Routine MeNZB™ vaccination programme ends
Background
The Meningococcal B Immunisation programme was designed to help control an epidemic of a New Zealand specific strain of meningococcal B disease. The MeNZB™ vaccine was used successfully as a circuit breaker, preventing cases of meningococcal disease during the epidemic. Disease rates are now at the lowest level in a decade, and the Ministry of Health has advised that there is no longer a need for mass immunisation. Routine immunisation for children under 5 years old will finish 1st June 2008. There will still be cases of both meningococcal B and other forms of meningococcal disease that continue to occur, likely for many years to come. Parents and health professionals will have to remain vigilant for the worrying signs in unwell children and seek medical help immediately if concerned. My child has already started the MeNZB™ vaccine course, should I finish it?
Yes, a child may complete a course of MeNZB™ vaccine and is encouraged to do so before 31 December 2008, although the vaccine will still be available and funded through the family doctor after that date. The MeNZB™ vaccine will still be available if a parent of a child or young person up to 19 years of age requests it, and the doctor thinks the child or young person is at risk. What do I need to do now about meningococcal disease?Even though epidemic strain disease rates are low, the disease is still present. The MeNZB™ vaccine protects against the strain of meningococcal B causing the epidemic, but it will not protect against other strains and no vaccine is 100 per cent effective. This is why you still need to watch out for the signs and symptoms of this disease, and seek medical help immediately if you are concerned. What is meningococcal disease?Meningococcal disease is a bacterial infection. It causes severe illnesses including meningitis (an infection of membranes that cover the brain) and septicaemia (blood poisoning). There are several strains of bacteria which cause meningococcal disease including A, B and C. MeNZB™ vaccine was developed to protect against the strain of meningococcal B causing the New Zealand epidemic. What are the symptoms of Meningococcal disease?In the early stages meningococcal disease may look like influenza. It can progress quickly and can be difficult to diagnose.
A baby or child might have a fever;
- be crying or unsettled
- refuse drinks or feeds
- vomit
- be sleepy, floppy or hard to wake
- dislike bright lights
- have a rash or spots.
An adult may have:
- a fever or headache
- a stiff neck, joint pain or aching muscles
- may vomit, be sleepy, confused, delirious or unconscious
- dislike bright lights
- have a rash or spots.
Should giving MeNZB™ be avoided at the same visit as the PCV7 (Prevenar®) vaccine?
There have been no clinical studies giving MeNZB™ vaccine at the same time as PCV7 (Prevenar®), however there are no problems anticipated, either in the immune response or safety. The introduction of the pneumococcal vaccine Prevenar® from the 1st June 2008 has been an opportunity to review MeNZB™ vaccine as a routine mass immunisation.
It is best to discuss with your Nurse or Doctor if you would like your child to have MeNZB™ and Prevenar® as they are familiar with the recommended prescribed timing of childhood vaccines. How effective is the MeNZB™ vaccine? The effectiveness of the MeNZB™ programme has been monitored through its effect on disease incidence. A regression model has estimated that MeNZB™ vaccination produced an 73% (95% CI = 52% - 85%) reduction in the incidence of meningococcal disease in vaccinated people (Ameratunga S et al, 2005). It is known internationally that these vaccines do not have long lasting duration of action. Data from the MeNZB™ trials have shown that the detectable duration of immunity post-vaccination is measured in months rather than years.
How safe is MeNZB™ vaccine?
MeNZB™ and closely related vaccines have undergone extensive trials before being used widely in New Zealand. There has also been on-going safety follow-up and reporting that showed there are no concerns with the vaccine’s safety. The vaccine does cause a sore arm, sometimes with redness and swelling and some children have a fever, rash or are irritable after immunisation. While concerning at the time, these expected responses resolve on their own without any long-term effect. Very rarely, a child may be severely allergic so, like any vaccine, MeNZB™ should always be given under medical supervision. Is the MeNZB™ vaccine still available for certain occupational groups?
