Tag: meningitis vaccines

Is the Meningococcal Vaccine More Dangerous Than Meningococcal Disease?

No one who has ever seen a child with meningococcal disease would ever think that it was even remotely possible that getting a meningococcal vaccine was more dangerous than getting the disease.

“The case-fatality ratio of meningococcal disease is 10% to 15%, even with appropriate antibiotic therapy. The case-fatality ratio of meningococcemia is up to 40%. As many as 20% of survivors have permanent sequelae, such as hearing loss, neurologic damage, or loss of a limb.”

Epidemiology of Vaccine Preventable Diseases (PinkBook)

Of course, that doesn’t stop anti-vaccine folks from spreading misinformation about these vaccines to try and scare parents away from vaccinating and protecting their kids.

Is the Meningococcal Vaccine More Dangerous Than Meningococcal Disease?

We actually vaccinate against meningitis with many different vaccines, including Hib, Prevnar, MMR, and the meningococcal vaccines.

And there are different types of meningococcal vaccines, including those that protect against Neisseria meningitidis serogroups A, C, W, Y and Men B.

Meningococcal vaccines are safe and effective against meningococcemia and meningococcal meningitis, both terrible diseases.
Meningococcal vaccines are safe and effective against meningococcemia and meningococcal meningitis, both terrible diseases.

So routine vaccinations likely prevent up to 500 meningitis deaths each year, just in the United States, including many deaths from Hib meningitis, pneumococcal meningitis, and meningococcal disease.

“During 2005-2011, an estimated 800-1,200 cases of meningococcal disease occurred annually in the United States, representing an incidence of 0.3 cases per 100,000 population.”

Epidemiology of Vaccine Preventable Diseases (PinkBook)

What about the idea that 1 in 100 people will have a serious reaction to the vaccine?

“The most frequently reported adverse events for MenACWY-D include fever (16.8%), headache (16.0%) injection site erythema (14.6%), and dizziness (13.4%). Syncope was reported in 10.0% of reports involving MenACWY-D. Of all reported MenACWY-D events, 6.6% were coded as serious (i.e., resulted in death, life-threatening illness, hospitalization, prolongation of hospitalization, or permanent disability). Serious events included headache, fever, vomiting, and nausea. A total of 24 deaths (0.3%) were reported.”

Epidemiology of Vaccine Preventable Diseases (PinkBook)

The serious events listed above were from the clinical trials for the vaccine and didn’t differ between the vaccine and placebo.

Although meningococcal vaccines can have frequent mild side effects, they very rarely have serious side effects.

Not everything that happens during a clinical trial is related to the vaccine, even though it still gets reported. Another Menactra trial reported no deaths and the serious adverse events that were reported weren’t related to getting vaccinated.

Here is another meningococcal study in which a few of the participants died – one in a car accident and the other a drug overdose.

These deaths were not related to getting vaccinated, but were listed because they occurred during the study.
These deaths were not related to getting vaccinated, but were listed because they occurred during the study.

Unfortunately, vaccines can’t protect you from everything…

It would be especially nice if they could protect us from bad anti-vaccine memes.

More on Meningococcal Vaccine Safety

Is Meningitis a Side Effect of Vaccines?

Most folks know that there are several meningitis vaccines.

Hib, Prevnar, MMR, and the meningococcal vaccines, for example, all protect folks against meningitis.

Is Meningitis a Side Effect of Vaccines?

So why would some people think that vaccines could actually cause meningitis?

Is meningitis listed on the package insert of any vaccines?
Is meningitis listed on the package insert of any vaccines?

Meningitis is listed as a possible adverse event in the package insert of some vaccines, but only in the section that includes spontaneously reported data from post-marketing experience, where it “may not be possible to reliably estimate their frequency or establish a causal relationship to vaccine exposure.”

It is just like when folks find autism or SIDS in a vaccine’s package insert and think that it is evidence that vaccines are associated with autism or SIDS.

SIDS and autism are listed in Tripedia package insert, but are not causally linked to the vaccine.
SIDS and autism are listed in Tripedia package insert, but are not causally linked to the vaccine.

It isn’t.

These adverse reactions are listed “because of the seriousness OR frequency of reporting.” They are not included because they are serious AND frequent, as some anti-vaccine sites like to proclaim.

