Teenagers are to be offered a vaccination to prevent meningitis W (Men W) disease.
Cases of meningitis and septicaemia caused by meningococcal group W bacteria are rising due to a particularly deadly strain of the Men W bacteria.
Men W can be prevented by a single injection into the upper arm with the Men ACWY vaccine which protects against four different types of meningitis: A, C, W and Y.
Teenagers are at higher risk of developing meningococcal disease and in England this group will likely be vaccinated against Men W in summer 2015.
All 14-18 year olds (children in school years 10-13) will be offered the Men ACWY vaccine as part of the routine NHS vaccination programme. The programme will probably replace the existing teenage Men C vaccine. Teenagers who have already received the Men C vaccine will also be offered the Men ACWY vaccine to provide extra protection against Men W.
The Men ACWY can be given to teenagers at the same time as the 3-in-1 teenage booster.
Why do we need meningitis W vaccination?
Cases of meningitis (infection of the lining of the brain) and septicaemia (blood poisoning) due to Men W have been increasing in England from 22 cases in 2009 to 117 in 2014. The increase seems to be speeding up into 2015 and is caused by an aggressive strain of the bug.
Men W infections are associated with severe illness that often requires treatment in intensive care and which has a higher death rate than the more common Men B strains.
The Men ACWY vaccine will not only protect teenagers against Men C disease but will also protect against the circulating Men W strain.
Until now, only the Men C vaccine has been included in the UK’s routine NHS vaccination programme. The Men ACWY vaccine is currently recommended only for people at increased risk of meningococcal disease, including people with no spleen or a spleen that doesn’t work properly, for Hajj pilgrims, and for travellers to countries with high rates of meningococcal disease, including parts of Africa and Latin America.
More about Men ACWY as a travel vaccine.
The Men ACWY vaccine
The Men ACWY vaccine provides good protection against serious infections caused by four different meningococcal groups (A, C, W and Y) including meningitis and septicaemia.
The vaccine only contains the sugar coating on the surface of the four groups of meningococcal bacteria and works by triggering the body’s immune system to develop antibodies against the sugar coating without causing disease.
Read more about about vaccine ingredients.
Men ACWY vaccine side effects
Like all vaccines, the Men ACWY vaccine can cause side effects, but studies suggest they are generally mild and soon settle.
The most common side effects seen in teenagers who receive the vaccine are redness, hardening and itching at the injection site, headache, nausea and fatigue.
What is meningococcal disease?
Meningococcal disease is caused by a bacterium called Neisseria meningitidis (also called the meningococcus). These bacteria can be divided into 13 different groups, of which five (A, B, C, W and Y) are responsible for nearly all serious meningococcal infections.
The meningococcal bacteria live in the back of the nose and throat in about one in 10 of the population without causing any illness. The bacteria is spread from person to person by close prolonged contact with a person carrying the bacteria. Coughing, kissing and sneezing are all ways of spreading meningococcal bacteria.
Very occasionally, the meningococcal bacteria can cause serious illness, including meningitis and septicaemia.
Meningococcal infections can strike at any age, but babies, young children and teenagers are especially vulnerable.
Read more about how meningitis bugs are spread.
Why is Men W so worrying?
In England, most meningococcal infections are caused by group B (Men B). Men C, Men W and Men Y are usually responsible for only 10-20% of cases.
Although the total number of meningococcal cases in England has been falling since the early 2000s, Men W infections have increased from only 22 cases in 2009 to 117 in 2014. Currently Men W alone accounts for almost a quarter of all meningococcal infections in England.
Between 2009 and 2012, an average of four people died of meningitis W each year. Most of the people who died were elderly. But during 2013 and 2014 there were 24 deaths from Men W disease including, for the first time in over a decade, babies and toddlers.
Read more about meningitis and septicaemia.
Will babies and older people be vaccinated against Men W?
Teenagers only will be vaccinated against Men W as part of the NHS vaccination programme as they will be directly protected by the Men ACWY vaccine at a time when they're at increased risk (entering colleges and universities where they will be socialising more).
But vaccinating teenagers against Men W should have the added benefit of indirectly protecting other age groups including unvaccinated babies, children and older people. This is because teenagers are the age group most likely to carry the meningococcal bacteria at the back of their noses. Vaccinating teenagers will reduce the number of carriers and therefore transmission of the Men W bug both within their social circles and also to other age groups.
How to spot meningitis and septicaemia
Meningococcal W disease, like all meningococcal infections, can come on suddenly and progress quickly.
All meningococcal infections can cause meningitis and septicaemia, but Men W can also cause other illnesses, such as pneumonia and joint infections (septic arthritis).
Early symptoms of meningococcal disease include:
- headache
- vomiting
- muscle pain
- fever
- cold hands and feet
A rash of tiny red pinpricks may also develop once septicaemia has set in. You can tell this is a meningitis rash if it doesn’t fade under pressure, for instance when gently pressing a glass against it (the 'glass test').
If you, or a child or adult you know, has these symptoms, seek urgent medical advice. Don’t wait for a rash to develop. Early diagnosis and treatment with antibiotics are vital.
Here’s more info on the symptoms of meningitis and the treatment of meningitis.
What other meningitis vaccines are available?
The Men C vaccine is given as part of the NHS vaccination programme to babies, teenagers and university students.
A Men B vaccine (Bexsero) was licensed in early 2014. This vaccine is currently not part of the NHS vaccination programme, but may be offered to all babies in the near future if the vaccine can be obtained at a cost-effective price.