Prévenar, InfanrixHexa… Several vaccines exist in France against meningitis (meningococci, pneumococci, Hib). Are they mandatory? Starting at what age ? What efficiency? What side effects?
Meningitis is a inflammation of the meninges, natural membranes that wrap and protect the brain and spinal cord. This inflammation can be caused by a infectiongenerally caused by a virus or, less frequently but with often much more severe consequences, by a bacterium ( pneumococci as Streptococcus pneumonia, meningococci like Neisseria meningitidis or Haemophilus influenzae). Meningitis is a disease serious can be deadly, which is why it is recommended to protect yourself. They can affect anyone, but are more common in infants under 2 years old, in adolescents and young adults, in the elderly, in immunocompromised people, in people who live in communities (boarding schools, nurseries, barracks, etc.), in people in contact with an affected individual, in smokers or in people living in a region at risk (or epidemic, endemic or hyper endemic). THE meningitis epidemics are now well controlled thanks to vaccination. What vaccines are available in France against meningitis? Are they mandatory in the vaccination of children ? To what age ? What Side effects ?
How do meningitis vaccines work?
Several vaccines exist in France against meningococci, pneumococci and Hib (Haemophilus influenzae b). Some are mandatory and do part of the vaccination schedule applying to infants, to children and adults. Meningococcus and pneumococcus have different variants, called serotypes (or serogroups). For example, 12 meningococcal serotypes and 90 pneumococcal serotypes are identified. Existing vaccines are directed against the most frequent serotypes of these bacteria, either against 13 or 23 pneumococcal serotypes and against 1 or 4 meningococcal serotypes (A, B, C, W135 and Y).
What is the name of the meningitis vaccines?
► Vaccines targeting meningococcal type C are the Menjugate® and Neisvac®.
► Vaccines targeting meningococcal type B are the Bexsero® and Trumenba®.
► Vaccines targeting meningococci types A, C, Y and W135 (called tetravalent vaccines) are the Menveo® and Nimenrix®.
► Vaccines directed against pneumococci are the Prévenar® (13-valent) and Pneumovax® (23-valent).
► The vaccine directed against Hib exists alone or included in pentavalent or hexavalent vaccines: Act-Hib (Hib only), Infanrixquinta® (DTPolio, whooping cough, Hib), Pentavac® (DTPolio, whooping cough, Hib), Hexyon (DTPolio, whooping cough, Hib), Infanrixhexa (DTPolio, whooping cough, Hib, hepatitis B) and Vaxelis (DTPolio, whooping cough, Hib, hepatitis B).
Is the meningitis vaccine compulsory?
Today in France, vaccination against Hib, meningococcal type C and pneumococcal (13-valent) infections are mandatory for all infants. It is recommended, for these same pathogens, in children over 2 years of age and in unvaccinated adults, and for other types of bacteria only in the event of risk factors for meningitis (persons at risk, region at risk, contact at risk), with the exception of Bexsero® (against meningococcal B) which is, in addition to the risk factors mentioned above, now recommended in all infants aged 2 months to 2 years (but not mandatory).
When should babies be vaccinated against meningitis?
Babies must be vaccinated against meningitis from their first year of life. According to the vaccination schedule in force:
►infants should receive their first dose of vaccine at 5 months of age for type C meningococcus (Neisvac® or Menjugate®),
► at the age of 2 months for the hib (by a combined vaccine against diphtheria, tetanus, poliomyelitis, whooping cough and hepatitis B, also compulsory for infants: Hexyon®, Infanrixhexa®, Vaxelis®)
► and at the age of 2 months also for pneumococcus (prevent 13®).
Concerning meningococcal type B Bexsero®THE new recommendations for 2022 recommend vaccination for all infants from the age of 2 months and before the age of 2 years. However, this vaccination is not compulsory to date. In the case of meningitis risk situations, Nimenrix® (tetravalent vaccine A, C, W135 and Y) can be recommended and given to infants from 6 weeks of age. Again, this vaccine is not mandatory. Other meningitis vaccines are not indicated for infants.
Vaccination in adults is only recommended in risk situations.
Should we do a booster in adulthood?
No reminder is needed in adulthood for compulsory vaccinations carried out during childhood (in infants).
Vaccination against meningococcal type C is generally recommended for all adults up to and including 24 years of age who have not been vaccinated in childhood or adolescence. A single dose is then recommended according to the vaccination schedule in force. For vaccines directed against Hib (Haemophilus influenzae b) and against type B or tetravalent meningococci (A, C, W135, Y), vaccination in adults is only recommended in high-risk situations (example: certain blood disease, group epidemic, risk contact, risk area, endemic, etc.). Vaccination against pneumococci is recommended in adults only for unvaccinated people at high risk of severe pneumococcal infections. In general, if vaccination must take place in adults, it is most often done with a single dose of vaccineexcept in certain special cases where a booster dose may be recommended (example: in the event of a continuous risk of exposure to the germ, in the event of an increased risk of meningitis linked to a pathology or state of health, etc.) .
Vaccine efficacy is very good
How effective are meningitis vaccines?
Meningitis vaccines are effective only on bacterial meningitis caused by the germs concerned by vaccination (Haemophilus influenzae b, pneumococci Streptococcus pneumoniae and meningococci Neisseria meningitidis types A, B, C, Y and W135). The effectiveness of vaccines is very good hence their major interest in the prevention of meningitis. That of the vaccine against meningococcus is located between 83% and 98%that of the vaccine against pneumococcus East greater than 95% and that of the vaccine against hib is Dabout 95%.
What are the possible side effects after vaccination?
Meningitis vaccines are generally well tolerated. Adverse effects are infrequent and most often mild and transient: redness, pain and/or swelling at the injection site, fever, headache, muscle or joint pain. As with any medication, rare cases of allergic reactions may be observed: skin reactions (eruptions, lesions, itching), a swelling eyes or face, difficulty breathing or swallowing, discomfort or a drop in blood pressure.
What is their price?
To date, the prices of the various vaccines marketed, in whole or in part, against meningitis are as follows:
- Neisvac®: 21.50 €
- Menjugate ®: 21.50 €
- Menveo®: €42.25
- Nimenrix®: €42.25
- Bexsero®: €84.72
- Trumenba®: €84.72
- Preventar®: €51.32
- Pneumovax®: €18.67
- Infanrixquinta®: €24.60
- Pentavac®: €24.60
- Hexyon®: €35.94
- Infanrixhexa®: €36.51
- Vaxelis®: €35.94
- Act-Hib®: €35.12
Are they reimbursed?
Yes, all meningitis vaccines are reimbursed provided they are prescribed within the framework of their indications provided for by their marketing authorization (AMM) and moreover for some, only in the indications giving rise to the right to reimbursement (established according to the recommendations of the HAS in force). Apart from these situations, they are not refundable. According to the new recommendations of 2022, the Bexsero® vaccine is now covered for all infants from the age of 2 months and before the age of 2 years, which was not the case before. The booster carried out after the second year for infants whose vaccination was started before the age of two years is also covered.