MenACWY Vaccine (Meningococcal group A, C, W-135 and Y conjugate vaccine)

Vaccine

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This vaccine gives protection against meningococcal disease caused by four types of the Neisseria meningitidis bacteria, A, C, W and Y (MenA, MenC, MenW and MenY). Meningococcal disease is a major cause of meningitis and septicaemia. This vaccine does not protect against MenB.

Meningitis is an infection of the protective lining of the outside of the brain and spinal cord. Septicaemia is commonly called blood poisoning, caused by the bacteria growing in the blood stream. These can both cause serious illness and death. In 5% to 10% of cases, the infection is fatal, while survivors can suffer serious long-term complications. These include hearing loss, visual impairment, limb amputation, seizures, and brain damage.

Along with MenB, A,C,W and Y are the most common types of the bacteria found in the UK.

In the UK, the MenACWY vaccine is given to children as a single dose injection at around 14 years of age. It provides first-time protection against MenA,W and Y and boosts the MenC vaccine given to babies aged around one year old. Teenagers who miss having the MenACWY vaccine at 14 can still receive it up until the age of 25.  

Rates of meningococcal disease are highest in children under the age of five. The second highest group is young people aged 15 to 19. Outbreaks can occur in higher education institutions. However, anyone can be infected. The MenACWY vaccine was introduced in the UK in summer 2015 because of an increase in cases of MenW disease. One dose offers very good protection. 

The MenACWY vaccine does not contain any live bacteria and cannot cause meningococcal disease. It is is a type of subunit vaccine, called a conjugate vaccine. This means it uses sugars from the surface of the bacteria, joined to a protein from another organism, to help produce an immune response.

It can safely be given at the same time as the Teenage booster vaccine. You can read more about multiple vaccinations and why these are not a risk to your child's immune system.

Three brands of MenACWY vaccine are used in the UK: Menveo (see the patient information leaflet), Nimenrix (see the patient information leaflet ) and MenQuadfi (see the patient information leaflet).

 

In the UK the MenACWY vaccine is usually given to teenagers at around 14 years of age, when they are in school years 9 or 10, as part of the routine NHS schedule. However, young people can have the vaccine from the age of 10 up until their 25th birthday. 

If you are aged between 15 and 25 and missed having your MenACWY vaccination at school, or if you are not sure, it is recommended that you ask your GP for vaccination. This includes people who are not in higher education, as well as students attending university for the first time.

Students of any nationality entering a UK university for the first time who have not had their MenACWY vaccine are also eligible, again up until their 25th birthday.

Meningitis Survivor Amy Davis tells her story to Stacey Dooley

Amy Davis caught meningitis when she was just 18 years old, with life-changing consequences. In this short film she tells her story and the importance of getting vaccinated.

Please note, this was filmed in 2015 shortly after the MenACWY vaccine was first introduced. The schedule has since changed slightly but the advice remains the same.

  

Meningitis: A Survivor’s Story

https://www.youtube.com/embed/NuknOh6IfLg?wmode=opaque&controls=&rel=0

 

As well as teens and young adults, the MenACWY vaccine is recommended for people with some long-term health conditions who are at greater risk of complications from meningococcal disease. This includes people with:

  • asplenia or splenic dysfunction (a spleen that is missing or does not work properly)
  • sickle cell anaemia
  • coeliac disease
  • disorders of the complement system (an important part of the immune system) that result in immunodeficiencies

 

Safety and side effects

The frequency and type of side effects are slightly different for the three MenACWY vaccines used in the UK (Menveo, Nimenrix and MenQuadfi). For full information on side effects, ask for the patient information leaflet for the vaccine you are offered. As a general guide, side effects may be experienced as listed below.

Very common (affecting more than 1 in 10 people at each dose):

  • pain, redness and swelling at the injection site
  • headache
  • feeling tired, irritable or sleepy
  • feeling generally unwell
  • loss of appetite
  • fever

Many of the common symptoms can be relieved by giving paracetamol or ibuprofen.