Yes, the MeNZB™ vaccine will still be available for microbiologist and laboratory workers. See the Immunisation Handbook 2006, page 301 (Ministry of Health 2006). Is the MeNZB™ vaccine still available for certain high-risk groups? Yes, the vaccine will still be available for individuals of any age with a high risk of invasive meningococcal infection and specific conditions (three doses of MeNZB™ vaccines at six-week intervals). Specific conditions include: - actual or functional asplenia (Individuals scheduled for MeNZB™ vaccine pre-splenectomy will need to have completed their MeNZB™ vaccine course (all three doses) at least four weeks before the scheduled operation date).
- sickle cell anaemia
- deficiencies of the terminal complement components.
- individuals with HIV infection, who may be safely immunised with meningococcal polysaccharide vaccines.
See 2008 National Immunisation Schedule Health Providers Booklet, (Ministry of Health, May 2008). Will ongoing surveillance of Meningococcal Disease continue?
The Ministry of Health will continue to monitor meningococcal disease. Even though meningococcal B epidemic strain disease rates are low, the disease is still present. The MeNZB™ vaccine protects against the strain of meningococcal B causing the epidemic, but it will not protect against other strains. This is why New Zealanders should be reminded to watch out for the signs and symptoms of this disease, and seek medical help immediately if they are concerned. Health practitioners need to be aware of the risk of meningococcal disease in individuals presenting with illness particularly young children. For more detail on various aspects of MeNZB™ vaccine talk to your Nurse or Doctor. A free phone line is available to discuss questions: Phone : 0800 466 863 (0800 IMMUNE) for in depth information on the science of immunisation & MeNZB™ Or go to :
The consumer medicine information sheet at http://www.medsafe.govt.nz/Consumers/cmi/m/menzb.htm
Ministry Of Health website: http://www.immunise.moh.govt.nz - Summary of Considerations for MeNZB Cessation
- Ministry of Health information
MeNZB™ ImmunisationMeNZB™ vaccine continues to be available for those who need to complete their doses, those at high risk, and for children of parents who are concerned and the doctor thinks they are at-risk. Doses:- For babies starting immunisation at 6 weeks of age four doses are given at: 6 weeks, 3 months, 5 months and 10 months of age.
- For older children starting MeNZB™ immunisation at 6 months of age or older only three doses are needed, given 6 weeks between each dose
Rationale:Babies are the group at highest risk of catching meningococcal group B disease. The risk for an under six-month-old infant is similar to the risk of an infant aged six to 12 months old. However children under 12 months old have twice the risk of contacting meningococcal disease compared to the second most vulnerable group, children aged 1 to 4 years old.
It takes time to build immune protection so delaying starting means the infant is at risk from the disease for longer than necessary. Infants immunised with MeNZB™ before age 6 months do have lower initial antibody rises than older children, so even though their protection is building it can be improved further by a 4th dose given at 10 months of age (or four months after the third dose). The data on the administration of a fourth MeNZB™ vaccine shows a clear improvement in response rate for babies and is recommended for this age group by the Ministry of Health.
School Programme
The immunisation programme in schools has finished throughout the country now.
Before deciding about MeNZB™ immunisation parents are given a 3 page consent form which details key information about; the disease, the vaccine, possible side effects and the expected protection. It is important to remember that no immunisation is 100% effective for every person and there are other, less common types of meningococcal disease in New Zealand that this vaccine won’t protect against. Parents are always reminded to stay alert for signs & symptoms of danger. Generally when making informed decisions we seek advice from people & places whose opinion and expertise we value. Some parents ask for much more information than is contained in the 3-page consent form and others may need more information even as new questions arise. It is important that information about our children’s health comes from evidence-based sources and is available when we need it. For more detail on various aspects of MeNZB™ vaccine click on the links below. Latest news: Media/Press releases |
