Meningitis vaccines

Are there vaccinations for meningitis and septicaemia?

Yes, there are vaccines that protect against some forms of meningitis and septicaemia, but although these vaccines provide excellent protection, they can't prevent all strains of these diseases. As yet there is no vaccine that can prevent all forms of meningitis and septicaemia.

MenB (Meningococcal B) vaccine

Most cases of meningococcal disease in the UK and Ireland are caused by group B meningococcal bacteria. A new MenB vaccine, called Bexsero®, which is licensed in Europe, has now been recommended for all babies in the UK, although the timetable for introducing it has not been set out yet. It has not yet been recommended in Ireland. Find out more.

MenC (Meningococcal C) vaccine

The MenC vaccine provides excellent protection against meningitis and septicaemia caused by group C meningococcal bacteria. The MenC vaccination campaign was introduced in the UK in 1999 and in Ireland in 2000. Before the vaccine was routinely available group C meningococcal disease killed about 150 people in the UK every year. Following vaccine introduction, cases of group C disease fell by over 90% in the age groups targeted for vaccination. Since then case numbers have continued to fall and as a result of the ongoing vaccination programme disease incidence is now at a very low level.

Who should be immunised with MenC vaccine?

Currently in the UK, children are immunised at 3 and 12-13 months of age (one dose at each visit, the second given as a combined Hib/MenC). A routine booster dose is being given at around 14 years of age (school years 9 or 10 in England and Wales, 11 in Northern Ireland and S3 in Scotland) at the same time as the current teenage Td/IPV booster.

In Ireland babies 2, 4 and 6 months of age get MenC (one dose at each visit) along with the other vaccines (DTP, Hib and polio) in the routine Childhood Immunisation Programme.

A catch up campaign to vaccinate first year university students will take place for a limited time.

Information for first year university students in the UK


First year university students staying in halls of residents and having close contact with other new students during fresher’s week are considered to be at increased risk of encountering the bacteria that cause meningococcal disease. Many new starters at university will have only received one dose of MenC vaccine at a young age and will no longer have immunity to the bacteria. Therefore it is recommended that students born after September 1995, and those of any age who have never had a MenC vaccination get immunised before they enrol on their course. There is no recommendation for students attending further education colleges to receive the vaccine because they are unlikely to be exposed to the same level of risk as those entering university for the first time. Older students (those born before September 1995) who had the vaccine at school are still protected and should not need the booster.

Prospective students will be informed of the need for a MenC vaccination through the Universities and Colleges Administration Services (UCAS). These students should arrange to get MenC from their GP at least 2 weeks before they go away to study. After term starts, first-year students who are still not immunised can get MenC by registering with their university health centre or other GP practice. In particular, undergraduate students coming to study from abroad who have not been able to obtain MenC at home should take steps to do this.

Information for under 25 year olds

Anyone in this age group who has not received any dose of the vaccine can arrange to be immunised by contacting their GP.

Information for people without a functioning spleen

People with no spleen, with a disease or condition that stops their spleen from functioning properly and those who have complement disorders are at high risk of serious bacterial infection. People with the above medical conditions, may need extra meningococcal vaccinations and should contact their GP to discuss this.

Is MenC vaccine safe?

  • Before it was introduced, the MenC vaccine was tested on over 25,000 people worldwide and shown to be safe and effective.
  • Safety testing discovered no serious side effects. Some babies and children had a temperature, an unsettled night, or redness and swelling of skin where they were injected, but the chance of having these mild reactions was no greater than with other childhood vaccines. Older children and teenagers sometimes also complained of headaches. Vomiting was reported in some babies, but this is at least as likely to be due to other vaccines given at the same time. 
  • Millions of doses of MenC vaccine have been routinely given in the UK for over a decade now. As with all licensed drugs, safety is continuously monitored. Adverse reactions are unusual, and for babies and toddlers are just the same as the mild reactions reported during the trials. For older children and teenagers, a few additional reactions were very occasionally reported including dizziness, aches and pains, swollen glands and rash. These reactions are not serious and disappear fast.
  • It is never possible to be sure that a child will not react seriously to any medicine, vaccine or even food, but parents make decisions every day about the level of risk that is acceptable to them. The risk of severe allergic reaction to MenC is tiny - for every half million doses of vaccine distributed, just one severe allergic reaction was reported, and none were fatal. Although the risk of getting Group C meningococcal disease is not high, it outweighs any small risk from the vaccine.
  • The vaccine is not 'live' and cannot cause even a mild form of meningitis or septicaemia. 
  • There are no new ingredients in the vaccine. All ingredients of the MenC vaccine have already been given to millions of children over many years as components of other vaccines, without causing any harm.

