Meningococcal Vaccines In Canada: An Update

Question 1

What does neisseria meningitis look like under the microscope?

Answer 1

Gram negative diplococcus

Question 2

What are the clinical manifestations of neisseria meningitis

Answer 2

Septicaemia
Meningitis
Septic arthritis
Pneumonia
Conjunctivitis

Question 3

What are the mortality rates for invasive disease? Which stereotype has the worst mortality?

Answer 3

10%

Serotype C: higher rates of septicaemia and higher mortality especially in adolescents

Question 4

How frequently do kids in Canada get invasive meningococcal disease?

Answer 4

1/100 000

Question 5

Which groups of kids get serogroup B and C?

Answer 5

B - children less than five years of age

C - adolescents

Question 6

What is the benefit of conjugate vaccines?

Answer 6

They procure a test ringer antibody response and prime the immune system for good memory response

Question 7

What are some of the challenges creating a vaccine for neisseria meningitis

Answer 7

It has a very short incubation period (as short as 48 hours) so you cannot rely upon the anamnestic response for protection. This is why you need boosters to continue to have available immune response

We also cannot create a good B vaccine, which is responsible for the bulk of the burden in younger children

Immunizing kids under 12 months with our current vaccines does not confer immunity over 12 months

Question 8

What are the options for meningococcal vaccines?

Answer 8

Mengococcal C

MCV-4 with A C Y W

Question 9

What are the Canadian recommendations for a normal healthy kid?

Answer 9

1. Kids get MCV-C at 12 months.
2. Depending on the province they can get MCV-C before 12 months of age, but need to get it again at 12 months
3. Adolescents should be given a booster dose of either MCV-4 or MCV-C at 12 years

Question 10

Who is at higher risk for meningococcal disease?

Answer 10

Functional or anatomical asplenia 
Primary antibody deficiency
Deficiency in complements, progerdin or factor D
Laboratory personnel exposed
Military

Question 11

What are the serogroups of meningococcal disease?

And what cause disease in Canada?

Answer 11

A B C Y and W-135

C and B

Y is starting to become more prevalent in the USA for adolescents

Question 12

What are the Canadian recommendations for high risk kids?

Answer 12

• Infants at increased risk of meningococcal disease should get MCV-C at 2 months of age.
• MCV-4 should be given to all kids > 2 years who are at higher risk

-Consider MCV-4 at 2 years for HIV positive kids