Cartoon image of a man showing his arm where he received a vaccination

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covid.immune.org.nz

Visit our COVID-19 website for more information

covid.immune.org.nz

Overview

Meningococcal disease is caused by the bacterium Neisseria meningitidis. At least 12 groups have been identified, including groups A, B, C, W, X, and Y. The pattern of disease caused by each group varies by time and country or geographical areas.

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. In 2022, for the cases in which the groups were known, group B was the most dominant group followed by groups Y and W, no cases of group C were identified. Meningococcal group A rarely causes disease in New Zealand.

In New Zealand, conjugate vaccines protect against groups A, C, W and Y (MenQuadfi or Nimenrix) or group C only (NeisVac-C), and the multicomponent recombinant vaccine protects against group B (Bexsero). For best protection against all meningococcal disease in New Zealand, separate vaccinations against group B disease and groups A, C, W and Y disease are recommended.

Responses to vaccine

MenQuadfi (MenACWY)
Very common side effects
Common responses
  • Mild pain, redness and swelling around injection site

In infants and children:

  • Mild fever
  • Decreased appetite
  • Irritability
  • Malaise / tiredness

In adolescents and adults

  • Headache
  • Fatigue
  • Mild fever
Rare responses

Other formulations and brands

Other brands:

Meningococcal A, C, W, Y conjugate vaccine:

  • Nimenrix

Meningococcal C only conjugate vaccine:

  • NeisVac-C

Meningococcal group B only recombinant vaccine

  • Bexsero

MenQuadfi is recommended and funded from 12* months of age for:

  • Individuals who have previously had meningococcal disease of any group
  • Close contacts of a meningococcal disease case of any group
  • Adolescents and young adults aged 13–25 years inclusively who are entering within the next 3 months, or in their first year of living in a boarding school hostel, tertiary education halls of residence, military barrack, or prison
  • Individuals pre- or post-splenectomy or with functional asplenia
  • HIV-positive individuals
  • Individuals with a complement deficiency
  • Pre/post-solid organ transplantation
  • Following stem cell/bone marrow transplantation
  • Pre- and post-immunosuppression longer than 28 days

Conjugated meningococcal vaccine (MenQuadfi or Nimenrix) is recommended but not funded for individuals:

  • Infants and young children aged between 12 months and 5 years, adolescents and young adults who do not meet the eligibility criteria listed above
  • Who are laboratory workers regularly handling meningococcal cultures
  • Who are travelling to high-risk countries or before the Hajj

*Note: Those aged 6 weeks to 11 month could receive meningococcal C vaccine (Neisvac-C) for their first dose; give MenQuadfi for any subsequent doses from age 12 months and to complete their course of meningococcal ACWY vaccination.

Storage and preparation

Store as per cold chain between 2°C to 8°C.

Administration

MenQuadfi can be administered as a 0.5ml single dose intramuscular injection into deltoid region or anterolateral thigh, depending on the recipient's age and muscle mass.

It can be given at the same visit as other vaccines including vaccines on the National Immunisation Schedule including DTaP, Tdap and PCV13.

For:

Primary vaccination

  • Single dose for healthy individuals 12 months and older.
  • Certain special groups may require two doses given at least 8 weeks apart.

Booster vaccination

  • Single booster dose can be given to adolescents and adults who have previously been primed with meningococcal vaccine at least 5 years prior, particularly if at continued risk from meningococcal disease.

Vaccine Safety

Who shouldn't have MenQuadfi

MenQuadfi is contraindicated in anyone with a known systemic hypersensitivity reaction to any component of MenQuadfi or after previous administration of the vaccine or a vaccine containing the same components.

Anaphylaxis

Appropriate observation and medical treatment should always be readily available in case of an anaphylactic event following the administration of the vaccine.

More detail

More detail available on the MenQuadfi datasheet.

Vaccine Effectiveness

Since MenQuadfi has only recently become available globally, there is no new data on vaccine effectiveness. Due to meningococcal being a rare disease clinical trials use immunogenicity (bactericidal antibody response) as a proxy for efficacy. Several clinical trials have assessed the immunogenicity of MenQuadfi. These studies have included healthy vaccine-naïve toddlers aged from 12 months; vaccine-naïve older children and adolescents; booster doses in toddlers, children and adolescents following prior MenACWY or MenC vaccination; given concurrently with routine vaccines (DTaP-IPV-HepB/Hib, MMR, VV, PCV13, Tdap and HPV); and in adults aged over 56 years. In all studies, robust antibody responses were observed in all groups, immunogenicity was equivalent to comparator MenACWY vaccines and booster responses were observed. Based on this, MenQuadfi is expected to have similar or better effectiveness to other quadrivalent conjugated meningococcal vaccines. There is no published data to date on effectiveness or use in immunocompromised individuals.

References

Martinón-Torres F, Bertrand-Gerentes I ,Oster P. A novel vaccine to prevent meningococcal disease beyond the first year of life: an early review of MenACYW-TT. Expert Rev Vaccines, 2021. 20(9): p. 1123-1146.

Last updated:
Mar 2023