Meningococcal Groups ACWY vaccine in the UK

Since August 2015 all 14 to 18 years olds in the UK are being offered MenACWY vaccine. 


The teenage/fresher MenACWY vaccine against meningitis and septicaemia

Since August 2015 all 14 to 18 years olds in the UK are being offered MenACWY vaccine.  This is part of a one off catch-up vaccination campaign due to a rapid rise in a harmful strain of meningococcal group W (MenW) disease. 

The catch up vaccination campaign was completed within one year in Scotland and Northern Ireland and is being completed within two years in England and Wales.

There is no MenACWY vaccination programme in the Republic of Ireland.

Each year children in secondary school will be routinely vaccinated with MenACWY during their third academic year.
Young people across the UK are being offered free MenACWY vaccine to combat a rapid rise in a deadly strain of meningitis
For everyone aged 14-18 in the UK and first year university students under the age of 25.
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MenACWY vaccine directly protects vaccinated people from four different strains of meningococcal meningitis and septicaemia (groups A, C, W & Y) and also stops them from carrying the bacteria in the back of the nose and throat. 

It is particularly important to protect teenagers because they are at increased risk of disease and are more likely to carry the bacteria than other age groups, so they are key to stopping the spread of infection amongst the wider population.

Importance of protection against MenW disease

Cases of MenW disease have been rising steeply year on year in England and Wales. Public Health England has shown that in 2014/15 MenW accounted for 24% of cases of meningococcal disease compared to only 1-2% in 2008/9.

This rapid rise in disease incidence is due to a particularly virulent strain of bacteria which is causing severe disease in previously healthy people and has a high death rate. The strain was identified using the MRF Meningococcal Genome Library to be a particular ST-11 strain which has caused high disease rates and very high fatality rates in South America.  Vaccinating teenagers with a MenACWY vaccine will protect them and stop the spread of this virulent strain. 

Find out more about the rise of cases of MenW

Importance of maintaining protection against MenC (meningococcal C meningitis and septicaemia)

Since introduction of the MenC vaccine in 1999-2000, MenC has been nearly eliminated in the UK.  The vaccine has prevented over 13,000 cases and 1,300 deaths.  The reason for this success was not just because the vaccine directly protected babies from disease, but because it was introduced with a one-off catch up campaign, which extended to teenagers and young adults. This stopped people in this age group from carrying bacteria and reduced the spread of disease amongst the wider population.

Research has shown that the direct protection young children get from MenC vaccination is relatively short lived1-3 which means that teenagers who were vaccinated as babies are no longer directly protected and are vulnerable to carrying these bacteria in the back of the nose and throat.   Boosting teenagers with a MenC containing vaccine will protect them, which is important as they are entering a higher risk age group for this disease. It also keeps disease levels amongst the population at low levels by stopping the spread of bacteria.
 
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Teenagers and young adults

The MenACWY vaccine is now routinely given to children at around 14 years of age along with a vaccine that protects against tetanus, diphtheria and polio. 

Most teenagers of this age will be vaccinated at school.  A catch up campaign began across the UK in August 2015 to vaccinate older teenagers up to age 18. 

Where young people go to get their vaccine and when they should have had it will vary according to their age and where they live.

University freshers in England, Wales and Northern Ireland

Because MenC and MenW can spread rapidly in halls of residence, new starters at university up to age 25 are also being offered a catch-up MenACWY vaccination before they enrol on their course.  

Ideally first year students should arrange to get MenACWY from their GP at least 2 weeks before they go away to study.

Any first-year students not immunised before they started should get the vaccine by registering with their university health centre or other GP practice.

If you live in London, you may be able to get the MenACWY vaccine free at your local pharmacy. Pharmacies offering the vaccine are listed on the following website which also details other available vaccines, such as the flu vaccine: https://www.londonflu.co.uk/

Check eligibility using our online checker

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Scotland will not be running a Universities Freshers programme this year.

Due to the success of their MenACWY programme offered to all 14-18 year olds in Scotland during 2015/16, the majority of Scottish entrants to university will have already been vaccinated and there therefore isn’t a need for a specific freshers programme this year.  

