Meningitis and the Meningitis vaccine - What you should know

Meningococcal disease

What is it?

Meningococcal disease is a bacterial infection caused by the bacteria Neisseria meningitidis (N. meningitidis).¹ There are thirteen identified types (serogroups) of N. meningitidis or meningococci,² with six causing epidemics resulting in invasive meningococcal disease. Meningitis is the most common form of invasive meningococcal disease, accounting for about 75 percent of all cases.

Symptoms of meningitis usually appear between three and seven days after exposure to the meningococcal bacteria. At first, symptoms may appear mild and similar to cold or flu symptoms, such as headache, fever, aches, and pains. As the illness progresses, additional symptoms may arise, including skin rash, severe headache, stiff neck, nausea, vomiting, inability to look at bright lights, mental confusion and irritability, extreme fatigue/sleepiness, convulsions, and unconsciousness. In babies, symptoms may include a high-pitched moaning cry, difficulty or refusal to feed, and bulging of the fontanel (the soft area on the top of the head).¹

Rates of meningococcal disease

According to the CDC²

Rates of meningococcal disease have declined in the United States since the 1990s and remain low. In 2019, there were about 375 total cases of meningococcal disease reported (incidence rate of 0.11 cases per 100,000 persons). Anyone can get meningococcal disease, but rates of disease are highest in children younger than 1 year old, with a second peak in adolescence. Among adolescents and young adults, those 16 through 23 years old have the highest rates of meningococcal disease.

Meningitis vaccine

There are currently seven FDA licensed meningococcal vaccines in the U.S. However, two vaccines, Menactra and Menomune, are no longer produced. In total, these vaccines target five of the 13 meningococcal serotypes. Menveo, MenQuadfi, and PENBRAYA are conjugate vaccines that target serogroups A, C, Y and W-135.8 BEXSERO and TRUMENBA are recombinant vaccines that target serogroup B.

The CDC recommends that children 11 to 12 years of age receive the first dose of ACWY meningococcal vaccine conjugate, and a booster dose at age 16. For individuals at age 16 or older, vaccines for all currently available serogroups (A, C, W, Y and B) are recommended by the CDC. The CDC also recommends that high risk children between 2 months and 10 years and high-risk adults be vaccinated with meningococcal conjugate vaccine.³

NVIC’s Quick Facts

Meningococcal

What it is:⁴

Meningococcal disease is a serious and potentially life-threatening infection caused by the bacteria Neisseria meningitides. Most frequently, the illness can result in inflammation of the meninges of the brain (meningitis) and a serious bloodstream infection (septicemia/meningococcemia). Invasive meningococcal disease can also present as arthritis and pneumonia.

Not easily spread:

Meningococcal disease is not easily spread and requires one to be susceptible to the infection and to have regular close contact with a person who is colonizing the bacteria. Between 10-20 percent of individuals are asymptomatic carriers and colonize the bacteria that causes meningococcal disease in the back of their throats.

Natural community immunity:

Natural community immunity contributes significantly to low disease incidence. Research shows that about 20 to 40 percent of Americans are asymptomatically colonizing meningococcal organisms in their nasal passages and throats.¹²¹³ ¹⁴This colonization boosts an individual’s innate immunity to invasive meningococcal infection throughout life.¹⁵ The CDC has recognized high levels of innate community immunity and noted that the majority of Americans will experience asymptomatic infection as children or young adults without complications and develop protective bactericidal antibodies against meningococcal disease.¹⁶ ¹⁷

Low rates in the U.S.:

Meningococcal rates are low in the U.S. and have steadily declined since the 1990’s. In 2020, there were approximately 235 cases in the U.S. Of these cases 26 percent were unknown and ungroupable serotypes with 20 percent occurring in children too young to be vaccinated. For 2020, 23 death were reported, or less than ten percent of cases.¹⁸ Individuals most at risk for contracting meningococcal disease are infants, adolescents, young adults and seniors.

Meningitis Vaccine

Adverse effects

The CDC states that individuals receiving meningococcal vaccines may experience mild side effects such as pain or redness at the injection site, headache, fatigue, muscle and joint pain, fever, chills, nausea, and diarrhea. Additionally, the CDC warns that persons receiving any vaccine may collapse (faint), experience a severe allergic reaction, and even serious injury and death. Serious adverse events associated with meningococcal vaccines include anaphylaxis, wheezing, upper airway swelling, difficulty breathing, hypotension, itching, hives, lymph node swelling, Guillain-Barre syndrome, convulsions, facial palsy, vasovagal syncope, paresthesia, transverse myelitis, acute disseminated encephalomyelitis, extensive swelling of the injected limb and injection site.

Meningitis B vaccine not routinely recommended

Meningococcal B vaccines have not been given a routine recommendation by the CDC due to several factors. These factors included the high number of vaccinations that would be required to prevent a single case of the disease, low rates of disease, cost of the vaccine, lack of efficacy and safety data, and the possibility of serious adverse vaccine reactions exceeding the number of cases prevented.

In 2020, 85.7 percent of college students (18-24 years) and 69.2 percent of persons not attending college (18-24 years) had received at least one dose of MenACWY vaccine. For this same age group and college status, 14.3 percent of college students and 18.2 percent of persons not attending college had received at least one dose of MenB vaccine.

Meningitis vaccine can cause meningitis

In a paper in the journal Neurology, study authors have found evidence from VAERS and the FDA that the vaccine can cause meningitis.⁵

Treatment

Bacterial meningitis can be treated with several different antibiotics.⁶ Readers should be aware that the antibiotic ciprofloxacin, which is sometimes recommended for meningitis, is part of the fluoroquinolone family of antibiotics that carry a black box warning. Their use has been proscribed for certain infections.

Fluoroquinolones are antibiotics that kill or stop the growth of bacteria. While these drugs are effective in treating serious bacterial infections, an FDA safety review found that both oral and injectable fluroquinolones are associated with disabling side effects involving tendons, muscles, joints, nerves and the central nervous system. These side effects can occur hours to weeks after exposure to fluoroquinolones and may potentially be permanent.⁷

Prevent & Manage Meningitis Symptoms 5 Natural Ways provides a comprehensive overview of the different types of meningitis.

Feature image by Arek Socha from Pixabay

Footnotes[+]

↑1	“Meningococcal and Meningococcal Vaccine Information – National Vaccine Information Center (NVIC).” Meningococcal and Meningococcal Vaccine Information – National Vaccine Information Center (NVIC), www.nvic.org/disease-vaccine/meningitis.
↑2, ↑6	“Meningococcal Disease: Technical and Clinical Information.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 Feb. 2022, www.cdc.gov/meningococcal/clinical-info.html.
↑3, ↑4	See footnote 1.
↑5	Sheikh, Zubeda, et al. “Meningitis after Vaccination in United States, a Report from the CDC/FDA Vaccine Adverse Event Reporting System [1990–2010] (P03.243) \| Neurology.” Neurology, 23 Apr. 2012, n.neurology.org/content/78/1_Supplement/P03.243.
↑7	“FDA Updates Warnings for Fluoroquinolone Antibiotics.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/press-announcements/fda-updates-warnings-fluoroquinolone-antibiotics.