Immunization for meningococcal serogroup B - What does the practitioner need to know? Flashcards
How many serogroups of Neisseria meningitidis are there?
12 determined by the polysaccharide capsule
Which serogroups cause most invasive meningococcal disease?
A, B, C, Y, and W
Which serogroups are routinely immunized in infancy?
All provinces C
Alberta, Saskatchewan, Ontario, NB, PEI, Nfld quadrivalent (A,C,Y,W) conjugate vaccine
What is the most prevalent serogroup in Canada?
B (>50% of cases)
What are the four components in 4CMenB?
- Neisserial heparin-binding antigen (NHBA)
- Factor H-binding protein (fHbp)
- Neisserial adhesion A (NadA)
- PorA (the most immunogenic protein from the outer membrane vesicles)
What percentage of Canadian meningitis B strains would be covered by 4CMenB?
66% of strains
What is the effectiveness of 4CMenB?
Estimates of effectiveness are still very tentative
How many does are required?
2m, 4m,, and 6m
Likely will require boosters
What adverse effects are associated with 4CMenB?
- Fever in 65% of infants, may result in FSWU in children at 2m
What is the NNT for 4CMenB?
As infants younger than 6m will remain unprotected 1 in 141 000
10-20 times that number to prevent one death
Who should receive 4CMenB?
- Asplenia
- Hyposplenism
- Congenital complement deficiency
- Properdin deficiency
- Factor D deficiency
- Primary antibody deficiency
- > 1 episode of invasive meningococcal disease
- Laboratory personnel working with the organism
- Consider with eculizumab >2wks prior to the first dose or within 1 week post-eculizumab as risk of hemolysis
