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Meningococcal disease continues to be disabling and deadly, especially for infants and adolescents

Rates of meningococcal disease have been declining in the United States since the late 1990s, and in 2016, there were about 370 total cases of meningococcal disease reported, according to the Centers for Disease Control and Prevention. Still, it is a deadly disease, affecting primarily children and young adults. Rates of meningococcal disease are highest in children younger than age 1 year, followed by a peak in adolescents and young adults, with those aged 16-23 years having the highest rates in this portion of the population. Of all cases of meningococcal disease, 21% affect preteens, teens, and young adults aged 11-24 years. Even with antibiotic treatment, 10%-15% of patients infected with Neisseria meningitidis die. Of those who survive, 11%-19% have permanent disabilities, such as brain damage, hearing loss, loss of kidney function, or limb amputations, according to the CDC. There are vaccines for a number of the serotypes of N. meningitidis, the organism that causes meningococcal disease. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends that all children aged 11-12 years be vaccinated with a meningococcal conjugate vaccine, which protects against serotypes A, C, W, and Y. The vaccine should also be given to children aged 12-23 months who are at increased risk for meningococcal disease. But why does ACIP only recommend that all adolescents and young adults (16-23 years) may be vaccinated with a serogroup B meningococcal vaccine, preferably at age 16-18 years? There are other questions about meningococcal disease, its prevention, and treatment. What is the difficulty of early recognition of meningococcal infection? How long does the protection of vaccines against N. meningitidis last? What are the costs of untreated meningococcal infection?

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Why did the ACIP decide on a Category B recommendation for the MenB vaccines?

The Advisory Committee on Immunization Practices (ACIP) develops written recommendations for the routine administration of vaccines, in addition to schedules regarding the appropriate timing, dosage, and contraindications. Key factors – the balance between benefits and harm, the evidence type or quality, values and preferences, and health economic analyses – are used to refine the recommendation and to determine what category of recommendation is made, either Category A or Category B. Read more to discover why ACIP decided on a Category B recommendation for the MenB vaccines.

Vaccine hesitancy or refusal of MenB vaccination during an outbreak

Parents sometimes are hesitant to allow their children to receive vaccines. Read about why parents may be hesitant or refuse to allow their teens to receive the MenB vaccines during an outbreak of Neisseria meningitides serotype B infections and how to talk with these parents.

Extending MenB vaccine to children under age 10 years

The Food and Drug Administration granted Pfizer’s serogroup B bivalent meningococcal vaccine, brand name Trumemba, breakthrough therapy status, approving it as the first MenB vaccine for use in 1- to 9-year-olds. Read more about why it did so.

What are the adverse effects of MenB vaccines?

There are two currently FDA-licensed MenB vaccines available in the United States. There are specific indications for the vaccine based on Category A (high-risk patients and situations) and Category B (healthy adolescents) as outlined by the Advisory Committee on Immunization Practices.
It is important to familiarize yourself with the vaccine that is used in your practice. Your personal and professional experience with the vaccine as the provider is important to be able to share with your patients, including the side effects associated with that particular vaccine.

Who is at risk of being infected with Neisseria meningitides?

Watch our video with Dr. Sheldon L. Kaplan, who is chief of the infectious disease service at Texas Children’s Hospital, Houston, who explains the populations most at risk of contracting infection with Neisseria meningitides.

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