What's new with the meningococcal vaccine?

The newer meningococcal conjugate vaccine should be used instead of the older meningococcal polysaccharide vaccine for children and teens, according to the latest recommendations from the American Academy of Pediatrics released online today.

Meningococcal disease refers to any illness that is caused by Neisseria meningitidis, also known as meningococcus bacteria. Why is a new vaccine needed to fight it? Among children and adolescents, bacterial meningitis (a bacterial infection of the lining of the brain) was historically caused by three different species of bacteria. The development of two vaccines using a new technology called conjugation, linking the sugar part of the outer crust of the bacteria to a protein, virtually eliminated meningitis caused by H. influenzae and S. pneumoniae. 

Today, the most common cause of these meningitis infections is N. meningitidis.  This same technology has produced new vaccines effective against many of the strains of N. meningitidis that cause bacterial meningitis.  The AAP now advises the following:

1. All children should receive the initial dose of vaccine between 11 and 12 years of age; a booster dose is required at age 16.
2. College students or military recruits living in dormitories or barracks who have never been vaccinated or received their last vaccine before the age of 16 should receive a single dose of the vaccine.

The AAP goes on to point out that there are several strains of N. meningitides that cause disease in children and adolescents.  The current vaccines cover the strains most commonly associated with infection in older children and adolescents.  One strain, type B, is not covered by the vaccine and often causes infections under the age of 5 years. 

Besides older children and adolescents, the AAP also recommends vaccination for children aged 2 through 10 with certain immune disorders, those without a spleen and for those travelling to areas where meningococcal disease is prevalent. 

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