Common (affecting up to 1 in 10 people at each dose):

  • stomach upsets (such as feeling sick, diarrhoea or vomiting)
  • a hard lump or a large amount of redness and swelling at the injection site
  • rash
  • muscle or joint pain

Uncommon (affecting up to 1 in 100 people at each dose):

  • in babies: crying or sleeplessness
  • dizziness
  • loss of feeling, warmth or itching at the injection site

Rare (affecting up to 1 in 1000 people at each dose):

  • swelling of the injected limb
  • febrile convulsions (fits)
  • diarrhoea, stomach pain
  • enlarged lymph nodes

It is quite common for teenagers to have panic attacks before vaccination, or to faint during vaccination. These should not be confused with reactions to the vaccination itself.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but can be treated with adrenaline.

Health care workers who give vaccines know how to do this. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations. Around 117 million doses of vaccines were given in the UK during this period. This means that the overall rate of anaphylaxis is around 1 in 900,000.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme .

The MHRA has a particular interest in any side effects from the MenQuadfi vaccine, as this is a newly licensed product. As with any vaccine, it has undergone all the usual rigorous testing before it was licensed.  

You can contact the MHRA to ask for data on Yellow Card reports for individual vaccines . See more information on the Yellow Card scheme and monitoring of vaccine safety.

 

The MenACWY vaccines used in the UK are called Menveo, Nimenrix and MenQuadfi. Apart from the active ingredients (the antigens), they contain very small amounts of these ingredients:

  • sucrose (sugar), used as a stabiliser
  • sodium chloride (salt)
  • sodium acetate (MenQuadfi only)
  • water 

The vaccines may also contain traces of these products used during the manufacturing process:

These ingredients can all be used in food manufacturing.

Other brands of MenACWY vaccines used in other countries may contain different ingredients. If you are not in the UK, ask for the patient information leaflet for the vaccine you are offered.

 

MenACWY is a conjugate vaccine (see our page on 'Types of vaccine'). Sugars (polysaccharides) are taken from the capsule around the meningococcal bacteria and joined to a non-toxic protein from diphtheria (called CRM197) or from tetanus. The protein helps to stimulate the immune system in a broader way to respond well to the vaccine. This gives a better immune response in individuals of all ages.

The main aim of giving this vaccine is to protect young people against four different types of meningococcal disease. Those aged 15 to 19 are more at risk from meningococcal disease than any other age group, except the under 5s.

However, it is expected that vaccinating this age group will also offer herd protection against MenW and MenC disease for the rest of the population, including infants. This is because teenagers and young adults are the main carriers of meningococcal bacteria, which are carried at the back of the nose and throat. People who are immunised can no longer carry the bacteria and pass them on to others in the population.

To achieve herd protection a high proportion of young people need to be vaccinated.

In October 2018 the Joint Committee on Vaccination and Immunisation (JCVI) issued a statement outlining the importance of improving vaccine uptake in 18-25 year olds who have missed out on MenACWY vaccination. Across childhood vaccines, the target in the UK for vaccination coverage is 95%.

At just under 80% for children in school year 10, MenACWY coverage for 2021 to 2022 is not yet back up to pre COVID-19 pandemic levels when it stood at almost 87% for that year group. 

As well as teenagers and young people, the MenACWY vaccine is also recommended for travellers to parts of the world which are high risk for meningococcal disease. This includes parts of Africa and Saudi Arabia.

All visitors to the Hajj and Umrah pilgrimages in Saudi Arabia need proof that they have been vaccinated against type A, C, W and Y meningococcal disease. When required for travel, the MenACWY vaccine is not provided free of charge if you are over the age of 25.

Does the vaccine work?

Since the introduction of the different vaccines against meningococcal disease from 1999, there has been a large decline in the number of cases. And recent modelling suggests that the disease will eventually be eradicated in the UK as a result of the vaccination programme. 

UK Health Security Agency data show that in England confirmed cases of meningococcal disease peaked at 2,595 cases in 1999 to 2000 before a steep decline. There were just 205 confirmed cases for 2021 to 2022, although the lockdowns and social distancing measures of the COVID-19 pandemic have affected these figures.

The incidence of meningococcal disease has decreased from 2 per 100,000 in 2006 to 2007, to 1 per 100,000 in 2011 to 2012. It is currently below 1 per 100,000.

 

 

Page last updated Tuesday, September 12, 2023