How Could a Vaccine Cause Meningitis?

When you think about it, how could a vaccine actually cause someone to develop meningitis?

Why would you even think this is true?

Meningitis is typically caused by a virus, bacteria, parasite, or fungus, etc.

While a live virus vaccine might rarely be able to cause an infection, few of the meningitis vaccines are live virus vaccines. Prevnar, Hib and the meningococcal vaccines are all sub-unit vaccines. Since only a part of bacteria (antigens) is actually present in the vaccine, it is not possible for them to cause an infection.

What about the live virus vaccines, like MMR, chicken pox, and rotavirus?

Since these viral infections rarely cause meningitis, except for mumps, you wouldn’t expect the rare vaccine induced infection to cause meningitis either. A natural measles infection, for example, is more likely to cause encephalitis instead.

“…there is no evidence to link Jeryl Lynn mumps vaccine to aseptic meningitis.”

MMR Package Insert

What about the chicken pox vaccine? There is a case report of a vaccinated child who later developed shingles and meningitis, caused by vaccine strain chicken pox virus. He recovered fully and it is important to note that folks with natural chicken pox are thought to be even more likely to develop shingles, and they too can develop meningitis.

The bottom line is that if someone has meningitis, even if they were recently vaccinated, you shouldn’t be blaming the vaccines.

Like they do with VAERS reports, misusing package inserts is a common method that anti-vaccine folks use to scare parents away from vaccinating and protecting their kids.

What to Know About Meningitis and Vaccine Package Inserts

Although included in some vaccine package inserts, except for rare circumstances with some live virus vaccines, none actually claim that vaccines cause meningitis.

More on Meningitis and Vaccine Package Inserts

Grave Reminders of Life Before Vaccines

Need a reminder of just how serious vaccine preventable diseases can be?

Don’t remember the pre-vaccine era?

That could be why some folks are so quick to think that skipping or delaying vaccines is a safe option for their kids.

Vaccines are necessary.

Without them, we will see even more outbreaks of measles, mumps, and pertussis and kids will continue to die of rabies, tetanus, and other now vaccine-preventable diseases.

The South Park Cemetary was begun in 1891 during a diphtheria epidemic.
A diphtheria cemetery in Wyoming.

Isolation hospitals and pest houses were commonly used to quarantine folks with smallpox.
Isolation hospitals and pest houses were commonly used to quarantine folks with smallpox and other now vaccine-preventable diseases.

Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over...
Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over…

People continued to die of smallpox well into the 20th century, even though an effective vaccine was developed in 1796.
People continued to die of smallpox well into the 20th century, even though an effective vaccine was developed in 1796.

In the pre-vaccine era, we had outbreaks of polio, and other, now vaccine-preventable diseases.
Outbreaks of polio would once isolate entire towns, as parents feared their kids would get sick too.

Fight Polio Poster
When was the last time you saw a child with polio?

Before wide use of the Hib and Prevnar vaccines, infants with fever would routinely get spinal taps and you would hope for clear fluid (cloudy fluid could be a sign of a bacterial infection).
Before wide use of the Hib and Prevnar vaccines, younger infants with fever would routinely need spinal taps and you would hope for clear fluid (cloudy fluid could be a sign of a Hib or Strep pneumo infection).

In the pre-vaccine era, Hib caused epiglottitis, meningitis, and pneumonia - all life-threatening diseases that are now prevented by the Hib vaccine.
In the pre-vaccine era, Hib caused epiglottitis, meningitis, and pneumonia – all life-threatening diseases that are now prevented by the Hib vaccine.

Before the 1990s, when the Hib vaccine available, hospitals had an epiglottitis team on call and always available.
Before the 1990s, when the Hib vaccine available, hospitals had an epiglottitis team on call and always available.

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
In 1885, several boys from Newark went all of the way to Paris to get Pasteur’s new rabies vaccine, as the disease had always been fatal up until that time.

Even if they survive, kids can lose fingers, toes, or even arms and legs to meningococcemia.
Even if they survive, kids can lose fingers, toes, or even arms and legs to meningococcemia.

Roald Dahl's daughter died of measles in 1962, the year before the development of the first measles vaccine.
Roald Dahl’s daughter died of measles in 1962, the year before the development of the first measles vaccine.