Unvaccinated students coming from other parts of the UK to study in Scotland should ensure they get vaccinated before they travel to Scotland as there is no guarantee the MenACWY vaccine will be available at Scottish university health centres and GP practices.
 
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We have been contacted by students and other young people who have had difficulty getting the MenACWY vaccine from their GP even though they were eligible for the vaccine.

Protecting yourself through vaccination is important, so don’t be put off.

The NHS has sent information to GPs about the vaccine and so most GPs should be offering it to those who are eligible.

If you experience difficulties please:
  If you are still experiencing difficulties call our free helpline on 080 88 00 33 44 for assistance.
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Timing of vaccinations according to age and location (information for academic year 2016/17)
 

England
  • Those born between 1st September 1996 and 31st August 1998 should have already been contacted by their GP to get the vaccine.  If you have not had your invitation, go to your GP and ask for the vaccine.
  • Young people born between 1st September 1999 to 31st August 2002 (school years 10 to 12) should have either already been vaccinated in the 2015/16 academic year or will be vaccinated during this academic year via their school nursing system or other local arrangements.  If you are unsure about whether your child has been vaccinated, speak to the school or your child’s GP.
  • Young people born between 1st September 1998 and 31st August 1999 (current school year 13s) will be offered the vaccine from their GP after April 2017. 
  • Year 9 pupils will be routinely immunised in school during this academic year.
Wales
  • Those born between 1st September 1996 and 31st August 1999 should have already been contacted by their GP to get the vaccine.  If you have not had your invitation, go to your GP and ask for the vaccine.
  • Young people born between 1st September 1999 to 31st August 2000 (current school year 12s) and those born between 1st September 2001 to 31st August 2002 (current school year 10s) should have received the vaccine via their school nursing system or other local arrangements during 2015/16 academic year.  If you are unsure about whether your child has been vaccinated, speak to the school nurse or your child’s GP surgery.
  • Young people born between 1st September 2000 to 31st August 2001 (current school year 11s) should get the vaccine via their school nursing system or other local arrangements this academic year.
  • Year 9 pupils will be routinely immunised in school during this academic year.
Northern Ireland
  • Those born between 2nd July 1996 and 1st July 1999 are eligible for vaccination and should have already been contacted by their GP to get the vaccine.  If you have not had your vaccination yet, go to your GP and ask for the vaccine.
  • Young people born between 2nd July 1999 and 1st July 2001 (current school years 12 and 13) should have received the vaccine via their school nursing system or other local arrangements during 2015/16 academic year.
  • Year 11 pupils will be routinely immunised in school during this academic year.
Scotland
  • Vaccination of those born between 2nd August 1996 and 28th February 2002 was completed by the end of March 2016.  Any school children who missed their vaccination should speak to the school nurse.
  • S3 pupils will be routinely immunised in school. 
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People with asplenia or splenic dysfunction, those with complement disorders, or those on Eculizumab therapy are at increased risk of meningococcal disease.  They are entitled to receive the MenACWY and other meningitis vaccines free of charge on the NHS whatever their age4 and anyone with any of these medical conditions should contact their GP to ask about vaccination.
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There are two MenACWY vaccines currently available in the UK, Menveo® and Nimenrix®.  Both vaccines have been licensed in Europe and widely used for several years: Menveo® since 2010 and Nimenrix® since 2012. Either of these vaccines can be used to immunise teenagers.
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Both vaccines have a good safety profile.  As with all drugs, vaccines can cause side effects. Side effects of MenACWY vaccines are similar to other routine vaccines and may include soreness/redness/swelling or hardness of skin at the injection site, fever, headache, nausea, muscle aches, tiredness/fatigue, loss of appetite, generally feeling unwell.

The vaccines have been used extensively in the UK and around the world amongst pilgrims attending Hajj to combat meningitis outbreaks that have occurred among Hajj pilgrims in the past.  MenACWY vaccine is compulsory for people attending Hajj, and since 2010, there have been 2-3 million Hajj pilgrims each year worldwide.  