How does MenC vaccine work?

  • Conjugate vaccines are made by linking a tiny fragment from the bacteria's sugar coat (polysaccharide) to a protein. Our immune systems respond much more strongly to proteins than to sugars, so conjugate vaccines trigger a long-lasting immune response, and are effective in babies as young as two months of age. However, research has shown that conjugate vaccines provide longer lasting protection if a dose is given in the second year of life 1 . This prompted a change to the routine immunisation schedule in 2006 when a booster dose at 1 year of age was introduced. In 2013 the schedule was improved again to provide even longer lasting protection by introducing a booster vaccine for 14 year olds.

Who should not be given the MenC vaccine?

  • There are very few people who cannot receive meningococcal vaccines. People who have had a confirmed anaphylactic reaction (not just a sore arm or a mild temperature) to a previous dose of MenC vaccine or to any component of the MenC vaccine should not have it 2 .
  • Vaccination should be postponed in anyone who is ill with a high fever. 

Is there a problem with 'multiple' vaccines?

Some parents might be worried that having DTP, Hib, polio and MenC together will overload babies' immature immune systems.

  • Trials showed that all of these vaccines are safe and effective when given together.
  • Vaccines do not 'overload' the immune system 3. In order to work, vaccines must bring on a response from the immune system, but everyday mishaps like scraped knees and sore throats place more of a demand on the immune system than the combination of MenC and all of the routine vaccinations for babies.
  • Routine vaccinations are timed to protect babies when they need it most.

Although the MenC vaccine has been tremendously successful, it is important to remember that not all forms of meningitis and septicaemia are vaccine preventable and it is still important to be aware of the symptoms of meningitis and septicaemia.

Group B meningococcal bacteria currently cause around 50% of all meningitis and septicaemia in the UK. A new MenB vaccine, called Bexsero®, which is licensed in Europe, has recently been recommended for all babies in the UK, however, the timetable for introducing it has not been set out yet and it has not yet been recommended in Ireland.

References

  1. Trotter CL, Andrews NJ, Kaczmarski EB, Miller E, Ramsay ME. Effectiveness of meningococcal serogroup C conjugate vaccine 4 years after introduction. The Lancet 2004;364:365-367
  2. Department of Health. Immunisation against infectious disease. Chapter 22 Meningococcal. https://www.gov.uk/government/publications/meningococcal-the-green-book-chapter-22 (accessed April 2014).
  3. Offit PA, Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, Gellin BG, Landry S. Addressing parents' concerns: Do multiple vaccines overwhelm or weaken the infant's immune system? Pediatrics Jan 2002;109(1):124-9. http://pediatrics.aappublications.org/cgi/content/full/109/1/124 (accessed 17 May 2007)

Hib (Haemophilus Influenzae Type B) vaccine

A conjugate vaccine (made from a tiny fragment of the bacteria's sugar-coat attached to a protein) against Hib was introduced in the UK and Ireland in 1992, and provides long-lasting immunity. Since the introduction of the Hib vaccine, the incidence of meningitis cause by Haemophilus influenzae has been reduced by over 90%, across the UK and Ireland 1,2 .

Introduction of the conjugate Hib vaccine has also reduced carriage rates of the bacteria 3 . Before the vaccine was introduced, a large proportion of children under age 5 carried the bacteria. Now that vaccination is routine, carriage of the bacteria is much less common, and as a result protection is extended to the rest of the population, even those not immunised. This is called 'herd immunity'.

Is Hib vaccine safe?

Millions of doses given to children worldwide over more than a decade have established an excellent safety record. Adverse reactions are no more common than for other vaccines routinely given to babies and children. The Hib vaccine is not a live vaccine and cannot cause even a very mild form of the disease.

Who gets Hib vaccine?

