaccine is associated with injection-site reactions and very rarely headache, fatigue, fever, and drowsiness. Hypersensitivity reactions including anaphylaxis have been reported.