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

Key vaccine facts

This vaccine gives protection against four types of meningococcal disease caused by groups A, C, W and Y (MenA, MenC, MenW and MenY). Meningococcal disease is a major cause of meningitis and septicaemia. It can affect all age groups, but the rates of disease are highest in children under five years of age. It is also often seen in young people aged 15 to 19.

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

The vaccine does not contain any live bacteria, and it cannot cause meningococcal disease.

The MenACWY vaccine was introduced in the UK in summer 2015 because of the recent increase in cases of MenW disease in the UK (see 'More information about the vaccine' below).

Two brands of MenACWY vaccine are used in the UK: Menveo (see the Patient Information Leaflet ) and Nimenrix (see the Patient Information Leaflet ).

Who should have the vaccine?

In the UK the MenACWY vaccine is given to teenagers as part of the routine NHS schedule. It is usually given to all students in school years 9 or 10 (at around 14 years of age).

There is a catch-up programme for anyone aged 15 or older who has missed out on MenACWY vaccinination. Young people are entitled to receive the vaccine any time up to their 25th birthday. This includes students aged up to 25 years attending university for the first time, as well as those who are not in higher education. Students of any nationality entering a UK university for the first time who have not had MenACWY vaccine are also eligible up to their 25th birthday.

The MenACWY vaccine is also 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
complement disorders (the complement system is an important part of the immune system)

What protection does the vaccine give?

The vaccine boosts protection against MenC disease (for those who received a MenC vaccine as a baby). It also protects against MenA, MenW and MenY meningococcal disease. One dose of the vaccine offers very good protection. It has been used for many years as a travel vaccine and has an excellent safety profile.

The main aim of giving this vaccine is to protect young people against four different types of meningococcal disease. 15-19 year olds 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.

A high proportion of young people need to be vaccinated to achieve herd protection. In October 2018 the Joint Committee on Vaccination and Immunisation (JCVI) issued a statement about meningococcal vaccination . This outlined the importance of improving vaccine uptake in 18-25 year olds who have so far missed out on MenACWY vaccination. (Currently MenACWY vaccine uptake is 80-85% in young people aged 14-16 years, 70-80% in those aged 16-18 years, and around 40% in those aged 18-21 years.)

Ingredients

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

Sucrose (sugar), used as a stabiliser
Sodium chloride (salt)

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

Harmless sodium and potassium salts used as acidity regulators
Trometamol, another acidity regulator (Nimenrix only)

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.

Side effects

The frequency and type of side effects are slightly different for the two MenACWY vaccines used in the UK. 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)

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.

Anaphylaxis

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.

More information on side effects

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

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 . You can also 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.

More information about the vaccine

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 MenACWY vaccine is also recommended for travellers to parts of the world which are high risk for meningococcal disease (including 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. Travel vaccines are not provided free of charge.

There have been a number of changes to the schedule for meningococcal vaccines in the last few years. A teenage MenC booster was introduced in 2013, and a booster for student freshers in 2014. Both of these were replaced by the MenACWY vaccine in 2015.

These changes have been made because of a recent increase in cases of MenW disease in the UK. Overall, the number of cases of meningococcal disease has been falling in the UK since the MenC vaccine was introduced in 1999, but disease caused by MenW has increased. Cases in England increased from 30 cases in 2011-12 to 225 cases in 2016-17 (cases are counted from July one year to June the next year). There was a slight fall in cases in 2017-18 (193 cases). See more information from Public Health England and our blog post from March 2015.

Does the vaccine work?

In July 2017 Public Health England published research on the first year of the UK's MenACWY programme (September 2015 – August 2016). This showed that there were 69% fewer cases of MenW than expected overall. There were no cases of MenW in vaccinated teenagers in this period.

Following introduction of the MenC vaccine in 1999, the number of cases of meningococcal disease caused by group C bacteria fell by over 90% in vaccinated groups. There has been a very slight rise in cases since 2014-15.