NeisVac-C^® is funded for children aged under 9 months with a medical condition that increases their risk of meningococcal disease AND is listed on the Pharmaceutical Schedule. The vaccine is available for purchase for children and adults with a medical condition that is not listed on the Pharmaceutical Schedule.

When available, use of meningococcal vaccine against the groups A, C, Y and W (Menactra or Nimenrix) is preferred over the group C only (NeisVac-C) vaccine due to the observed increases in disease caused by groups W or Y since 2018.

Special groups

NeisVac-C is recommended and funded for infants aged under 9 months in the following groups:

• Infants who have previously had meningococcal disease of any group
• Close contacts of a meningococcal disease case of any group
• Infants pre/post-splenectomy or with functional asplenia
• HIV positive infants
• Infants with a complement deficiency
• Pre/post-solid organ transplantation
• Following stem cell/bone marrow transplantation
• Pre- and post-immunosuppression that will be/is for longer than 28 days

Catch-up doses

Not relevant

Storage and preparation

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

NeisVac-C is presented as a semi-opaque white to off-white suspension in single dose syringe. Upon storage a white deposit and clear supernatant can be observed. The vaccine should be shaken thoroughly before us. After shaking, the vaccine should be a homogeneous semi-opaque white to off-white suspension.

Administration

NeisVac-C can be administered at the same visit as other vaccines including all vaccines on the National Immunisation Schedule.

NeisVac-C is for intramuscular use only, preferably in the vastus lateralis in infants and the deltoid region in older children, adolescent and adults. The vaccine must not be administered subcutaneously or intravenously.

For:

Infants and children aged 8 weeks to 11 months:**

• Two doses 8 weeks apart
• Booster at 12 months of age or a minimum of 6 months after second dose, at least 8 weeks after 2^nd dose

Children aged 12 months to under 7 years:**

• One dose
• If still at risk 2–3 years later – offer a booster dose

Children aged 7 years or over and adults:**

• One dose
• If still at risk 5 years later – offer a booster dose

**When available, use of meningococcal vaccine against the groups A, C, Y and W (Menactra or Nimenrix) is preferred over the group C only (NeisVac-C) vaccine due to the observed increases in disease caused by groups W or Y since 2018.

More than 20 years of studies and safety monitoring have shown that the conjugate meningococcal vaccines have excellent safely profiles.

NeisVac-C should not be given to:

• Anyone with severe allergy (anaphylaxis) to a previous dose of a meningococcal vaccine or a component of the vaccine
• Administration of NeisVac-C should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation

Specialist advice should be sought for the following groups:

• Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions

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.

After completion of the recommended vaccination course:

• Infants and young children aged 2–13 months: 97–100% had protective levels of circulating antibodies.
• Children aged 12–17 months: 97–100% had protective levels of circulating antibodies.
• Children aged 3–6 years: 100% had protective levels of circulating antibodies.
• Adolescents aged 13–17 years: 100% had protective levels of circulating antibodies.
• Adults aged 18 years or older: 100% had protective levels of circulating antibodies.

• Borrow R and Findlow J. Prevention of meningococcal serogroup c disease by NeisVac-C. Expert Rev Vaccines 2009 8(3) 265-279 doi: 10.1586/14760584.8.3.265
• Institute of Environmental Science and Research Ltd. Meningococcal disease quarterly report Jan - Dec 2019. Porirua: Institute of Environmental Science and Research Ltd (ESR); 2020
• Lopez L, Sherwood J. The epidemiology of meningococcal disease in New Zealand 2013. Wellington: Institute of Environmental Science and Research Ltd (ESR); 2014. Report No.: FW14023.
• Medsafe. New Zealand data sheet: NeisVac-C [Internet]. Wellington: New Zealand Medicines and Medical Devices Safety Authority; 2008 [updated 2018 December 12; cited 2021 August 13]. Available from: https://www.medsafe.govt.nz/profs/Datasheet/n/NeisVacCinj.pdf
• Ministry of Health. Immunisation handbook [Internet]. Wellington: Ministry of Health; 2020 [updated 2021 June 23; cited 2021 August 13]. Available from: https://www.health.govt.nz/publication/immunisation-handbook-2020
• PHARMAC. Community Pharmaceutical Schedule [Internet]. Wellington:PHARMAC. 2021 [cited 13 August 2021]. Available from: https://pharmac.govt.nz/pharmaceutical-schedule/community-section-b/