Currently in the UK, the vaccine is offered to babies at 2, 3, and 4 months of age in the routine immunisation programme, with a Hib booster (given as combined Hib/MenC) offered at 12-13  months of age. 

In addition, in the UK, Hib vaccine is recommended for older children and adults with certain immune deficiencies such as people with HIV or those without a functioning spleen (asplenics and hyposplenics), including people who have sickle cell disorder 4 .

Currently in Ireland, the vaccine is offered to babies at 2, 4 and 6 months of age in the routine immunisation programme, with a Hib booster dose offered at 12 months of age.

In addition to babies, in Ireland, Hib vaccine is recommended for all children under four years of age who have not previously had the vaccine and for anyone with malfunctioning or lack of spleen, sickle cell disease, HIV or other immunodeficiency, irrespective of how old they are 5 .

Is Hib still an important cause of meningitis?

The Hib vaccine is very effective, but no vaccine is 100% effective. It does not work as well in children with certain immune problems. In addition, a very small proportion of perfectly healthy children do not respond to the vaccine well enough to be protected against Hib meningitis. It is unusual for adults and older children to be susceptible to Hib infection, but cases are known to occur, particularly in hospitalised, sick and elderly patients. Illness caused by non-b types of Haemophilus influenzae is also being monitored.

Immunisation has dramatically reduced cases of Hib meningitis, but in countries which have not introduced the vaccine, Hib is still a major cause of serious disease in children.


References

  1. JCVI Statement: Haemophilus influenzae type b (Hib) Disease and Hib Vaccine. Executive Summary. http://www.advisorybodies.doh.gov.uk/jcvi/hib.pdf (accessed 17 May 2007).
  2. Health Protection Surveillance Centre. Hib FAQs, How safe and effective is the Hib vaccine? http://www.immunisation.ie/en/HealthcareProfessionals/Hib/#howsafe (accessed May 2007).
  3. Frasch CE, Haemophilus influenzae Type b Conjugate and Combination Vaccines. 1995. Clin.Immunother. 4 (5):376-386
  4. Department of Health. Immunisation against infectious diseases. Chapter 16: Haemophilus influenzae type B (Hib) pages 127-135. Ed Salisbury D, Ramsay M and Noakes K. 2006. Third edition. TSO. http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Greenbook/DH_4097254 (accessed 17 May 2007).
  5. Immunisation Guidelines 2002.
    http://www.ndsc.ie/hpsc/A-Z/VaccinePreventable/Vaccination/Guidance/ (accessed May 2007)
  6. Professional Letter-  Chief Medical Officer (2003)2: Planned HIB vaccination catch-up campaign: further information Department of Health. http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_4004833 (accessed 17 May 2007)

Pneumococcal vaccine in the UK

Currently two different vaccines are used in the UK, one in theroutine childhood immunisation schedule for all babies and the otherfor everyone over 65. These vaccines are also available to people withparticular health conditions that increase their risk from pneumococcalinfection. The single most important thing you can do to preventpneumococcal meningitis is to make sure your children are up to datewith their routine immunisations, and to have the immunisations you areeligible for.

Pneumococcal ‘conjugate’ vaccine (PCV)


The current vaccine in the childhood immunisation schedule, Prevenar13®(PCV13) can protect against severe infection caused by thirteen of themost common strains of pneumococcal bacteria. Conjugate vaccines areexplained in more detail in the box opposite.

This vaccine:

  • is routinely offered to all babies at 2, 4 and 12-13 months of age, within the routine childhood immunisation programme,
  • is similar to the successful Hib and MenC vaccines, which are also conjugate vaccines,
  • provides direct protection to those who are vaccinated. However, because the vaccine also reduces the number of people who are carrying and potentially transmitting the bacteria, people who are not vaccinated also benefit from indirect protection. This is called ‘herd’ immunity. 

PCV13 was introduced in spring 2010 and directly replaced PCV7,which only provided protection against seven strains of pneumococcalbacteria. The change was made to provide broader coverage for childrenby protecting against six additional strains of bacteria.

Is this vaccine safe for my child?

Yes. The widespread use of PCV7 in over 100 countries, with over 300million doses distributed worldwide, established a solid safety record.Clinical trial data from studies involving more than 7000 children showthat PCV13 has a similar safety profile to PCV7.

What if my child has already received one or two doses of PCV7?

