Which vaccines protect against meningococcal disease?

No one vaccine covers all the meningococcal groups causing disease in New Zealand.

Bexsero® protects against meningococcal group B

• Group B caused 43–45% of typed cases over 2018–2019, and around 80% of cases in 2021 and 2022.

MenQuadfi® and Nimenrix® protect against meningococcal groups A, C, Y and W

• In 2022, Group Y caused 14% of typed cases, and group W caused 5%.

NeisVac-C® protects against meningococcal group C

• Group C caused 5–8% of typed cases over 2018–2019, with no new cases reported in 2022.

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Should we recommend a MenACWY vaccine over a MenB vaccine, or vice-versa?

For best protection against all meningococcal disease, separate vaccinations against groups A, C, W and Y disease and group B disease are available. Health professionals are not advised to recommend an ACWY vaccine over a B vaccine or vice versa, a B vaccine over an ACWY vaccine. Who will get meningococcal disease or which meningococcal group could be the cause cannot be accurately predicted.

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How long does protection last after immunisation?

In general, children aged under 7 years when vaccinated are expected to have around 3 years of protection. In older children, adolescents and adults, protection is expected to last for around 5 years after vaccination.

The MeNZB™ vaccine used in New Zealand from 2004 to 2011 targeted one type of meningococcal group B disease. Those who received MeNZB™ are no longer expected to have protection against this type of group B disease.

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Can we give less doses of Bexsero if a person has a history of MeNZB vaccination?

No. Two doses of Bexsero are recommended for older children, adolescents and adults regardless of a history of MeNZB vaccination.

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Can MenB be given at the same visit as MenACWY vaccines?

Yes. MenQuadfi, Nimenrix and Bexsero can be administered at the same visit, using different sites.

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Is a minimum interval required between administration of MenB and MenACWY vaccines?

No. When MenQuadfi or Nimenrix and Bexsero are not co-administered, no minimum interval is required before administration of the subsequent vaccine.

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Is a minimum interval required between administration of MenB, MenACWY and any other vaccine?

MenQuadfi, Nimenrix and Bexsero can be administered at the same visit as any other vaccine or any interval before/after any other vaccine.

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Is a minimum interval required between administration of NeisVac-C and MenACWY vaccines?

No minimum interval is required between administration of NeisVac-C and subsequent MenACWY vaccines.

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Can a combination of MenACWY vaccines be used to deliver a primary course of meningococcal A, C, W and Y vaccines in children aged under 24 months?

If a child in this age group received one dose of Menactra previously, they can receive either MenQuadfi (licensed from 12 months) or Nimenrix, a minimum of three months later to complete their primary vaccine course.

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Can a pregnant woman receive MenB and MenACWY?

There are no safety concerns around administration of Nimenrix, MenQuadfi, MenQuadfi or Bexsero at any stage of pregnancy. These are non-live vaccines and the advice is consistent with the recommendation for a pregnant woman to receive non-live vaccines when she has an increased risk of disease, for example influenza vaccination is recommended at any stage of pregnancy because they have an increased risk of influenza disease and complications.

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Who should receive meningococcal vaccination?

• Infants and children under 5 years. Bexsero is recommended and funded for all infants on the NIS. Catch up doses of Bexsero are available for children 59 months and under until 31 August 2025. MenACWY vaccines are recommended, but not funded outside special groups.

• Individuals aged 13–25 years, inclusively, who are entering within the next three months, or are in their first year of living in boarding school hostels, tertiary education halls of residence, military barracks, Youth Justice residences or prisons; Bexsero and MenQuadfi is recommended and funded. Catch up doses of Bexsero are available for those living outside their first year in these communal living arrangements until 28 February 2024.

• A small group of individuals with a high-risk medical condition listed on the Pharmaceutical Schedule, NeisVac-C (aged under 9 months), MenQuadfi (aged 12 months or over) and Bexsero are recommended and funded.

For individuals outside these specified groups, meningococcal vaccines can be prescribed and purchased. Groups for whom meningococcal vaccination is recommended but not funded are noted in the Immunisation Handbook section 13.5.

Meningococcal disease incidence is highest in Māori (2.6 per 100,000 cases in 2021) compared with the total population. Household crowding is an important risk factor, independent of ethnicity.

In 2021, the highest age-specific disease rates were among those aged under 1 year (27.8 per 100,000, 17 cases) decreasing in ages 1–4 years (2.0 per 100,000, 5 cases). Three deaths occurred in 2021, giving a case fatality rate of 6.8 percent (ESR, April 2022).