Tag: meningococcal vaccines

When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

Can you guess what happens when you ask for advice about vaccines in an anti-vaccine Facebook Group?

Meningitis is not a side effect of vaccines.

What could go wrong?

When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

While most of us are used to hearing about meningococcal meningitis being a big risk for teens and young adults, it is important to realize that rates of disease are also high for infants, with a second peak during adolescence.

The highest rates of meningococcal disease occurs during infancy and adolescence.

So why don’t we routinely vaccinate infants against meningococcal disease?

Many countries do, including Australia and the UK, and in the United States, high risk infants are vaccinated against meningococcal disease.

If you were on the fence but were advised by your paediatrician (Australian spelling) to get vaccinated and protected because a child in your town had just died, would you get vaccinated?

Or would you listen to folks in an anti-vaccine Facebook group who tried to convince you that meningitis was actually a side effect of getting vaccinated?

Folks who insist that deaths from vaccine-preventable disease aren’t real and that instead, they are actually vaccine-injuries?

This is the modern anti-vaccine movement.
This is the modern anti-vaccine movement.

We know what happens when you ask for vaccine advice in an anti-vaccine Facebook group. The members push their propaganda to scare you away from vaccinating and protecting your kids.

Don’t listen to them. Vaccines are safe and necessary.

More on When You Ask for Vaccine Advice in an Anti-Vaccine Facebook Group…

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

At What Age Should Kids Get a Meningococcal Vaccine?

Knowing when to give or get a vaccine doesn’t usually cause any confusion.

You simply have to check the immunization schedule.

Take the meningococcal vaccines, for example. Most parents and pediatricians understand that kids get them before entering middle school and again before going off to college. And some high risk kids should get them even earlier, as infants.

Simple, right?

At What Age Should Kids Get a Meningococcal Vaccine?

Actually, there are some things that make it a little more complicated than it should be…

Why?

  • some overnight and summer camps are actually starting to require a dose of meningococcal vaccine for younger kids, even though this is not a formal recommendation of the CDC or AAP
  • some parents might request a dose of meningococcal vaccine for younger kids going to overnight and summer camps, even though this is not a formal recommendation of the CDC or AAP
  • some folks are misunderstanding recommendations that campers be up-to-date on all immunizations as a recommendation that they get an early meningococcal vaccine
  • getting an early dose, before age 10 years won’t count as the middle school dose, and will need to be repeated
  • some states have very strict laws on timing, like that kids have to get their meningococcal vaccine before starting 6th grade, but only after they turn 11 years old, which creates a problem for those kids who start 6th grade before they are 11 years old
  • many folks don’t understand the recommendations for the MenB vaccines

What’s the answer?

It is not to skip or delay your child’s meningococcal vaccine, of course.

Older teens and young adults are at much higher risk of meningococcal disease than younger school age children.
Older teens and young adults are at much higher risk of meningococcal disease than younger school age children.

Instead, states should likely institute their meningococcal vaccine laws to require a dose before entering 7th grade, that way, most will have plenty of time to get it while they are in 6th grade. Or at least keep to the standard minimum age of 10 years for a dose to count towards middle school requirements.

What about a meningococcal vaccine for campers?

“In New York State, PHL Article 21, Title 6, Section 2167 also requires the notification of campers and parents about recommendations for and the availability of meningococcal vaccine for all campers attending overnight camps for a period of 7 or more consecutive nights. Meningococcal ACWY (MenACWY) vaccine is recommended at age 11 or 12 years, with a booster dose at age 16 years. Please note that the NYSDOH does not recommend that campers receive either dose of MenACWY vaccine before the recommended ages. Students who are vaccinated before the recommended ages may need to have the doses repeated in order to attend school.”

Recommended Immunizations for Campers

Unless they are in a high risk group, folks should likely stick to the standard ages of the immunization schedule to get their kids vaccinated.

And keep in mind that if your child does get an early dose, it won’t count as part of the routine series and will have to be repeated.

“Doses of quadrivalent meningococcal vaccine (either MPSV4 or MenACWY) given before 10 years of age should not be counted as part of the routine 2-dose series. If a child received a dose of either MPSV4 or MenACWY before age 10 years, they should receive a dose of MenACWY at 11 or 12 years and a booster dose at age 16 years.”

Ask the Experts Meningococcal ACWY

Talk to your pediatrician about an early dose if the extra coverage is important to you though. It will protect your child, but isn’t a general recommendation because younger kids have a lower risk for disease and vaccinating everyone likely wouldn’t impact disease rates that much.

Another situation in which getting an extra dose may be required is if you are traveling to a high risk part of the world. In this case, the extra dose is essential, even if it has to be repeated later.

More on Ages to Give Meningococcal Vaccines

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

Can Vaccines Cause Kawasaki Disease?

Kawasaki disease is rare and there is a good chance that you have never even heard of it, even though the first case was diagnosed in 1961.

Kids with this condition are typically irritable and can develop high fever, swollen glands in their neck, red eyes, red, cracked lips, red, swollen hands and feet, and a rash.

If you have heard of it, there is a good chance it is because anti-vaccine folks are using Kawasaki disease to scare you away from vaccinating and protecting your kids. Lately, talk about Kawasaki disease and the meningococcal B vaccines have been going around.

What Causes Kawasaki Disease?

Kawasaki disease is a type of vasculitis.

Kids who develop Kawasaki disease, who are typically under age 5 years, develop inflammation of their blood vessels, which leads to many of the symptoms and complications we see.