Children who have already received one or two doses of PCV7 cancomplete their vaccination course with PCV13 with no change to theroutine vaccination schedule.

Did PCV7 vaccine reduce cases of pneumococcal meningitis after it was introduced in 2006?

PCV7 was very successful at preventing the seven strains ofpneumococcal infection it covers. In the first two and a half yearsafter the introduction of PCV7, it is been estimated that 959 cases ofserious illness and 53 deaths due to invasive pneumococcal disease wereprevented2.

Meanwhile, as disease caused by the seven most common strainsdecreased, cases caused by other strains of pneumococcal bacteria hadbeen increasing3. Therefore, the vaccine was upgraded to provide broader protection.

There are over 90 strains of pneumococcal bacteria, but most strainsrarely cause disease. PCV13 covers the strains that account forapproximately 74% of all severe pneumococcal disease in young childrenin England and Wales1.

Severe pneumococcal disease in children aged under 5 caused by strains in Prevenar and Prevenar13

 

Pneumococcal ‘polysaccharide’ vaccine (PPV)4

Thisvaccine provides a level of short-term protection against seriouspneumococcal disease caused by the top 23 disease-causing types ofpneumococcal bacteria (see box opposite). This vaccine is offered toadults over the age of 65 and children over the age of 2 who havehealth conditions which put them at increased risk from pneumococcalinfection.

What health conditions increase the risk from pneumococcal infection?

Health conditions which increase the risk of infection include4:

  • having no spleen, due to injury or disease, or a spleen that does not work properly as in sickle cell disorder, and coeliac disease;
  • other immunodeficiency, whether inherited or acquired (e.g. HIV);
  • immunosuppression as with cancer therapy or organ transplant;
  • chronic disease of the heart, kidney or liver;
  • chronic respiratory diseases, including, for example, asthma requiring repeated use of systemic steroids, chronic obstructive pulmonary disease;
  • diabetes requiring insulin;
  • people with or about to have cochlear implantation or other conditions where leakage of cerebrospinal fluid can occur (but vaccination must not delay cochlear implantation).

What protection is offered to people with 'at risk' health conditions?

People with at risk health conditions should be offered vaccinationwith PCV, PPV or both depending on their age and the condition theyhave.

In general the following applies to people with “at risk” health conditions*:

  • Babies should be immunised according to the routine schedule followed by one dose of PPV after their second birthday,
  • Children under 5 years of age, who haven’t previously been vaccinated should be offered PCV and then PPV after their second birthday,
  • Children over 5 years of age and adults should be offered PPV if they haven’t already received this.
*People with an absent or damaged spleen, who are HIVpositive, receive bone marrow transplants or have chronic renal diseaseshould seek specialist advice as recommendations in these cases candiffer.

Children under 2 years of age with at risk conditions and who havealready had the full course of PCV7 are eligible for a PCV13vaccination.

Children who get severe pneumococcal disease

Any child under age 5 years who gets pneumococcal meningitis or othersevere pneumococcal disease will be followed up by their GP orpaediatrician, to check whether they have an ‘at-risk’ health condition5. These children should be offered PCV even if they have already had it. They may also be offered PPV.

ALL children who are under the age of 2 and have missedimmunisations are entitled to receive PCV and are entitled to receiveother routine immunisations up to age 10.

IMPORTANT: Vaccines cannot protect against all forms of meningitis

It is important to remember that although vaccinescan provide excellent protection, there are still some types ofmeningitis and septicaemia for which there are no vaccines. It isimportant to be aware of the symptoms of these diseases and to seekmedical help immediately if you suspect that someone has meningitis orsepticaemia.

References


  1. Kaye P, Malkani E, Martin S, Slack M, Trotter C, Jit M, George R & Miller E. Invasive pneumococcal disease (IPD) in England & Wales after 7-valent conjugate vaccine (PCV7); potential impact of 10 and 13-valent vaccines.
  2. Report of the Director of Immunisation: April 2009.(Accessed 17 Feb 2010).
  3. Pichon B, Beasley L, Slack M, Efstratiou A, Miller E. and George R. Effect of the introduction of the pneumococcal conjugate vaccine in the UK childhood immunisation scheme on the genetic structure of paediatric invasive pneumococci.  (Accessed 17 Feb 2010)
  4. Department of Health. Immunisation against infectious diseases. Chapter 25: Pneumococcal. August 2006. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4137924.pdf (accessed 25 Feb 2010).
  5. Health Protection Agency. Clinical Management Protocol version 3: January 2007 (accessed 17 March 2008).

