Pediatrics

Vaccination against meningococci

What is meningococcal vaccination?

Meningococci are bacteria and can cause dangerous infections. These include in particular meningitis (meningitis) and blood poisoning (meningococcal sepsis). Meningococci occur worldwide, but there are different types, the so-called serogroups.

In Germany, types B and C occur mainly, but there are also 10 other known serogroups that occur in other regions of the world. Since the infection, especially with meningococcal C, often takes on very serious courses, a single vaccination in the second year of life has been recommended for some time. This is intended to prevent meningitis or blood poisoning from meningococci and minimize the risk of infection by the bacterium.

What does the meningococcal vaccination protect against?

The vaccination against meningococcal serogroup C recommended by the Standing Vaccination Commission is primarily intended to protect against severe and fatal courses of meningococcal infections. These include meningitis (meningitis) and blood poisoning (Meningococcal sepsis).

In the body of the vaccinated, antibodies against the bacteria are formed, which become active immediately on contact with the real bacteria and can destroy them by the immune system. Meningitis caused by other pathogens cannot be prevented by vaccinating against meningococci.

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Meningitis
Vaccination against meningitis

Who should be vaccinated against meningococci?

Since 2006 there has been a recommendation by standing vaccination committee (STIKO), which provides for vaccination against meningococci of serogroup C. This should be done once in the second year of life and applies first to all children, provided there is no underlying disease that makes vaccinations impossible. In addition to vaccination against meningococcal C, it is also possible to vaccinate against serogroups A, C, W and Y, which are rare in Germany, but can cause epidemics in parts of Africa. However, there is no general vaccination recommendation here; instead, only special groups of people should be vaccinated. This includes:

People who want to travel to affected countries
People who come into contact with sick people or who work with potentially infected material, e.g. in laboratories
People who have a weak immune system and who therefore have a more severe disease course

In the meantime, a vaccination against meningococcal B is possible, which, like meningococcal C, occurs in Germany. However, there are no vaccination recommendations yet. Only a vaccination of immunocompromised people is currently being discussed.

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Who shouldn't get vaccinated?

In general, it should be noted that people who are allergic to ingredients of the vaccine must not be given it. This also applies to the meningococcal vaccination. The second important contraindication for vaccination is a feverish infection with a temperature of over 38.5 ° C. Then you should wait until recovery and only then be vaccinated.

Otherwise, according to STIKO, there are no real contraindications for meningococcal vaccination. Since it is not a live vaccine, immunocompromised people can also be vaccinated. Here, however, it can happen that the success of the vaccination is limited. It is advisable to check the antibodies in the blood after vaccination to check the effectiveness of the vaccination.

The STIKO has also issued a number of so-called "false contraindications". These include, for example, minor infections with subfebrile temperatures (<38.5 ° C), seizures in the family or febrile seizures of the person to be vaccinated, current treatment with antibiotics or pregnancy of the mother of the person to be vaccinated. In these cases it is usually still possible to vaccinate. The attending physician will explain this to you in each case.

Side effects of vaccination

As with all vaccinations, local symptoms at the injection site can occur after a meningococcal vaccination.
These include Redness, pain or a hardening. However, these temporary symptoms are usually completely harmless and indicate that the immune system is dealing with the vaccine. In addition, general symptoms such as a slight fever, headache, pain in the limbs, tiredness and gastrointestinal complaints can occur. These symptoms also disappear completely after a few hours to days.

Serious side effects are very rare. So it can too allergic reactions caused by the vaccine. In exceptional cases, these can lead to allergic shock, but are extremely rare. Also only in very rare cases can seizures occur occur.

Read more on the topic: Vaccination side effects

Fever after meningococcal vaccination

Occasionally, slightly elevated temperatures may occur after vaccination. However, in most cases this is completely harmless and only indicates an immune system response to the vaccine.
Rarely, there may be a high fever up to chills and very rarely febrile convulsions. A doctor should then be consulted and the previous vaccination should be reported.

More information is available here: Fever after vaccination

Pain after meningococcal vaccination

After vaccination, pain, swelling and reddening can occur, especially at the injection site occur. However, this is normal and, like the mild general symptoms, indicates the desired reaction of the immune system to the vaccine.
The pain at the puncture site and also in the whole muscle can last for a few days and are not worrying at first. General muscle and limb pain, such as a flu-like infection, can also occur. These are also in most cases harmless and a normal reaction of the immune system. However, if the pain is unusually severe or persists for a long time, a doctor should be consulted again and the previous vaccination should be reported.