The vaccines have also been used amongst people at higher risk of the infections as a result of medical conditions and Menveo® has been used as part of the routine immunisation programme in Chile and some parts of the US to routinely immunise teenagers.
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No, quite the contrary. Vaccinating adolescents not only protects them, but reduces their risk of acquiring the bacteria, which commonly live in the nose and throat, particularly in adolescents. By getting vaccinated, adolescents are also protecting younger and older people who are vulnerable to the infections.
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Each different group (A,C,W and Y) of meningococcal bacteria has a different type of sugar capsule surrounding the bug. The MenACWY vaccines contain fragments of the sugar capsules of all four groups. The sugar fragments are linked to a protein which makes the vaccine stronger and longer lasting.

All of the vaccine components have been processed and inactivated and are not part of any living bacteria, but can still stimulate the immune system.

Once you are vaccinated with MenACWY, your immune system can recognise and kill bacteria with the same sugar capsule that is contained in the vaccine, so if you are exposed to these types of bacteria you do not become ill.

Other ingredients in the vaccines are used to ensure it is has the same level of acidity and salt concentration as your body.

In Menveo® the other ingredients include5:
  • Sucrose
  • Potassium dihydrogen phosphate
  • Sodium dihydrogen phosphate monohydrate
  • Disodium phosphate dihydrate
  • Sodium chloride 
  • Water for injections
In Nimenrix® the other ingredients include6:
  • Sucrose
  • Trometamol
  • Sodium chloride 
  • Water for injections
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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.

Find out more 
 
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People who have previously had an anaphylactic reaction to any of the vaccine components listed above should not get the vaccine.

Anaphylaxis to current vaccines is very rare and is estimated to occur in one in a million doses given, although a recent study7 found no reports of anaphylaxis following more than 5 million preschool and infant immunisations over an entire year in the UK and Ireland.

People with severe immune system problems cannot have live vaccines, but the MenACWY vaccines are not live. Food allergies are not a reason to avoid vaccination. People often worry that eczema, asthma, epilepsy and a family history of reactions to vaccinations are a reason to avoid vaccinations, but this is not true8.
The packaging on both vaccines may contain natural rubber latex.  The risk of developing an allergic reaction is very small, but in case of known severe latex allergy, you should speak to your doctor or nurse before being vaccinated.

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A MenC vaccine for 14 year olds was added to the routine schedule in June 2013 to ensure that levels of MenC disease remain low, but this vaccine did not give protection against MenW disease.  The MenACWY catch up programme was recommended for 14 to 18 year olds in response to rise in a harmful strain of MenW disease.

Vaccinating with MenACWY will give vital protection against MenW whilst boosting protection against MenC.
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Yes.  The MenACWY vaccine can be administered safely at any interval after MenC vaccine.
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No.  There is currently no licensed vaccine that just protects against MenW.
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Yes. The vaccine is safe for people who have previously had meningococcal disease, and the vaccine cannot give them the disease. 

There are very few safety reasons for not vaccinating and these are outlined above.

There are many different types of meningococcal disease.  Although someone who has been ill in the past may have some immunity against the strain that caused disease, they would not be protected against other types.  Vaccination is necessary for broader protection and to boost any existing immunity generated from a previous infection. 
 
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Yes.  Meningococcal vaccines may be given to pregnant women.  There is no evidence of risk from vaccinating pregnant women or those who are breast-feeding.
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All university freshers in England, Wales and Northern Ireland up to the age of 25 are eligible for this vaccine.  If you are not a fresher, your eligibility for the vaccine will depend on your date of birth and where you live. 

Use our online eligibility checker to see if you are entitled to the vaccine
 
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There is no current recommendation for babies to be vaccinated against MenACWY. 

The MenB vaccine Bexsero, which is given to children at 2, 4 and 12 months in the UK, should provide some protection against this particular ST-11 MenW strain that is causing severe disease9.

Adolescents are more likely to carry meningococcal bacteria than any other age group and offering MenACWY vaccine to all of them should stop the bacteria from being passed on. This means that even unvaccinated people including babies should eventually also be indirectly protected from catching the disease – an effect known as population protection (or herd protection).
 
