Invasive meningococcal disease (IMD) is a really nasty disease and is the leading cause of meningitis and septicaemia globally. It tends to affect the under 5 year age group (with another peak in adolescence) and particularly attacks infants. The incidence in the under 1 year olds is 14 cases per 100,000 population and 5.8% of these babies die. Not only that, in the survivors over a third of them have long term effects, either brain damage or even amputation of limbs. Though often occurring in epidemics, there is always an incidence of the disease lurking in the background.
The present vaccine available on the schedule is very effective against the serotype C and the incidence of disease from that has fallen to very low levels since its introduction in 2003 (45 disease notifications in NSW in 2003, down to 2 in 2012). Serotype B (MenB) however remains at about 45 notifications a year.
Bexsero® is a recombinant (i.e. manufactured, no live components) vaccine that contains a number of components that induce antibodies in the recipient that can attack parts of the germ. It appears to be effective against about three quarters of the MenB strains around. It has been tested in clinical trials involving tens of thousands of people of all ages and has been shown to be safe and effective.
It is recommended for:
- Infants and young children particularly those aged less than 2 years old
- Adolescents aged 15 – 19 years
- Anyone whose spleen does not function properly or who has had their spleen removed surgically, and those with complement component disorders (a specific immune deficiency).
- Laboratory staff dealing with meningococcal specimens
It can given at the same time as other vaccines but at a different site. It can be started as early as 6 weeks of age (to fit in with the present schedule) but is usually given in three doses at 2, 4 and 12 months.
Following administration, in babies up to one year of age fevers and injection site reactions are fairly common. It is therefore recommended to use prophylactic paracetamol (15mg/kg/dose), given about half an hour before the injection and followed by further doses as needed. The fever seems to be more common when the vaccine is given at the same time as the other vaccines. So separating it from the other vaccines in the schedule seems to be a good idea.
The incidence of MenB disease at present is the same as MenC in 2003 when its vaccine was introduced. That vaccine was very effective and reduced the incidence of MenC to very low levels. There is no reason to suppose that the same will not happen to this even more common serotype.
Unfortunately the vaccine is not yet free, but whatever the cost (in the UK it was about 75 pounds until it was approved on the NHS) it is worth it for your baby.
Just checked availability: It is distributed in NSW by Team Medical Supplies (https://www.teammed.com.au) phone 1 300 224 450. They have ample supplies available. It costs $110 per dose (baby needs three).
I’ll add this information to the blog too. Get your GP write a script and the pharmacy (or the GP) can order it.