Disease Overview: Invasive meningococcal disease (IMD) is caused by Neisseria meningitidis serogroups A, B, C, Y, and W. It is endemic in Canada but rare, with the highest incidence in infants.
High-Risk Groups:
Individuals with certain medical conditions (e.g., asplenia, complement deficiencies, HIV).
People exposed through travel to high-risk areas, laboratory personnel, military personnel, close contacts of IMD cases, and during outbreaks.
Menactra® (meningococcal groups A, C, Y, and W polysaccharides conjugated to diphtheria toxoid)
MENVEO (meningococcal groups A, C, Y, and W oligosaccharides conjugated to CRM197 protein)
NIMENRIX® (meningococcal groups A, C, Y, and W polysaccharides conjugated to tetanus toxoid)
MenQuadfi™ (meningococcal groups A, C, Y, and W polysaccharides conjugated to tetanus toxoid)
Serogroup B Meningococcal Vaccines:
BEXSERO® (recombinant proteins of serogroup B: factor H binding protein [fHBP], neisserial heparin binding antigen [NHBA], Neisserial adhesion A [NadA], and PorA)
Trumenba® (recombinant lipidated factor H binding protein [fHBP] subfamily A and B)
Recommendations for Use
Routine Immunization:
Infants and Children (2-23 months): Men-C-C vaccine at 12-23 months; additional doses as per provincial schedules.
Adolescents and Young Adults (12-24 years): Men-C-C or Men-C-ACYW vaccine at 12 years; optional 4CMenB or MenB-fHBP for additional protection.
High-Risk Individuals:
Children and Adults: Men-C-ACYW with 4CMenB or MenB-fHBP based on age and risk factors.
Schedules and Boosters
Catch-Up Schedules: One dose of Men-C-C for unimmunized children under 5 years; optional doses for older children and specific MenB vaccines based on individual risk.
Booster Doses: Recommended every 3-5 years for children vaccinated before age 6 and every 5 years for those vaccinated at age 7 or older.
Special Populations
Pregnancy and Breastfeeding: Men-C-ACYW and serogroup B vaccines may be considered if benefits outweigh risks.
Premature Infants: Should be vaccinated on the same schedule as full-term infants but monitored post-vaccination.
Travellers: Men-C-ACYW for travel to high-risk areas, and 4CMenB or MenB-fHBP if exposed to relevant serogroup B strains.
Post-Exposure and Outbreak Control
Close Contacts: Chemoprophylaxis and immunoprophylaxis based on the serogroup.
Outbreak Control: Vaccination strategies depend on the serogroup causing the outbreak.
Safety and Adverse Events
Common Reactions: Injection site reactions, fever, irritability, headache, and malaise.
Serious Adverse Events: Rare, including anaphylaxis and immune thrombocytopenic purpura.