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Babies are at the highest risk of contracting meningococcal disease with peak incidence at around 5 months of age.  All babies are now immunised with the MenB vaccine Bexsero which should provide some protection against this virulent ST-11 MenW strain9

Children older than 5 months of age are still at risk of disease, but their risk is substantially lower than that of younger babies. Current incidence of disease amongst the under 1s is around 20 per 100,000 per year (or 1 baby in 5000 per year), reducing to 6 per 100,000 per year for children aged 1-4 (1 child in about 16,667 per year).  The incidence of disease amongst people older than age 5 is substantially less.

Vaccinating adolescents should stop the bacteria from being passed on which means that even unvaccinated people should be indirectly protected from catching the disease.

However, meningococcal disease is such a deadly and disabling disease that some may wish to be protected however small the risk of them contracting disease. The vaccine is available privately for those who wish purchase it.
 
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Separate stocks of the vaccine are available privately for travellers, and it is usually possible to pay for MenACWY vaccination at pharmacies and travel clinics.
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As a guideline, the NHS list price of both vaccines is £30 per dose excluding VAT. The price that you will be charged will vary according to where it is being purchased.  The provider of the vaccine is likely to charge a fee for administering the vaccine.
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Unfortunately yes, although it is much less likely. Meningitis vaccines are excellent, but they do not protect against all strains.

For example MenB has been the most common kind of meningitis for decades. A new MenB vaccine has recently been recommended for routine use in babies the UK which should prevent many more cases of meningitis. However, there is currently no recommendation for this vaccine to be offered to teenagers and there are still some kinds of meningitis that cannot be prevented, so it is important to know the symptoms.

Symptoms in teens and yougn adults.
 
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1. Snape, M.D. and A.J. Pollard, Meningococcal polysaccharide-protein conjugate vaccines. Lancet Infect Dis, 2005. 5(1): p. 21-30.
2. Khatami, A., M.D. Snape, T. John, S. Westcar, C. Klinger, L. Rollinson, D. Boutriau, N. Mesaros, J. Wysocki, A. Galaj, L.M. Yu, and A.J. Pollard, Persistence of immunity following a booster dose of Haemophilus influenzae type B-Meningococcal serogroup C glycoconjugate vaccine: follow-up of a randomized controlled trial. Pediatr Infect Dis J, 2011. 30(3): p. 197-202.
3. Ishola, D.A., Jr., R. Borrow, H. Findlow, J. Findlow, C. Trotter, and M.E. Ramsay, Prevalence of serum bactericidal antibody to serogroup C Neisseria meningitidis in England a decade after vaccine introduction. Clin Vaccine Immunol, 2012. 19(8): p. 1126-30.
4. Department of Health. Meningococcal: the green book, chapter 22.  [cited 2016 February]; Available from: https://www.gov.uk/government/publications/meningococcal-the-green-book-chapter-22
5. GSK. Menveo.  Summary of product Characteristics.  Cited February 2016.  Available https://www.medicines.org.uk/emc/medicine/27347
6. Pfizer.  Nimenrix.  Summary of Product Characteristics.  Cited February 2016.  Available from https://www.medicines.org.uk/emc/medicine/26514
7. Erlewyn-Lajeunesse M, Hunt L.P, Heath P.T, Finn A, Anaphylaxis as an adverse event following immunisation in the UK and Ireland. Arch Dis Child, 2012. 97:487-90.
8.Department of Health. Contraindications and special considerations:the green book, chapter 6.  2013  [cited 2013 November ]; Available from: https://www.gov.uk/government/publications/contraindications-and-special-considerations-the-green-book-chapter-6.
9. Ladhani S.N, Giuliana M.M, Biolchi A, Pizza M, Beebeejaun K, Lucidarme J, Findlow J, Ramsay M.E, Borrow, R, Effectiveness of meningococcal B vaccine against endemic hypervirulent Neisseria meningitides W strain, England.  Emerg infect Dis. 2016 Feb;22(2):309-11. doi: 10.3201/eid2202.150369.

Sharon lost her daughter, Lauren, to MenW meningitis

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