Nationwide, at least 123 people died in the United States during a large measles epidemic from 1989 to 1991, during a time that we had good sanitation, nutrition, and medical care.
Nationwide, at least 123 people died in the United States during large measles epidemics from 1989 to 1991, a time when we had good sanitation, nutrition, and medical care, but some folks weren’t vaccinated and we weren’t yet giving a second dose of MMR.

A papilloma caused by HPV on the vocal cords of a child with recurrent respiratory papillomatosis.
A papilloma caused by HPV on the vocal cords of a child with recurrent respiratory papillomatosis. (CC BY 4.0)

You don't have to go back to the pre-vaccine era to know that pertussis kills.
You don’t have to go back to the pre-vaccine era to know that pertussis kills. Ten infants died in 2010 in California from pertussis infections.

We should never forget what life was like before vaccines.

We should know that vaccine-preventable diseases were rarely mild, natural immunity comes at a cost, and that those who died from smallpox, diphtheria, measles, and polio aren’t around to talk about their experiences on Facebook (survivorship bias).

We should never forget that vaccine-preventable diseases were once big killers, and the only reason some folks have grown to fear the side effects of vaccines more than the diseases they prevent, is because we don’t see those diseases very much any more. If more people skip or delay getting vaccinated, we will though.

immunization-program-stages
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

Vaccines are safe and vaccines work.

Get vaccinated and protected.

Outbreaks of vaccine-preventable diseases belong in the past.

What to Know About Life Before Vaccines

Forgetting the pre-vaccine era and the benefits of vaccines makes folks susceptible to anti-vaccine talking points and scares them away from vaccinating and protecting their kids.

More on Remembering Life Before Vaccines

Meningitis Vaccines

Meningitis is classically defined as an inflammation of the membranes that cover the brain and spinal cord.

Infections that can cause meningitis include:

  • viruses – also called aseptic meningitis, it can be caused by enteroviruses, measles, mumps, and herpes, etc.
  • bacteria – Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Haemophilus influenzae type b (Hib), Group B strep
  • a fungus – Cryptococcus, Histoplasma
  • parasites – uncommon
  • amebas – Naegleria fowleri

There are even non-infectious causes of meningitis, including the side-effects of medications and certain systemic illnesses.

Meningitis Vaccines

Teens and young adults need two different kinds of meningococcal vaccines to get full protection.
Teens and young adults need two different kinds of meningococcal vaccines to get full protection.

Fortunately, many of these diseases that cause meningitis are vaccine-preventable.

You don’t often think about them in this way, but all of the following vaccines are available to prevent meningitis, including:

  • Hib – the Haemophilus influenzae type b bacteria was a common cause of meningitis in the pre-vaccine era, in addition to causing epiglottitis and pneumonia
  • Prevnar – you mean it’s not just an ear infection vaccine?
  • MMR – both measles and mumps can cause meningitis
  • Menactra and Menveo – serogroup A, C, W, Y meningococcal vaccines
  • Bexsero and Trumenba – serogroup B meningococcal vaccines

But just because your child has been vaccinated doesn’t mean that you are in the clear if they are exposed to someone with meningitis. They might still need preventative antibiotics if they are exposed to someone with Hib or meningococcal meningitis.

Still, getting fully vaccinated on time is the best way to prevent many of these types of meningitis and other life-threatening diseases.

What to Know About Meningitis Vaccines

Learn which vaccines are available to provide protection against bacterial and viral meningitis.

More on Meningitis Vaccines

What to Do If Your Child Is Exposed to Meningitis

Meningitis is classically defined as an inflammation of the membranes that cover the brain and spinal cord, and it can be caused by:

  • viruses – also called aseptic meningitis, it can be caused by enteroviruses, measles, mumps, and herpes, etc.
  • bacteria – Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, Haemophilus influenzae type b (Hib), Group B strep
  • a fungus – Cryptococcus, Histoplasma
  • parasites – uncommon
  • amebas – Naegleria fowleri

Surprisingly, there are even non-infectious causes of meningitis. These might be include side-effects of a medication or that the child’s meningitis is a part of another systemic illness.

What to Do If Your Child Is Exposed to Meningitis

While meningitis can be contagious, it greatly depends on the type of meningitis to which they are exposed as to whether or not your child is at any risk.

Teens and young adults need two different kinds of meningococcal vaccines to get full protection.
Teens and young adults need two different kinds of meningococcal vaccines to get full protection.

