Being up to date with immunizations always has been more of a concern for children entering kindergarten than for older ones—until now. Immunization recommendations are changing for your tweens and teens—a new vaccine against meningococcal disease has been developed and is recommended for this age group by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. As you prepare your older child for school, make sure getting immunized against meningococcal disease is on your list of things to do.
The new meningococcal vaccine, MCV4 or Menactra (meningococcal conjugate vaccine), is thought to be an improvement upon MPSV4 (meningococcal polysaccharide vaccine), which was introduced in 1981. This new vaccine is believed to stimulate the immune system better and provide longer-lasting immunity than the old one. The latter’s protection wanes significantly two years after administration.
The new vaccine is also designed to be given routinely to adolescents, while the old vaccine was used only on people at high risk of meningococcal disease. It is important to note that the new vaccine, like the old one, only provides protection against four of the strains of the bacteria. One major strain, strain B, has evaded vaccine development. The new vaccine is not licensed for use in children under 11, and neither vaccine is effective when given to children under 2.
About meningococcal disease
Meningococcal disease is caused by the bacteria Neisseria meningitidis. This organism lives in the noses, mouths and throats of about one in 10 people without causing any disease. Under the right conditions, the bacteria then invades the body. Some of these conditions have to do with the environment—overcrowding, prolonged dry seasons or droughts. Other conditions have to do with us as individuals—people with underlying conditions that prevent them from having a working spleen (such as sickle cell disease) or with certain immune deficiencies do not fight off meningococcal disease well. Lastly, some of these conditions have to do with our herd immunity—how recently our immune systems collectively “remember” how to fight off this organism. Ultimately, invasive meningococcal disease usually causes infection in the lining of the brain (meningitis), the blood stream (meningococcemia) and the lungs (pneumonia).
Why target teenagers?
Who gets the disease and what happens to them are the basis for the new immunization recommendation. Deaths occur most frequently among teenagers and young adults, even though infants younger than 12 months get meningococcal disease more often. The higher death rate among older children and young adults is attributed to the fact that adolescents do not show signs of meningitis (lethargy, stiff neck, sensitivity to light) that could tip off an earlier diagnosis. Instead, teens tend to show only advanced stages of blood infection and can die quickly. Adolescents are being targeted with the meningococcal vaccine because the disease is more fatal in this age group.
The new vaccine has performed well in safety testing, but it has its side effects. The main side effect noted is slight pain and redness at the injection site. About half of the teenagers who received the vaccine also experienced a mild fever, headache, chills or rash. Severe reactions occurred in less than 1 in 1 million people. Meningococcal vaccines can be given at the same time as other vaccines and were tested with the tetanus booster recommended for 11- to 12-year-olds.
The vaccine should not be administered to people with allergies to the diphtheria vaccine or to latex (which is used in the stopper of the vial).
A similar vaccine has been in use in the United Kingdom since 1999, where there has been a significant decline in meningococcal disease.
In general, meningococcal disease is relatively uncommon, but it tends to be very serious when it occurs. Until now, our teens and young adults were largely unprotected from this disease. This new vaccine should provide an additional layer of protection for our children as they become more independent.
If you have more questions about this and other vaccines, visit www.aap.org or www.cdc.gov.
Alyna Chien is the mother of two, a pediatrician and a Robert Wood Johnson Clinical Scholar at the University of Chicago’s Department of Pediatrics.
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