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Risks of vaccination

If the vaccination against meningococcal C, as recommended by the STIKO, takes place in the second year of life in an otherwise healthy child, there are no special risks to be considered apart from the side effects mentioned above.
Children with compromised immune systems are at risk of an insufficient immune system response to the vaccine. Under certain circumstances, they are therefore still at risk of developing meningitis caused by meningococci. The success of the vaccination can therefore be checked by determining the antibodies formed in the blood.
Children at particular risk are sometimes vaccinated before they are one year old, often in combination with other vaccines. This can lead to increased fever after the vaccination. As a preventive measure, some doctors recommend giving the child paracetamol. In the case of children at particular risk, however, prior advice should always be given regarding the vaccination and the risk-benefit ratio.

What different vaccinations are there?

With meningococcal vaccinations, between conjugated and unconjugated vaccinations can be distinguished. In general, the vaccination is directed against sugar molecules on the surface of the bacteria. These sugar molecules are also included in the vaccination so that the immune system can form antibodies against them and react directly in the event of an infection with the bacterium.

Conjugated means that the sugar molecules are bound to special proteins; unconjugated means that these are present in the vaccine without proteins. The advantage of the conjugated vaccine is that infants can also be vaccinated. Such a vaccine is available for serogroup C; in some countries also for serogroup B.
The unconjugated vaccine can be given as a combination of serogroups A, C, W and Y, but children less than one year old may not develop sufficient antibodies after vaccination with this vaccine. They need the conjugated vaccine first in order to receive primary vaccination. Only from the age of two can the unconjugated vaccine can be administered.

More information can be found here: Vaccination against meningitis

It is also possible after contact with the pathogen to take a measure to protect the body and thus to escape the outbreak of the disease. For detailed information, read our article: Post exposure prophylaxis - the salvation?

When should vaccinations start?

The generally recommended vaccination against meningococci of serogroup C should take place in the second year of the child's life. So that the child is protected from the dangerous course of meningococcal infections as early as possible, paediatricians recommend vaccinating as early as the age of two.

Children at particular risk, e.g. Under certain circumstances, immunodeficiencies can also be vaccinated in infancy. A catch-up vaccination against meningococci is also recommended for children and adolescents up to the age of 17. Vaccinations against other types of meningococci can usually also be carried out from the age of two. However, a detailed consultation should be carried out with the attending physician in order to explain the individual risk-benefit ratio.

Read also: Meningitis in the baby

How often should I be vaccinated?

The vaccination against meningococcal C recommended by STIKO only requires a single vaccination in the second year of life. Older children and adolescents are also only vaccinated once.
The vaccination against meningococcal B, which is not yet recommended in Germany, requires two to three vaccinations, depending on the age of the person to be vaccinated, until a basic immunization is achieved.
In addition, a booster vaccination is necessary for children under two years of age. The combined vaccination against meningococcal ACWY is usually only necessary once. However, it is only approved from the age of two. Therefore, children under one year of age at particular risk, e.g. Immunodeficiencies, are vaccinated against meningococcal C as early as infants and receive the combined vaccine in the second year of life.

When should I have my vaccination refreshed?

Meningococcal C vaccination does not usually require a booster vaccination. It is administered once.

A refresher should only be given for particularly vulnerable children who have already been vaccinated before the age of one. The vaccinations against the other serogroups of the bacterium also usually do not need to be refreshed. A booster vaccination is only necessary for children under two years of age who have been vaccinated against meningococcal B.

Costs and coverage by the health insurance companies

The costs for the vaccination against meningococcal C are covered by all health insurance companies and are therefore not listed separately.

The situation is different with vaccinations against meningococcal B. Here the health insurance often only pays the costs for people at particular risk. If you have any questions about takeover, it is best to contact the treating doctor or the respective health insurance company. The meningococcal B vaccine costs approx. 100 €.

The combination vaccine against the ACWY serotypes is also not covered by all health insurance companies. It costs approx. 65€. In general, however, almost all health insurance companies fully cover the vaccinations for particularly vulnerable people, especially those with immunodeficiency.

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