So while the general advice is to “tell your doctor if you think you have been exposed to someone with meningitis,” you should try and gather as much information as you can about the exposure.

This information will hopefully include the type of meningitis they were exposed to, specifically if it was bacterial or viral, the exact organism if it has been identified, and how close of an exposure it was – were they simply in the same school or actually sitting next to each other in the same room.

For example, while the CDC states that “people who are close contacts of a person with meningococcal or Haemophilus influenzae type b (Hib) meningitis are at increased risk of getting infected and may need preventive antibiotics,” they also state that “close contacts of a person with meningitis caused by other bacteria, such as Streptococcus pneumoniae, do not need antibiotics.”

And you often don’t need to take any preventive measures if you are exposed to someone with viral meningitis.

While that might sound scary, it is basically because you typically aren’t at big risk after this kind of exposure. You could get the same virus, but the chances that it would spread and also cause meningitis are very unlikely.

Not only does Viera Scheibner think that vaccines cause SIDS and shaken baby syndrome, she thinks they are contaminated with amoeba.
The Naegleria fowleri ameba that can cause meningitis can be found in warm freshwater, including lakes and rivers.

Other types of meningitis, like primary amebic meningoencephalitis (PAM) and fungal and parasitic meningitis aren’t even contagious.

The Histoplasma fungus spreads from bird or bat droppings, for example, not from one person to another.

And parasites typically spread from ingesting raw or undercooked food, or in the case of Baylisascaris procyonis, from ingesting something contaminated with infectious parasite eggs in raccoon feces.

What to Do If Your Unvaccinated Child Is Exposed to Meningitis

Vaccines can prevent a number of different types of meningitis.

From Hib and Prevnar to MMR and the meningococcal vaccines, our children routinely get several vaccines to prevent meningitis.

While these meningitis vaccines don’t protect us from all of the different types of viruses, bacteria, and other organisms that can cause meningitis, they do prevent many of the most common.

So what do you do if your unvaccinated child is exposed to meningitis?

You should immediately call your pediatrician or local healthy department, because they might need:

  • antibiotics (usually rifampin, ciprofloxacin, or ceftriaxone) if the meningitis was caused by Neisseria meningitidis
  • antibiotics (rifampin) if the meningitis was caused by Haemophilus influenzae type b (Hib)

The availability of these antibiotics isn’t a good reason to skip or delay getting vaccinated though, as you won’t always know when your kids have been exposed to meningitis and not all types of vaccine-preventable meningitis can be prevented with antibiotics.

Of course, getting fully vaccinated on time is the best way to prevent many of these types of meningitis and other life-threatening diseases.

What to Do If Your Vaccinated Child Is Exposed to Meningitis

Even if your child is vaccinated, they might still need preventative antibiotics if they are exposed to someone with Hib or meningococcal meningitis, as vaccines are not 100% effective.

“Regardless of immunization status, close contacts of all people with invasive meningococcal disease , whether endemic or in an outbreak situation, are at high risk of infection and should receive chemoprophylaxis.”

AAP Red Book on Meningococcal Infections

This is especially true if they are not fully vaccinated.

Remember, to be fully vaccinated against Haemophilus influenzae type b, kids get a 2 or 3 dose primary series of the Hib vaccine when they are infants and a booster dose once they are 12 months old.

In the case of exposure to Hib meningitis, antibiotic prophylaxis would be recommended if:

  • the child is fully vaccinated, but there is a young child, under age 4 years, in the house who is unvaccinated or only partially vaccinated
  • the child is fully vaccinated, but there is another child in the house who is immunocompromised
  • the child is only partially vaccinated and under age 4 years
  • there is an outbreak in a preschool or daycare, with 2 or more cases within 60 days

And anyone exposed to someone with meningococcal meningitis should likely get antibiotics (chemoprophylaxis), even if they are fully vaccinated.

Talk to your pediatrician or local health department if your child is exposed to meningitis and you aren’t sure what to do, whether or not your child has been vaccinated.

What to Know About Getting Exposed to Meningitis

Learn what to do if your child is exposed to someone with meningitis, especially if they are unvaccinated, or have been exposed to someone with Hib meningitis or meningococcal disease.

More on Getting Exposed to Meningitis