Pneumococcal vaccine in Ireland

There are currently two vaccines that protect against pneumococcal disease; a 23-type 'polysaccharide' vaccine for and a newer 7-type 'conjugate' vaccine.

23-type polysaccharide vaccine

This vaccine can protect most adults for five years or more against the top 23 disease causing types of pneumococcal infection. However, it does not work in children under two years old and is less effective in people with immune deficiencies and the under-fives.

7-type conjugate vaccine

The newer 7-type 'conjugate' vaccine is similar to the successful Hib and Men C vaccines, which provide stronger, more long-term protection than the plain polysaccharide vaccines, even in babies. This vaccine covers the seven types that cause over 80% of serious pneumococcal disease in Irish and UK children aged 6 months to 2 years and about 75% in the under fives in Europe generally. The routine use of this vaccine in America since June 2000 has established a good safety record and shown that it is effective.  It is now also offered routinely in the UK, Australia, Canada, Austria, Italy, Spain and Norway.

This vaccine was introduced into the Irish childhood vaccination programme on 1 September 2008.

A newer 13-type vaccine will replace the 7-type later on this year.

Current schedule of vaccination in Ireland for children born on or after 1st July 2008

2 months 4 months 6 months 12 months 13 months 4-5 years
Diptheria/ Tetanus/ Pertussis/ Polio / Hib/ Hepatitis B
('6-in-one')
Diptheria/ Tetanus/ Pertussis/ Polio / Hib/ Hepatitis B
('6-in-one')
Diptheria/ Tetanus/ Pertussis/ Polio / Hib/ Hepatitis B
('6-in-one')




MenC MenC
MenC
Pneumococcal
Pneumococcal Pneumococcal




MMR
MMR




Hib





Diptheria/ Tetanus/ Pertussis/ Polio
('4-in-one')

There is a catch-up programme if your child was born between 02/09/06-30/06/08. You can view this immunisation schedule at http://www.immunisation.ie/en/HotTopics/Text_15413_en.html

Please remember that although meningitis vaccines that are currently available can provide excellent protection, there are several major forms of meningitis and septicaemia for which there is no vaccine.

Travel & Hajj: ACWY quadrivalent vaccine

Meningococcal infection can cause meningitis, septicaemia or both. Five strains of meningococcal bacteria (A, B, C, W135 and Y) cause most cases. Although it occurs in all countries, it is much more common in certain areas. There are epidemics in the ‘meningitis belt’ of sub-Saharan Africa, usually due to meningococcal A or W135 bacteria, and from time to time there are outbreaks in other countries.

Large epidemics of meningococcal disease have been linked to the Hajj pilgrimage, at first due to A-strain and then in 2000/2001 to W135[1]. Cases of meningococcal disease also occurred world-wide after pilgrims returned to their own countries[2].

Because of these epidemics, quadrivalent ACWY vaccination has been a compulsory entry requirement into Saudi Arabia for pilgrims on Hajj and Umrah, and for other travellers in Hajj season since 2002. It protects against meningitis and septicaemia caused by four different strains: A, C, W135 and Y. Vaccination is also recommended for travel to sub-Saharan Africa and certain other countries, especially if travellers will be living or working with local people or visiting during an outbreak. An up-to-date list of countries with potential risk can be obtained from www.nathnac.org.

Pilgrims on Hajj or Umrah are required to present a certificate of vaccination with ACWY, issued at least 10 days, but not more than 3 years before arrival. This also applies to seasonal workers in Hajj areas.

What vaccines are available?


There are three ACWY vaccines available. Menveo® and Nimenrix® are the most advanced vaccines, called ‘conjugate’ vaccines, ACWY Vax® is an older vaccine that does not work very well in young children. Although all vaccines are suitable for travel, the Department of Health recommends that children over 5 years of age and adults are vaccinated with a conjugate vaccine because they provide better and longer lasting protection. Children under 5 should always be vaccinated with conjugate vaccines. Those over 1 year of age should receive a single dose of either Nimenrix® or Menveo®. Babies under one year of age, should receive two doses of Menveo® one month apart for protection[3].

