From 1st August 2015, GP practices should routinely offer all 17- and 18-year olds currently in school year 13 a combined vaccine that protects against the A, C, W and Y strains of meningococcal disease (Menveo or Nimenrix). Vaccination is for all young people in the cohort, regardless of whether they are continuing into further education.
The combined vaccine should replace the meningitis C vaccine in the time-limited freshers' vaccination programme from 1st August, and should be offered on an opportunistic basis in place of MenC vaccination to older students aged 19 to 25 years who are starting university this year.
The routine schools-based MenC adolescent vaccination programme will also switch to the MenACWY vaccine from the 2015/16 academic year. Students in school year 9 or 10 will routinely receive the MenACWY vaccine and a catch-up programme will run from January 2016 for those in year 11 and from April 2016 for those in year 13.
Increase in cases
Meningitis ACWY vaccination is being introduced into the national immunisation programme in response to a rapid and accelerating increase in cases of invasive meningococcal group W disease, which has been declared a national incident. Vaccination will provide direct protection to the vaccinated cohort and, by reducing MenW carriage, will also provide indirect herd protection to unvaccinated children and adults.
MenACWY vaccines are expected to be available to order through ImmForm from July.
From 1st September 2015, the meningitis B vaccine (Bexsero) should be offered routinely to all babies born on or after 1st July 2015, when they attend for their first and third routine childhood immunisations at the age of 2 months and 4 months. A booster should then be offered at 12—13 months of age alongside current routine immunisations.
There will be a limited catch-up programme for infants who are due their 3- and 4-month vaccinations in September, to protect them when they are most at risk. Any children born on or after 1st May 2015 should therefore be vaccinated as follows:
- those who have not already received any routine vaccinations should have MenB at the same time as their first and third routine infant vaccinations
- those who have already received their first dose of routine vaccinations should have MenB at the same time as their second and third routine infant vaccinations
- those who have already received their first and second dose of routine vaccinations should have MenB at the same time as their third routine infant vaccinations
- a booster of MenB should also be offered at 12—13 months
It is recommended that all doses of Bexsero be given in the left thigh, ideally on their own, so that any local reactions can be monitored more accurately. The risk of fever is increased when Bexsero is given with other childhood immunisations. Administration of a 2.5ml dose of paracetamol oral suspension (120mg/5ml) at the time of or shortly after the first two MenB vaccinations (with a further dose four to six hours later) should reduce the likelihood or intensity of fever.
Bexsero will be available to order through ImmForm from the beginning of August.
In 2014, there were 628 confirmed cases and 32 deaths from meningococcal disease in England, including 400 cases and 15 deaths attributed to MenB. Half of all MenB cases occurred in children under 5 years of age.
Quick-reference vaccination guide
The MIMS quick-reference guide to the routine childhood immunisation schedule will be updated to reflect the new programmes.