What causes this inflammation?

“Evidence suggests that Kawasaki disease may be linked to a yet-to-be identified infectious agent, such as a virus or bacteria. However, despite intense research, no bacteria, virus, or toxin has been identified as a cause of the disease.”

AAP on Kawasaki disease

We don’t know.

Can Vaccines Cause Kawasaki Disease?

Ask about Kawasaki disease if your child has a fever for five days and other symptoms of Kawasaki disease.
Courtesy of the kdfoundation.org

Because the cause of Kawasaki disease is unknown, that leads some folks to think that it could be vaccines.

Could it?

That vaccine clinical trial data sometimes finds a higher, although not statistically significant risk for Kawasaki disease, gets some of those folks thinking about it even more, except they don’t seem to think about the fact that the risk is never statistically significant.

But aren’t there case reports of kids getting Kawasaki disease after getting a hepatitis A, yellow fever, hepatitis B, or flu vaccine?

Yes, but getting a case report published about one patient who you think got Kawasaki disease soon after getting a vaccine isn’t strong evidence that it wasn’t a coincidence.

“Childhood vaccinations’ studied did not increase the risk of Kawasaki disease; conversely, vaccination was associated with a transient decrease in Kawasaki disease incidence. Verifying and understanding this potential protective effect could yield clues to the underlying etiology of Kawasaki disease.”

Abrams et al. on Childhood vaccines and Kawasaki disease, Vaccine Safety Datalink, 1996-2006.

And not surprisingly, several studies have shown that there isn’t any extra risk for Kawasaki disease after routine vaccines.

One even showed that getting vaccinated could be protective! Another benefit of vaccines and another reason you shouldn’t skip or delay your child’s immunizations.

What to Know About Vaccines and Kawasaki Disease

While anti-vaccine folks often list Kawasaki disease among their vaccine-induced diseases, several studies have shown that vaccines are not associated with Kawasaki disease, except to maybe have a protective effective if you are fully vaccinated.

More on Vaccines and Kawasaki Disease

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

Vaccines in Special Situations

In addition to getting routine vaccines, there are some special situations in which kids need extra vaccines or extra dosages of vaccines.

800px-infant_with_cochlear_implant
Children with a cochlear implant need the Pneumovax 23 vaccine.

Traveling out of the country and being pregnant are almost certainly the most common special situation when it comes to vaccines.

Vaccines for High Risk Conditions

Other special situations include children with high risk conditions, such as:

  • complement component deficiencies – Menveo or Menactra, MenB
  • chronic heart disease – PPSV23
  • chronic lung disease (not including asthma) – PPSV23
  • diabetes mellitus – PPSV23
  • CSF leaks – PPSV23
  • cochlear implants – PPSV23
  • chronic liver disease – PPSV23
  • cigarette smoking – PPSV23
  • sickle cell disease – PPSV23
  • congenital or acquired asplenia – Menveo or Menactra, PPSV23, MenB
  • congenital or acquired immunodeficiencies – PPSV23
  • HIV infection – PPSV23
  • chronic renal failure – PPSV23
  • nephrotic syndrome – PPSV23
  • leukemia – PPSV23
  • lymphoma – PPSV23
  • hodgkin disease – PPSV23
  • iatrogenic immunosuppression – PPSV23
  • solid organ transplant – PPSV23
  • multiple myeloma – PPSV23

In general,  the 23-valent pneumococcal polysaccharide vaccine, PPSV23 or Pneumovax 23, should be given when a high risk child is at least 2 years old and at least 4 weeks after their last dose of Prevnar 13. Some will need an additional booster dose of Pneumovax 23 after five years.

Remember, most children routinely get 4 doses of Prevnar 13 when they are 2, 4, 6, and 12-15 months old.

And while most kids just get one dose of PPSV23, others, especially those with any type of immunosuppression, get a repeat dose every five years.

Getting Revaccinated

Are there ever situations when kids need to get revaccinated?

While it might be hard to believe, there are more than a few reasons that kids get revaccinated.

The most obvious is when kids lose their vaccine records, although checking vaccine titers might help avoid repeating some or all of your child’s vaccines.

Children who have had a hematopoietic cell transplant (HCT) should routinely get revaccinated:

  • starting with inactivated vaccines six months after the transplant, including a 3-dose regiment of Prevnar 13, followed by PPSV23, a 3-dose regiment of Hib, and a yearly flu shot and other inactivated vaccines
  • continuing with a dose of MMR 24 months after the transplant if they are immunocompetent and possibly the chicken pox vaccine

Children who are adopted in a foreign country also often need to repeat all or most of their vaccines. Again, titers can often be done to avoid repeating doses.

Other Special Situations

Other special situations in which your child might need to get vaccinated off the standard immunization schedule might include:

  • missing one or more vaccines and needing to catch-up
  • getting exposed to rabies (cats, dogs, raccoons, skunks, bats, foxes, and coyotes)
  • having a wound that is not considered clean and minor (usually “wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite”) if it has been more than five years since their last dose of tetanus vaccine (or a clean and minor wound and it has been more than 10 years)
  • getting exposed to chicken pox (or shingles) or measles and not being fully vaccinated (two doses of the chicken pox and two doses of the MMR vaccines) or naturally immune, as a vaccine within 72 hours may decrease their risk of getting sick

Do your kids have a medical condition that might put them at high risk for a vaccine-preventable disease?

Do they need a vaccine that other kids don’t routinely get?

For More Information on Vaccines in Special Situations

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