The Muslim Council of Britain (MCB) have set up a national network of vaccination clinics in England, Scotland and Wales where Menveo® is offered to pilgrims travelling on Hajj or Umrah at a reduced price of no more than £35. This cost includes the cost of the vaccine, administration and the certificate. For more information, or to find your nearest clinic visit www.mcb-vac.co.uk or call 08455 521 4160. The MCB network of vaccination clinics doesn’t cover Northern Ireland. GP practices and travel clinics can be contacted for information on vaccination.



Safety and acceptability


The ingredients of both the older polysaccharide vaccine and the newer conjugate vaccines have been in use for many years. Although mild side effects are fairly common, including pain where the vaccine was injected, and sometimes headache, or nausea, these reactions are similar to the reactions caused by routine vaccines.

Menveo® has been certified as Halal by the Indonesian Council of Ulama and the Islamic Services of America. Nimenrix® has been certified as Halal by the Halal Food Council of Europe.

References


  1. Lingappa, J.R., et al., Serogroup W-135 meningococcal disease during the Hajj, 2000. Emerg Infect Dis, 2003. 9(6): p. 665-71.
  2. Hahne, S.J., et al., W135 meningococcal disease in England and Wales associated with Hajj 2000 and 2001. Lancet, 2002. 359(9306): p. 582-3.
  3. 'Green Book'. Department of Health. Immunisation against infectious diseases. Chapter 22: Meningococcal. Updated April 2011. http://www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/Greenbook/DH_4097254.

Measles, Mumps and Rubella

Before immunisation was available, measles, mumps and rubella were fairly common diseases that could have very serious complications:

The most common complications of measles infection are otitis media, pneumonia, blindness and encephalitis (inflammation of the brain) 1 .

Mumps

Can cause complications ranging from inflammation of the pancreas and reproductive organs to deafness, meningitis (inflammation of the covering of the brain and spinal cord) and encephalitis.

Rubella

Can cause birth defects such as deafness and heart defects in babies whose mothers contract the illness while pregnant.

The role of MMR vaccine in preventing meningitis

Before MMR vaccine was introduced, mumps was the main cause of viral (or aseptic) meningitis - about 1,200 people (mainly children) in the UK were hospitalised each year with mumps 2 . Most of these cases had meningitis. Mumps was also the most frequent cause of viral encephalitis.

Measles encephalitis occurs in approximately 1 in 1000 cases of measles infection 3 and can be fatal.

Since the introduction of MMR in 1988, mumps and measles meningitis and encephalitis have virtually been eliminated.

Vaccine Uptake

Following adverse publicity about MMR in 1998, uptake of the vaccine in England fell from over 90% to around 80%, causing widespread concern among health professionals about the risk of outbreaks of these diseases. Similar patterns were seen in Scotland 4 , Wales 5 , Northern Ireland 6 and the Ireland 7 .

Cases of Measles

As a result of the decline in MMR uptake, outbreaks of measles occurred in the Ireland in 2000 leading to at least two deaths 8 In England and Wales in 2006, at least one child has died following outbreaks of measles, the majority of which have been seen in Surrey, Sussex and South Yorkshire 9. Fortunately, parents' acceptance of MMR seems to be improving again and uptake rates look to be increasing 9 .

Separate Vaccines

MMR* is given as two injections, one at 13 months (12 - 15 months in Ireland) and one between 3 - 5 years. Separate vaccines against measles, mumps and rubella would have to be given as six injections over a long period of time. Children would be left without protection in the gaps between injections and there would also be a fall in vaccine coverage as children may not complete the course of injections.

In particular, there is concern about the use of single vaccines and the impact on the occurrence of mumps and its complications. This is because, when seeking separate mumps immunisation, parents may find the vaccine they have obtained is the wrong sort. There are three strains of mumps vaccine available in Western Europe as single vaccines:

  • Urabe, which does not have a license in the UK and was withdrawn from use here in 1992 as the vaccine itself was responsible for a higher than acceptable risk of aseptic meningitis 10
  • Rubini which has been shown to be between only 1% and 22% effective 11
  • Pavivac, which is not licensed in the UK because there are questions about its safety 12 .

