Meningococcal disease is caused by the bacterium Neisseria meningitidis. At least 12 groups have been identified, including groups A, B, C, X, Y and W. The pattern of disease caused by each group varies by time and country or geographical areas.groups have been identified, including groups A, B, C, Y and W. In New Zealand from 2015 to 2017, groups B and C were the most frequent causes of meningococcal disease. However, this has changed since 2018 with an increase in disease caused by groups W or Y. Over 2018–2019, just under half of cases were caused by meningococcal group B, and just under half by groups C, W or Y. Meningococcal group A rarely causes disease in New Zealand.
In New Zealand, conjugate vaccines protect against groups A, C, Y and W (Menactra or Nimenrix) or group C only (NeisVac-C), and the multicomponent recombinant vaccine protects against group B only (Bexsero). For best protection against all meningococcal disease in New Zealand, separate vaccinations against group B disease and groups A, C, Y and W disease are recommended.
Menactra is a meningococcal conjugate vaccine to protect against meningococcal groups A, C, Y and W. The vaccine is funded for children and adults with a medical condition that increases their risk of invasive meningococcal disease AND is listed on the Pharmaceutical Schedule. Menactra is also available as a purchased vaccine through your family doctor.
In infants and children:
In adolescents and adults
Meningococcal A, C, Y, W conjugate vaccine:
Meningococcal C only conjugate vaccine:
Meningococcal group B only recombinant vaccine
Menactra is recommended and funded from 9 months of age for:
Conjugated meningococcal vaccine (Menactra or Nimenrix) is recommended but not funded for individuals:
Store as per cold chain between 2°C to 8°C. Protect from light.
Menactra can be administered at the same visit as other vaccines including vaccines on the national immunisation schedule except PCV13 (Prevenar 13). Where both Prevenar 13 and Menactra are to be given, administration of Menactra must be at least 4 weeks before or after a dose of Prevenar 13.
Protection against meningococcal disease is dependent on an individual having adequate existing circulating protection provided by antibodies because the bacteria cause disease more quickly than the immune system can generate new protection. Immunisation generates circulating antibodies. Over time the antibody levels decrease. The number and quality of antibodies and how long they last depend on what type of vaccine is used, the meningococcal group(s) covered by the vaccine, and the age of the person receiving the vaccine.
As there are generally low numbers of meningococcal disease cases in countries such as Australia, England, Germany, New Zealand and the United States it is not possible to determine exactly how many cases of disease are prevented by vaccination and how long protection after vaccination lasts. Instead, the immune system response and antibody levels are used as an alternative measure of how well and how long meningococcal vaccines can protect from disease.
A case-control study in the US found that the overall vaccine effectiveness in adolescents was 69% up to 6 years after one dose of vaccine. Less than one year after vaccination, vaccine effectiveness was around 82% and at 3–6 years post vaccination, the vaccine was 59% effective in adolescents. Around 71-95% of adolescents, who received one dose Menactra between ages 11–18 years, had protective antibody levels three years later.
After two doses of Menactra, 96–100% of infants aged 9–12 months have protective antibodies against meningococcal groups A, C and Y and 86% have antibodies against group W-135.
Older children, adolescents and adults are expected to have at least five years protection after immunisation. Children aged 9–23 months at the time of their last Menactra immunisation are likely to have fewer years of protection but the exact period of time is not known.
A booster vaccination should be considered for individuals who remain at increased risk of meningococcal disease: