Meningitis or Meningococcal?
The difference between Meningitis and Meningococcal Disease. CDC explains:
- Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, vaccination, and other types of infections also can cause meningitis. It is important to know the specific cause of meningitis because the treatment differs depending on the cause.
- Meningococcal disease is any illness caused by a type of bacteria called Neisseria meningitidis. These illnesses are serious and include meningitis and bloodstream infections (septicemia).
This page is dedicated to Meningococcal Disease and corresponding vaccines.
There are several types of bacteria that can cause meningococcal disease. Most people who carry these bacteria never get sick, but if disease does develop, it is very serious. It is important to know what symptoms to watch for and to seek help immediately. CDC information HERE.
Meningococcal disease is very serious and very rare
- In the U.S. in 2015, there were around 359 reported cases of meningococcal disease and 51 associated deaths. DATA.
- In Washington State there were 10 cases of meningococcal disease and 1 associated death. DATA.
Vaccination does not guarantee immunity
- 90% of college student cases of meningococcal disease had been vaccinated with a MenACWY vaccine.
- 38% of non-college student cases of meningococcal disease had been vaccinated with a MenACWY vaccine.
- MenACWY vaccines include 4 serogroups (A, C, W, and Y), making them quadrivalent vaccines. 23/51 deaths were confirmed serogroups
- A serogroup B meningococcal vaccine was not available in 2015. 17 of the 51 deaths were confirmed serogroup B.
- 6 deaths were classified as “NG” and 5 were classifed “unknown” for serotype
Vaccination unlikely to prevent carriage
FAQs from Princeton University:
“Can someone be a “carrier” without experiencing symptoms?
Five to 25 percent of people may carry the bacteria in their nose or throat without getting sick, while still being contagious to others.. This carrier state may last for days or months before spontaneously disappearing. Most cases of meningitis are acquired through exposure to these asymptomatic carriers
Can I be a carrier if I have received one or two doses of the vaccine?
Yes. It is unlikely that the vaccine will stop carriage, but it does protect the individual who received the vaccine from developing symptoms of the disease. It is unknown whether the vaccine would prevent acquisition of carriage. If you are carrying the bacteria, you can transmit it to another person through close contact (exchange of saliva through kissing, sharing drinks, etc.).”
Vaccines currently available in the U.S.
- Meningococcal conjugate vaccines (Menactra®, Menveo®, and MenHibrix®)
- Meningococcal polysaccharide vaccine (Menomune®)
- Serogroup B meningococcal vaccines (Bexsero® and Trumenba®)
The vaccines come with high risks
From the CDC Pink Book:
Adverse Events Following Vaccination
Meningococcal Conjugate Vaccines
The most frequently reported adverse events for MenACWY-D include fever (16.8%), headache (16.0%) injection site erythema (14.6%), and dizziness (13.4%). Syncope was reported in 10.0% of reports involving MenACWY-D. Of all reported MenACWY-D events, 6.6% were coded as serious (i.e., resulted in death, life-threatening illness, hospitalization, prolongation of hopitalization, or permanent disability). Serious events included headache, fever, vomiting, and nausea. A total of 24 deaths (0.3%) were reported.
The most frequently reported adverse events for MenACWY-CRM were injection site erythema (19.7%) and injection-site swelling (13.7%). Syncope was reported in 8.8% of reports involving MenACWY-CRM. One death (0.4%) was reported.
From the NVIC:
Using the MedAlerts search engine, as of September 30, 2015, the federal Vaccine Adverse Events Reporting System (VAERS), which includes only a small fraction of the health problems that occur after vaccination in the U.S., had recorded more than 1,846 serious health problems, hospitalizations and injuries following meningococcal shots, including 99 deaths with about 34% of the deaths occurring in children under age six.
Serogroup B Meningococcal Vaccines (MenB)
“Effectiveness: The vaccine induces an immune response against most, but not all, circulating meningococcal B strains. No studies have been performed to evaluate the clinical effectiveness of the vaccine.Duration of Immunity: Duration of immunity is unknown. The vaccine provides short term protection against meningococcal B disease.”Safety: There is limited experience with meningococcal B vaccines outside of clinical trials. Current safety concerns include the possible development of an autoimmune response. Post licensure safety surveillance will be important in determining the safety profile for less frequent adverse events. Other vaccine reactions may include syncope, local inflammation at the site of injection, fatigue, headaches, and anaphylaxis.”
A recent study in the Lancet (PMID 29371070) found “The incidence of potentially vaccine-related, acute serious adverse events in individuals receiving 4CMenB was low (5·4 per 1000 individuals), but was significantly higher than routine vaccines (1·2 per 1000 individuals).”
The study authors may have found that rate low, but when considering how very rare meningococcal B infection is, that rate means vaccinating large groups of children/young adults puts more children at risk of injury from the vaccine than are at risk of poor infection outcome from infection. Since the vaccine (Bexsoro) was licensed in the U.S. in 2015, there have been 774 serious adverse events reported to VAERS, including 22 deaths (as of available data February 2018).
How to reduce risk of meningococcal disease
Conditions that increase risk of the bacteria causing illness include a compromised immune system. Poor diet, smoking or second-hand smoke exposure, some pharmaceuticals, some OTCs such as acetaminophen, are examples of common exposures that impair the immune system.