The mumps component of the MMR vaccine is the Jeryl Lynn strain, which is safe and effective but not often possible to obtain as a single vaccine either in the UK or mainland Europe. Children's health could be jeopardised if inappropriate vaccine is given.

Safety of MMR vaccine

Although MMR vaccination has had much adverse publicity, there is no factual basis for this.

Although no medicine is 100% safe, vaccines undergo stricter testing than other medicines. Over 30 years, more than 500 million doses of MMR have been given in over 100 countries, and it has an excellent safety record.

Articles published in medical journals and in the national press claiming that MMR vaccination causes autism and bowel disease have been thoroughly investigated and the evidence from several studies has shown no link between these conditions and MMR or measles vaccines.

There is no evidence that supports getting measles, mumps and rubella vaccinations separately-MMR vaccination is safer and more effective.

In recent years, many myths surrounding vaccination have developed and speculative media stories have understandably raised parental anxiety. Vital signs, Vital issues contains a large section which attempts to dispel these myths. This booklet can be downloaded from our website .

* The MMR vaccines used in the UK are M-M-RTMII and Priorix.

References

  1. Perry RT and Halsey NA. The clinical significance of measles: a review. Journal of Infectious Disease. May 2004; 189. (accessed 28 June 2006)
  2. Department of Health. Immunisation against infectious diseases. 1996. http://www.dh.gov.uk/assetRoot/04/07/29/84/04072984.pdf (accessed 28 June 2006)
  3. NHS Health Scotland. Ready Steady Baby http://www.hebs.scot.nhs.uk/readysteadybaby/moreinfo/hebs_pub4.cfm?TxtTCode=1172 (accessed 28 June 2006)
  4. Scottish Health Statistics. Latest Primary Immunisation uptake rates. May 2006. http://www.isdscotland.org/isd/info3.jsp?p_applic=CCC&p_service=Content.show&pContentID=1652& (accessed 28 June 2006)
  5. Local Health Board. Neath Port Talbort. Board Meeting, 6th May 2004. http://www.wales.nhs.uk/sites3/documents/245/DirectorOfPublicHealth.PDF#search='uptake%20of%20mmr%20in%20wales (accessed 28 June 2006)
  6. CDSC NI. Communicable Diseases Monthly Report. March 2003. http://www.cdscni.org.uk/publications/MonthlyReports/Volume_12_2003/No_1.pdf#search='uptake%20of%20mmr%20northern%20ireland' (accessed 28 June 2006)
  7. NDSC. Immunisation Uptake Statistics for Ireland. May 2002. http://www.ndsc.ie/A-Z/VaccinePreventable/Vaccination/Publications/ImmunisationUptakeStatistics/2001/File,926,en.pdf#search='fall%20in%20mmr%20uptake' (accessed 28 June 2006)
  8. Parliament of Ireland. Report on Childhood Immunisation. 7 December 2000. http://www.irlgov.ie/Committees-01/c-health/rep-childhood/071200.htm (accessed 28 June 2006)
  9. Health Protection Agency. Measles cases so far in 2006. June 2006. http://www.hpa.org.uk/hpa/news/articles/press_releases/2006/060615_measles.htm (accessed 28 June 2006)
  10. Dourado I, Cunha S, Teixeira MG, Farrington CP, Melo A, Lucena R, Barreto ML. Outbreak of aseptic meningitis associated with mass vaccination with a urabe-containing measles-mumps-rubella vaccine: implications for immunization programs. Am J Epidemiol March 2000; 151(5):524-530 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10707922&query_hl=24&itool=pubmed_docsum (accessed 28 June 2006)11.
  11. Goncalves G, de Araujo A, Monteiro Cardoso ML. Outbreaks of mumps associated with poor vaccine efficacy - Oporto Portugal 1996. Eurosurveillance 1998; 3(12):119-121 http://www.eurosurveillance.org/em/v03n12/0312-222.asp (accessed 28 June 2006)
  12. NHS. Ban on import of Pavivac mumps vaccine extended. January 2003. http://www.mmrthefacts.nhs.uk/news/newsitem.php?id=38 (accessed 28 June 2006)
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Jenny Dzafic
Meningococcal disease
Meningococcal disease at 2

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