New meningitis vaccination programme will save young lives, says PHE

Child Vaccination

Public Health England (PHE) is introducing two new vaccines to its national immunisation programme to protect babies and adolescents from various strains of the deadly disease meningitis, which can kill within hours.

From September 1, the new MenB vaccination Bexsero is to be added to the arsenal of vaccines offered to babies aged two months, again at four months with a further booster dose given alongside the MMR immunisation at around 12 months.

Meningococcal-causing bacteria, or Neisseria meningitidis and Streptococcus pneumoniae, are commonly found at the back of the nose and throat of around 10% of adults. In many people, the bacteria causes no illness but if introduced to others via close contact it can lead to the serious and potentially fatal disease meningitis, an infection of the protective membranes or meninges surrounding the brain and spinal cord.

If not diagnosed and treated as a matter of urgency meningitis can very quickly lead to septicaemia (blood poisoning) and, tragically, death. Survivors can be left to live with severe disabilities resulting from limb amputation and nerve and organ damage.

According to PHE, babies under the age of one are most at risk of developing meningitis, with cases peaking at around five or six months, around the time that babies begin exploring the world by mouthing objects and touching the faces and noses of those who care for them. Cases of meningitis peak again between the ages of 14-24, when young people begin socialising in larger groups at college and university.

The new vaccine is expected to prevent around 4,000 cases of MenB in the UK among the under fives but experts are urging parents to remain vigilant as not all strains are currently covered by immunisations. Parents are currently offered a vaccination to protect against MenC, or meningococcal type C, at three months but this only covers this particular strain of meningitis. A vaccine to protect against the bacteria Streptococcus pneumoniae, which can lead to meningitis, is also given at two, four and around 12 months.

Dr Mary Ramsay, Head of Immunisation at Public Health England says: "This vaccine will help to save lives and prevent permanent disability. Meningococcal B disease can be devastating for babies and young children and it has cut many lives short and left young people disabled."

"Increased risk of fever"

Parents are already routinely given advice regarding post-immunisation fever, but PHE has said that the risk of fever is increased following the MenB vaccine, and is urging parents to purchase infant liquid paracetamol prior to their appointment.

Dr Ramsay, who stresses that Bexsero has a good safety record, adds: "The fever peaks around six hours after vaccination but is nearly always mild and gone within two days. The fever shows the baby’s body is responding to the vaccine, although the level of fever depends on the individual child and does not indicate how well the vaccine has worked: some infants may not develop a fever at all.

"We know that fever in young infants may cause some parents concern, but it’s important to be aware that it will be short-lived in nearly all cases. The vaccine will go on to help protect against MenB disease during a period when babies and young children are most at risk. We’ve all too often seen the disease result in severe disabilities, or tragically even death, causing devastation to our families and communities."

PHE says that giving paracetamol reduces the chances of fever by more than 50%, while simultaneously reducing any discomfort at the injection site.

Chief Executive of Meningitis Research Foundation, Christopher Head, says: "We are delighted the MenB vaccine has been introduced as it has been at the top of this charity’s agenda for many years. We hope this vaccine will save many lives and spare countless families the trauma of seeing a loved one die or become seriously disabled because of MenB."

Extra protection for teenagers

PHE is also rolling out a nationwide vaccination programme for adolescents with the introduction of the MenACWY vaccination.

The MenACWY vaccination, which protects against four strains commonly affecting this age group, is to be rolled out with immediate effect to teens between 17 and 18 years of age. All adolescents born between September 1 1996 and August 31 1997 will be offered the vaccination and those who plan to begin studying at university or college are urged to contact their GP to arrange vaccination before they leave if they have not already been contacted.

This is because this group is at increased risk of developing meningococcal disease as they begin mixing with large groups of new people, some of whom may be carrying the bacteria.

The vaccine is being introduced in response to an growing increase in cases of a highly aggressive strain of meningococcal disease, group W. Cases of MenW have increased from 22 cases in 2009 to 117 last year, and is currently responsible for around a quarter of all laboratory-confirmed meningococcal cases in England.

As well as MenW, the vaccination also offers protection againstthe strains A, C and Y and will eventually be rolled out to all 14-18 year olds.

Students up to and including the age of 25 will also be able to access the vaccination programme via their GP.

Professor John Watson, Deputy Chief Medical Officer at PHE, says: "Protecting young people as they embark upon one of the most important periods of their life is crucial, particularly when they are at risk of catching the potentially deadly meningococcal disease."

Sue Davie, Chief Executive of Meningitis Now, says of the MenACWY vaccination: "As a charity dealing with the consequences of the disease on a daily basis, I would plead directly to parents to make sure that their children gets the MenACWY vaccination. We are particularly concerned with those going to university or college in the autumn as they are at a higher risk from what has been called ‘freshers’ flu’.

"It is critical that young people are not complacent about the disease and they take the necessary steps to protect themselves, stay vigilant and seek urgent medical help if they suspect it.

"This is a cruel disease, it does not discriminate and could significantly alter the future outlook for young people if they are not protected or meningitis aware."

Signs of meningitis in babies and young children

  • High fever, although fever is often absent in babies aged under three months
  • Pale, blotchy skin
  • Cold hands and feet
  • Vomiting and refusing feeds
  • Diarrhoea
  • Agitation
  • Drowsiness and being floppy and unresponsive
  • Bulging fontanelle or soft spot
  • Rapid breathing or grunting
  • Unusual high-pitched or moaning cry
  • Arching back
  • Sensitivity to light

Later signs include a rash that does not fade when pressed or examined under a glass but experts stress that parents should not wait for a rash to appear before seeking medical assistance.

Not all children will display all of the above symptoms, which can appear in any order, and parents are urged to trust their instincts and to seek urgent medical attention as soon as they feel something is wrong.

Signs of meningitis in older children, adolescents and adults:

  • Fever
  • Cold hands and feet
  • Vomiting
  • Confusion and irritability
  • Drowsiness, difficult to wake
  • Severe muscle aches and pains
  • Pale, blotchy skin
  • Severe headache
  • Neck stiffness, or difficulty placing the chin to the chest
  • Sensitivity to light
  • Convulsions or seizures
  • A rash that does not fade under glass - the glass test.

Again, symptoms can appear in any order and not all people with meningitis will display all of the symptoms.

Prior to heading off to university, when teenagers are often away from home and therefore responsible for their own health for the first time, parents should educate their children on what signs to look out for in both themselves and also in their friends. This should include how to seek urgent medical advice by calling 111 if there is any cause for concern.

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