The HSE recommends two vaccines for your baby for meningococcal disease. This will amount to 4 vaccine doses before 13 months of age targeting 2 out of the 13 meningococcal serotypes. The two vaccines are as follows:
- Bexsero manufactured by GlaxoSmithKline and introduced in 2016 targets meningococcal B and is recommended at 2, 4 and 12 months of age.
You may find it interesting that as of 2024, the United States, Denmark, Finland, Norway, and Sweden—countries with similar socioeconomic conditions—do not recommend meningococcal vaccines for healthy infants. This article provides an overview of the potential risks associated with both the vaccines and the disease it targets, helping you make an informed decision.
Disease versus Vaccine Risk Summary
| Risk from meningococcal disease |
|---|
|
Risk of getting meningococcal B for all ages Approx 1 in 203,000 (0.0005%) (2018 and 2022) Risk of death from invasive meningococcal disease (including men B&C and other strains) Pre vaccine: approx 1 in 248,000 (0.0004%) all ages Approx 1 in 44,000 (0.002%) for under 5s (1990 to 1999) Post vaccine: approx 1 in 1.14 million (0.00007%) all ages (2017 to 2023) Approx 1 in 1.2 million (0.00009%) under 5s |
| Risks from each dose of meningococcal B vaccine Bexsero |
|---|
| 3 doses recommended, at 2, 4 and 12 months (as per Bexsero patient information leaflet May 2023) |
| Observed side effects post administration of Bexsero (post marketing) |
|---|
|
| Risk Category | Observed Side Effects |
|---|---|
| Up to 1 in 1,000 (0.1%) | Kawasaki disease which may include symptoms such as fever that lasts for more than five days, associated with a skin rash on the trunk of the body, and sometimes followed by a peeling of the skin on the hands and fingers, swollen glands in the neck, red eyes, lips, throat and tongue, itchy rash, skin rash. |
| Up to 1 in 100 (1%) | High fever (> 40°C), seizures (including febrile seizures), dry skin, paleness (rare after booster) |
| Up to 1 in 10 (1% to 10%) | Skin rash |
| More than 1 in 10 (10%) | Fever (> 38°C), loss of appetite, tenderness at the injection site (including severe injection site tenderness resulting in crying when injected limb is moved), painful joints, skin rash (children aged 12 to 23 months after booster), irritability, unusual crying, vomiting (uncommon after booster), diarrhoea, headache. |
| Some other special warnings and precautions |
|---|
| Should not be given if allergic to antibiotic Kanamycin |
| WHO Vigaccess Adverse Events Reporting System As of August 2024, 155,928 adverse events have been reported for all meningococcal vaccines. |
What is meningococcal disease?
Invasive meningococcal disease (IMD) is caused by the bacterium neisseria meningitidis, the leading cause of meningitis in Ireland. This bacterium has 13 different serotypes, with groups B and C being the most common. An estimated 10% to 35% of young adults carry the bacteria in their nose or throat [1], often without symptoms. Most people are colonised at some point in their lives, typically developing immunity afterward. Only a small percentage of carriers develop IMD, which is not easily transmitted and requires close contact with a colonised person. The risk of developing invasive meningococcal disease is influenced by the immune system’s status, overcrowding, strain virulence and poor social conditions [2].
Invasive meningococcal disease can present as meningitis (see Meningitis overview) or septicaemia or both. Early symptoms of septicaemia can include:
- Fever and chills – high temperature, often accompanied by shivering.
- Rapid heart rate (tachycardia) – heart rate increases as the body fights infection.
- Rapid breathing (tachypnea) – breathing becomes fast and shallow.
- Confusion or disorientation – mental changes such as confusion
- Nausea, vomiting, or diarrhea – digestive issues may be present.
- Extreme pain or discomfort
- Sweating or clamminess – the skin may become cool, pale, or sweaty.
For both meninigtis and septicaemia, early detection is key to ensure best possible outcome.
What is the risk of getting meningococcal disease in Ireland?
The risk for all age groups of getting meningococcal B in Ireland between 2018 and 2022 was approximately 1 in 203,000 (0.0005%) and approximately 1 in 658,000 (0.0002%) for meningococcal C. The risk of getting invasive meningococcal disease from any serotype and for all ages during this period was approximately 1 in 112,000 (0.0009%).
What is the risk of death from meningococcal disease in Ireland?
The risk of death from meningococcal disease for children under 5 in Ireland before any vaccine was approximately 1 in 44,000 (0.002%).
The risk of death post vaccine for children under 5s in Ireland is approximately 1 in 1.2 million (0.00009%) and approximately 1 in 1.4 million (0.00007%) for all age groups. Three infants under 1 died between 2007 and 2023 from invasive meningococcal disease. Further detail on whether is was type B or C is unavailable.
Do the meningococcal vaccines guarantee protection against meningococcal disease?
No. Your baby can still get meningococcal disease after vaccination. Bexsero targets meningococcal group B bacteria only and menjugate, group C bacteria. They cannot protect against the other 11 types of meningococcal bacteria.
Additional safety data
Like all medicines, vaccines come with side effects, sometimes very serious. Parents need to research every vaccine and ensure benefits outweigh the risks.
- See Disease Vs Vaccine Risk table at the top of this page for list of possible side effects from Bexsero and Menjugate vaccines.
- “Severe allergic reactions can occur to any vaccine but they are very rare and are usually seen in less than 1 in 10,000 people who are vaccinated” [Menitorix PIL, 11/2016]
- As of June, 2024, 154,438 adverse events have been reported on the World Health Organisation Vigiaccess database for meningococcal vaccines including Bexsero (men B), and Menjugate (men C).
What are the vaccine ingredients
| Vaccine | Ingredients as listed on patient information leaflets |
|---|---|
| Bexsero Men B |
Active substances: men B proteins (produced in E. coli cells by recombinant DNA technology) Other ingredients: [popup_anything id=”2213″], (no amount given), [popup_anything id=”2221″], [popup_anything id=”3111″], [popup_anything id=”3109″], [popup_anything id=”3105″] |
| Menjugate Men C |
Active substance: Neisseria meningitidis group C (strain C11) oligosaccharide chemically joined to Corynebacterium diphtheriae CRM197 protein. The active substance is adsorbed on [popup_anything id=”2213″] Other ingredients: [popup_anything id=”2221″], [popup_anything id=”3111″]and water for injections |
