MenC: Conjugate vaccine against Group C meningitis and septicaemia
The MenC vaccine was introduced in the UK in 1999 and in the Republic of Ireland in 2000 and provides excellent protection against meningitis and septicaemia caused by Group C meningococcal bacteria which used to kill about 150 people in the UK every year. Since its introduction, the vaccine has been offered to almost everyone who was aged under 18 in September 1999 in the UK and up to 22 in the Republic of Ireland, reducing cases of Group C disease by over 90% in the age groups targeted for vaccination.
In January 2002, the programme of immunisation in the UK was extended to include everyone aged under 25.
Although MenC vaccine has been tremendously successful, it is important to remember that it cannot prevent all forms of meningitis and septicaemia. Even before MenC vaccine was available, Group B meningococcal disease was generally more common, accounting for up to 60% of cases, and no available vaccine can protect against it. There are many other equally deadly forms of meningitis and septicaemia that are not vaccine-preventable. For this reason, it is still crucial to be aware of the symptoms of meningitis and septicaemia .
Is the 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.
- Since 1999, more than 33 million doses of MenC vaccine have been given. 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 it 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 life1 . This has prompted the recent changes to the routine infant immunisation schedule. The new schedule now ensures that protection provided by conjugate vaccines is boosted after the child reaches one year of age.
Is there anyone who should not be given the vaccine?
- 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 it2 .
- 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 system3 . 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.
Getting immunised with MenC - Information for parents of babies
Currently in the UK, babies are immunised at 3 and 4 months of age with MenC (one dose at each visit) along with other vaccines in the routine Childhood Immunisation Programme. Additionally, a MenC booster (given as the combined Hib/MenC booster) dose is now also offered to babies at 12 months of age.
In the Republic of 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.
Getting immunised with MenC - Information for under 25 year olds
MenC has now been offered to everyone less than 25 years old (in the UK)4 and aged under 23 (in the Republic of Ireland) who have not yet received the vaccine. Anyone in this age group (including students) who has not yet received the vaccine can arrange to be immunised by contacting their GP.
Getting immunised with MenC - Information for first year university students
Nowadays, most students entering first-year university or college have already had MenC through their school in the MenC catch-up programme. Anyone of any age entering the first-year of a full-time undergraduate course that has not been immunised can arrange to get MenC from their GP before they go away to study. Getting immunised before the start of term protects students against the slightly higher risk of Group C meningitis and septicaemia that first-years are exposed to. 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.
Getting immunised with MenC - Information for people without a functioning spleen
People with no spleen, or with a disease or condition that stops their spleen from functioning properly are at high risk of serious bacterial infection. For anyone of any age with no functioning spleen, immunisation with MenC is now recommended and can be obtained through GP surgeries.
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 page 246. 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).
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).
4. Professional Letter- Chief Medical Officer (2002)1: Extending meningitis C vaccine to 20-24 year olds: pneumococcal vaccine for at-risk 2 year olds. Department of Health. http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_4004730 (accessed 17 May)
Page last updated 08.06.07