Dr. Mobasher: Meningitis B vaccine

By Dr. Mobasher Butt and Emily Grenfell

Great news! There is now a vaccine for meningitis B, the most common cause of bacterial meningitis, known as the MenB vaccine. Dr. Mobasher Butt tells you everything you need to know.

What is meningitis?

Meningitis is an infection that affects the membranes that cover the brain and spinal cord. There are three types: bacterial meningitis can be deadly and very contagious, viral meningitis is less severe and most patients recover completely, and fungal meningitis is rare and tends to only occur in patients with a weakened immune system.


Why do we vaccinate?

Vaccines are the only way to prevent meningitis, and thanks to the vaccines introduced since 1992, millions of children, who would otherwise have died, are alive today.

Developing a vaccine for Meningitis B has, until now, proved very difficult. All meningitis vaccines developed until now have been made from a fragment of the bacterial sugar coat (the coating of the bacteria that gives each bacteria its shape). Our immune system identifies this sugar as ‘foreign’ and produces antibodies that will destroy the bacteria if we come into contact with it in the future. The sugar coat of Meningitis B bacteria, however, does not trigger our immune system because it looks like our developing human cells and not a ‘foreign invader’.

Finding a substitute for the sugar coat has proved very difficult.

The vaccine will protect against meningitis and septicaemia caused by meningococcal B (meningitis B) infection.


Who is entitled?

The meningitis B vaccine will be offered to all babies alongside their other routine vaccinations at 2 months, 4 months, and 12 months of age. Those aged 2 months or younger from September 1st 2015 will receive 3 doses at 2, 4, and 12 months. Those aged between 2 and 4 months will receive 2 doses at 4 and 12 months. Babies and children who are older than 4 months will not be offered the vaccine on the NHS, but can have the vaccine privately.

The MenB vaccine will also be offered free to people with existing medical conditions that place them in a ‘high risk’ category for contracting meningococcal disease. These conditions include:

-       Asplenia

-       Splenic dysfunction

-       Complement disorder

-       People on Eculizumab therapy.

See: https://www.gov.uk/government/publications/meningococcal-the-green-book-chapter-22).

The vaccine will also be offered to people at risk of exposure to the meningitis B bacteria in their job, and Public Health England has published a guide about vaccinating the close contacts of people who have contracted meningococcal B.

See: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/328835/Invasive_meningococcus_secondary_case_prevention_April_2014.pdf.


Who is entitled in Ireland?

The detail of NIAC’s recommendation for routine childhood immunisation has not yet been announced, and the price of the vaccine is yet to be agreed.

NIAC has recommended that those with an existing medical condition that place them in a high risk category for contracting meningococcal disease should receive the vaccine.

See: http://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter13.pdf


Are there any side effects?

Like all vaccines there can be some side effects, but these are mild and tend not to last long. More than 5000 babies and toddlers have been given the vaccine during clinical trials to test its safety. Since the vaccine was licensed, a million doses have been given with no serious safety concerns identified.

Babies given the vaccine at 2 or 4 months are likely to develop a fever within 24 hours after being vaccinated. This is perfectly normal, and giving your baby liquid paracetamol after vaccination will reduce the risk of this. Your nurse or doctor will provide more information about this during your appointment.


How does it work?

There are hundreds of different strains of meningococcal B bacteria worldwide, and the MenB vaccine will protect against 90% of the ones most commonly found in England.

There are three active ingredients in the MenB vaccine that equip our immune

systems with the ability to fight off meningococcal infection.

-       Factor H Binding Protein (fHbp)

-       Neisseria Heparin Binding Antigen (NHBA)

-       Neisserial Adhesin A (NadA)

-       Added to these is the New Zealand MenB vaccine (MenZB) derived from the NewZealand outbreak strain (strain NZ 98/254)

These components have been made ‘inactive’ and are not part of any living bacteria, but they stimulate the immune system and activate your child’s natural defences.


Is there a reason why my child should not take the vaccine?

If you have experienced an anaphylactic reaction to vaccines in the past, you should notify your doctor.

Anaphylaxis is very rare. Current estimates put anaphylactic reactions to vaccines at 1 in every 1 million. A recent study has found no reports of anaphylaxis in more than 5 million preschool and infant immunisations over a year in the UK and Ireland.


How can I get the vaccine if I’m not eligible?

Ask your GP for the vaccine as it can be provided through most GP practices and this is likely to be the least costly option. If your GP surgery is not able to offer the vaccine, they may be able to arrange for you to have it at another surgery with a private prescription. If you decide to go down the private route, it’s worth asking more than one clinic as the price can vary considerably.

In Ireland the vaccine is available to order through a company called Allphar Services, based in Dublin. The brand name of the vaccine is Bexsero.


How much does it cost?

The following are guidelines only.

If you pay for the MenB vaccine through the NHS, the price is £75 + VAT. It is being provided to Irish pharmacies at a similar price.

GP surgeries or clinics can set their own prices for administration, and prices in the region of £125 or more per dose are not uncommon. It is important to remember that more than one dose is necessary to provide adequate protection.

Meningococcal infection has been the single largest cause of bacterial meningitis in the UK, with 85% of cases caused by meningitis B.  It leads to death in 10% of all cases and leads to long-term side-effects in a further 36%. It’s the illness parents of young children fear the most, and now we have a vaccine to prevent the most the most common cause.

If you have any questions, please ask our doctors.