My daughter was away when the school gave out the meningitis shot. Should I take her to our family doctor for it? What are the risks if I don’t, and how would I know the symptoms if she contracts it?
A. A Cautionary Tale
Invasive meningococcal disease is a persistent global health problem. It comes on very quickly and has rapid progression. It has high illness (morbidity) and death (mortality), despite the fact we have effective therapies. Symptoms include headache, fever, stiff neck, light sensitivity (photophobia), altered consciousness, (lethargy or hyperactivity), rashes and seizures. The bacteria are spread through aerosol (like a sneeze or cough), secretions and person-to-person contact. It is why adolescents in crowded environments such as schools are at increased risk.
The serious illness or morbidity associated with this disease includes loss of limbs, hearing loss, lung damage, speech disorders, mental retardation, paralysis, psychological disorders and seizures.
The bacterium N. Meningitidis that causes the disease has what are called different serogroups that are responsible for causing illness. These groups are called A, B, C, Y and W-135. Serogroup C is the major cause of disease in both Europe and America. It is the serogroup that is offered in the immunization programs across the country. Almost fifty percent of cases of meningitis occur between ages five and 24. It is why the vaccine is introduced in childhood. It is why your school offers the catch-up program for those who were not immunized in childhood.
Meningococcal C conjugate vaccine against meningitis was approved for use in Canada in 2001. The National Advisory Committee on Immunization recommends the vaccine for ALL children under five years, adolescents and young adults. Routine vaccines have been introduced in all jurisdictions in Canada. For those children who were not vaccinated in childhood, the vaccine is offered in many school settings.
Among the goals of vaccination, according to the Public Health Agency of Canada, are:
- Prevention of N. meningitides serogroup C in those under 25 by 2015. Achieve and sustain a 95 percent reduction in this disease in adolescents aged 12 to 19 by 2010.
- Achieve and maintain age-appropriate immunization coverage with meningococcal C conjugate vaccine in 97 percent of children by their second birthday by 2010.
- Achieve and maintain immunization of 97 percent of adolescents by their 17th birthday in 2010.
The current vaccines available in Canada are the conjugate vaccines that are currently used in the childhood vaccine programs. These cover serogroup C that is the most common of the vaccine-preventable serogroups that cause disease here in Canada. Menactra is a conjugate vaccine that covers A, C, Y and W-135. It can be used from ages two to 55. Conjugated vaccines have immune memory. They have a high immune response, which means antibodies against the bacteria develop and those antibodies will persist. Menomune is a polysaccharide vaccine that covers A, C, Y and W-135 that is usually used for travel and high-risk populations but is not used for routine childhood immunization in Canada.
The most common side effects include pain at the injection site, drowsiness, headache, irritability and fatigue.
As a physician and a parent, I support the NACI guidelines and would encourage you to have your child immunized against this devastating disease. As always, speak with your physician.