Meningococcal Disease

Neisseria meningitidis or meningococcus (serogroups A, B, C, Y, and W-135) is a leading cause of bacterial meningitis. The infection is highly contagious and is spread by airborne droplets and contact with respiratory secretions. Meningococcal meningitis occurs when N. meningitidis from an upper respiratory tract infection enters the bloodstream and causes inflammation of the meninges surrounding the brain and spinal cord. "Hallmark" signs and symptoms include headache, fever and a stiff neck.43

Active Immunization: Meningococcal Vaccines4,6,44

Three quadrivalent vaccines against N. meningitidis serogroups A, C, Y, and W0135 and two serogroup B meningococcal vaccines are available (Table 8). Vaccination is not recommended for an OHCP unless they have a certain risk: 1) asplenia or persistent complement component deficiencies, 2) travel to countries in which meningococcal disease is hyperendemic or epidemic, 3) participate in research OHCP and research microbiologists who might be exposed routinely to isolates of N. meningitides, or 4) any OHCP aged >55 years who have any of the aforementioned risk factors for meningococcal disease are recommended for vaccination.

Table 8. Meningococcal Vaccines.20,44
Vaccines Indications Schedules Adverse Effects

ACWY

 Menactra
 Menveo
 MedQuadfi

Preexposure 2 IM doses, 0 and 8 weeks.*
Redness, induration, and pain, at the site of injection.
Headache, fatigue, and malaise.

B

  Trumenba
  Bexsero

Preexposure 3 IM doses, 0 1-2, and 6 months.†

2 IM doses, 0 ≥1month.†
Erythema, induration, and pain at the site of injection.
Headache, fatigue, and myalgia 
* Revaccination every 5 years if risk criteria persist.
† Single dose boost at 1 year post-initial series and every 2-3 years thereafter if risk criteria persist.