VACCINE RESOURCE COMMITTEE

of the Edmonton Zone Medical Staff Association

View Full List of Vaccine Questions Here

Meningococcal Vaccine Question #2:

Why is this vaccine needed?

Invasive meningococcal disease (IMD) mortality is approximately 10%. Of IMD survivors, 10% to 20% have long term sequelae which may include hearing loss, neurologic disabilities, and digit or limb amputations.

The majority of invasive meningococcal disease (IMD) is associated with Neisseria meningitidis serogroups A, B, C, Y or W. Vaccines for the prevention of IMD that are authorized for use in Canada include:

  • Vaccines that cover serogroup C only: Monovalent conjugate meningococcal vaccines (Men-C-C)

  • Vaccines that cover A, C, Y, W: Quadrivalent conjugate meningococcal vaccines (Men-C-ACYW); and

  • Vaccines that cover serogroup B only:

    • Multicomponent meningococcal serogroup B vaccine (4CMenB)

    • Bivalent factor-H binding protein meningococcal serogroup B vaccine (MenB-fHBP)

These are pre-exposure vaccination (i.e. routine immunization) considerations:

Meningococcal vaccines are available in Alberta and publicly funded for all infants and children, and some adolescents and young adults. Refer to the Alberta Immunization Manual “Biological Pages” for the individual vaccine products to learn which ones are publicly funded. The links are here below, along with information sheets for each vaccine type.

All of the available vaccines are safe, and anything not publicly funded can be considered on an individual basis for purchase at a pharmacy with prescription.

The publicly funded vaccine types vary based upon age, previous immunizations (for example, receipt of a meningococcal vaccine in another province), and presence or absence of medical conditions. 

Menigococcal C vaccines: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-meng-conjate-vac-bio-pg-07-280.pdf; and this is the accompanying information sheet for your patients: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-mengconc-info-sht-07-280-r01.pdf

Meningococcal A,C,Y,W vaccines: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-meng-quadval-conjg-vac-bio-pg-07-281.pdf; and this is the accompanying information sheet for your patients: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-meng-acw-135-y-conjg-vac-info-ahs-imm-07-281-r01.pdf

Meninigococcal B vaccine(s): https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-men-b-vac-bio-pg-07-279.pdf; and this is the accompanying information sheet for your patients: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-men-b-vac-info-sh-07-279.pdf

In some instances, post-exposure vaccine may be offered (i.e. if a person is exposed to a contagious case).

When considering pre-exposure or post-exposure counselling, it is especially critical to note that there are high risk individuals. For these individuals, Men-C-ACYW provided together with 4CMenB or MenB-fHBP vaccine is recommended for children and adults with increased risk of IMD.

    • Persons at increased risk of meningococcal disease due to underlying medical conditions include:

      • persons with functional or anatomic asplenia, sickle cell disease

      • persons with congenital immunodeficiencies such as complement, properdin, factor D, combined T and B cell immunodeficiencies or primary antibody deficiencies

      • persons with acquired complement deficiency due to receipt of the terminal complement inhibitor eculizumab (Soliris™) or ravulizumab (ULTOMIRIS®)

      • HIV positive individuals, especially if HIV is perinatally acquired
        and

    • Persons at increased risk of exposure:

      • travellers to areas with high rates of endemic meningococcal disease or transmission, including travellers to the meningitis belt of sub-Saharan Africa and pilgrims for the purposes of Hajj or Umrah in Mecca, Saudi Arabia

      • research, industrial and clinical laboratory personnel who may be at risk of exposure to N. meningitidis

      • military personnel who are at increased risk of meningococcal disease

      • close contacts of a case of IMD and for individuals at risk in an outbreak setting if the disease is caused by a serogroup contained in the vaccine

In addition, the Canadian Immunization Guide Chapter on Meningococcal vaccines and this CCDR publication with an epidemiological summary are current and applicable:

Canadian Immunization Guide: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-13-meningococcal-vaccine.html

Epidemiology update for Canada 2023: https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2023-49/issue-9-september-2023/naci-update-invasive-meningococcal-disease-epidemiology-prevention.htmlAmerican CDC resource: https://www.cdc.gov/meningococcal/vaccines/index.html

 [ RH1]We cut this to keep it short and snappy. It is correct but more detailed than necessary.