Meningococcal: Questions and Answers
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What causes meningococcal disease?
Meningococcal disease is caused by the bacterium Neisseria meningitidis. This bacterium has at least 13 different subtypes (serogroups). Five of these serogroups, A, B, C, Y, and W-135, cause almost all invasive disease. The relative importance of these five serogroups depends on geographic location and other factors.
What are the symptoms?
The most common symptoms are high fever, chills, lethargy, and a rash. If meningitis is present, the symptoms will also include headache and neck stiffness (which may not be present in infants); seizures may also occur. In overwhelming meningococcal infections, shock, coma, and death can follow within several hours, even with appropriate medical treatment
How is the disease spread?
The disease is spread person-to-person through the exchange of respiratory and throat secretions (e.g., by coughing, kissing, or sharing eating utensils). Meningococcal bacteria can't live for more than a few minutes outside the body, so the disease is not spread as easily as the common cold or influenza.
How common is meningococcal disease?
Fewer than 1000 cases of meningococcal disease are reported each year in the United States. An estimated 100 deaths from meningococcal disease occurred in the United States in 2011. The disease is most common in children younger than 5 years (particularly children younger than age 1 year), people age 16–21 years, and people age 65 years and older.
Who is at special risk for meningococcal meningitis?
In addition to certain age groups, people at increased risk include travelers to places where meningococcal disease is common (e.g.., certain countries in Africa, and in Saudi Arabia), people with damaged or missing spleens, and people with persistent complement component deficiency (an immune system disorder). Other factors make it more likely an individual will develop meningococcal disease, including having a previous viral infection, living in a crowded household, having an underlying chronic illness, and being exposed to cigarette smoke (either directly or second-hand). Studies have also shown that college freshmen who live in a dormitory are at an increased risk of meningococcal disease compared with others their age.
Why are college students at greater risk for meningococcal disease than the general population?
While the reasons are not yet fully understood, studies from previous college outbreaks suggest that college students are more susceptible because they live and work in close proximity to each other in dormitories and classrooms. Behavioral and social aspects of college life appear to be risk factors as well, with smoking, exposure to second-hand smoke, excessive alcohol consumption, and bar patronage all increasing the chance that one will contract meningitis from an infected individual.
Is there any way for college students to protect themselves against the threat of meningococcal disease?
Two types of meningococcal vaccines are available in the US
- Meningococcal Polysaccharide vaccine (MPSV4) also known as Menomune has been available since the 1970's
- Meningococcal Conjugate vaccine (MCV4) also know as Menactra licensed in 2005. A second conjugate vaccine, Menveo was licensed in 2010.
Both vaccines can prevent 4 types of meningococcal disease (A, C, Y and W-135). In persons 15 - 24 years of age, 70% - 80% of cases are caused by potentially vaccine-preventable strains.
Both the vaccines work well, and protect more than 90% of those who get it. MCV4 (Menactra or Menveo) gives longer-lasting protection and should also be better at preventing the disease from spreading from person to person.
Should college students be vaccinated against meningococcal disease?
College freshmen living in residence halls, are at an increased risk of meningococcal disease relative to other people their age. The MCV4 vaccine is recommended for previously unvaccinated first-year college students, age younger than 22 years, who are or will be living in a residence hall. Some colleges and universities require incoming freshmen and others to be vaccinated; some may also require that a meningococcal vaccination have been given since the age of 16 years. The vaccine may be available from the college health service. Although the risk for meningococcal disease among other college students (such as those 22 years or older, or not living in a residence hall) is similar to that of the general population of the same age, students who wish to decrease their risk of meningococcal disease can be vaccinated.
Are booster doses needed following initial vaccination?
Yes, all adolescents who were first vaccinated at ages 11 - 12 years need a booster at age 16 years; all teens who were vaccinated at ages 13 - 15 years need a booster at age 16 - 18 years.
First-year college students younger than 22 years who are living in on-campus housing should get a booster dose if their previous dose was given before age 16 years.
What are the side effects of the vaccine? How safe is it?
The meningococcal vaccines have an excellent safety profile. Side effects are mild and consist primarily of redness and swelling at the site of injection lasting up to two days.
Meningococcal immunization should be deferred during any acute illness. The vaccine should not be administered to individuals sensitive to any of the components of the vaccine.
How effective is the vaccine?
The MPSV4 vaccine (Menomune) has been shown to create protective levels of antibodies against the four most common strains of meningococcus in over 85% of adults studied. As with any vaccine, meningococcal vaccination may not protect 100% of susceptible individuals. Protection from the vaccine lasts for about 3-5 years.
The MCV4 vaccine (Menactra/Menveo) has been shown to create equally effective levels of protection as MPSV4 and to have a longer duration of immunity.
Can college students do anything else to reduce the risk of contracting meningococcal disease?
Maximize your body's own immune response. Eat a balanced diet, and get adequate sleep and exercise. Avoid cigarettes and excessive use of alcohol. In particular, do not make a habit of sharing drinks and cigarettes.
Will my insurance company reimburse for this vaccine?
Many insurance companies do cover the cost of the meningitis vaccine. To help you work with your insurance company for reimbursement, we have provided this Frequently Asked Questions sheet. The student will also receive a copy of his/her Encounter Receipt, at the time of vaccination, with the following insurance billing information:
- Procedure Code 90733 (Menomune) or 90734 (Menactra/Menveo)
- Diagnosis Code V03.89
You may submit this information as a claim for reimbursement. However, there is no guarantee that you will be reimbursed.
STATE OF MARYLAND REQUIREMENTS
A waiver form must be signed for those students living in on campus housing choosing NOT to receive the vaccine. This is found on Residence Life Contract Form.