Meninges are membranes or layers of tissue that line the brain and spinal cord. When an external agent manages to break the barrier of the organism and infect the structure, igniting it, a picture of meningitis develops .
The term is well known, especially among the fathers and mothers of young children, as the disease has a high prevalence among children aged up to 5 years.
Although meningitis can be caused by factors other than infectious, such as trauma, it is the communicable types that cause most concern in health policies due to the high endemic capacity.
But the good news is that there is a vaccine to prevent bacterial infection, one of the most serious and intense types of the disease.
The Unified Health System (SUS) provides a free dose against meningitis C – which represents up to 70% of cases of infection – for children and adults, between 2 months and 50 years of age.
In the 1970s, there was an epidemic of meningococcal meningitis (of bacterial origin) in Brazil. The outbreak was controlled with the adoption of mass vaccination and, in the following years, the policies of the vaccination card or calendar began to be institutionalized.
Vaccines for types A, W, Y and, more recently, B, exist in Brazil, but are only available through the private health network.
By June 2018, approximately 116 cases of the disease in general (including several causes) had been diagnosed, less than the number registered in the same months of 2017 (in which 185 cases occurred).
Annually, it is estimated that there are about 500 thousand cases worldwide and, of these, 50 thousand patients die. Therefore, preventive measures are always essential to reduce risks and complications.
Contents
What is the meningitis vaccine?
Vaccines are doses capable of stimulating the body to produce antibodies against certain diseases. So, even if external and infectious agents invade our bodies, if we are properly vaccinated, we can fight the agents effectively and prevent the disease.
Unlike medicines – which treat the disease, fight infection or alleviate symptoms – vaccines immunize the body through inactivated or very weak doses of bacteria.
Thus, when injected, these dead or weakened elements cause a mobilization of the immune system, which acts to combat the agent. More than just eliminating and preventing disease, this defense system records the action and creates an immune memory.
It is as if, now, there is an antibody highly trained and specialized in quickly combating this bacterium, preventing the disease from installing itself if there is a future infection.
What is meningitis?
To understand meningitis, it is necessary to understand the anatomical structure of the body. The brain and spinal cord are parts protected by 3 layers, called the meninges. They are the dura mater (layer closest to the brain), arachnoid (intermediate layer) and the pia mater (layer most external to the brain).
When something causes the inflammation of these membranes, it is called meningitis, which can be of non-infectious cause or also called aseptic, and infectious (infectious agents that invade the organism).
Among the causes of non-infectious meningitis are tumors that invade the region, medications and intoxication by chemical agents. The infectious type, on the other hand, is caused by agents that invade the organism, and there are 3 most common types of infection: viral, bacterial and fungal .
Virus meningitis is, in general, the mildest and mildest form of the disease. The occurrence is higher in late summer and one of the main causative agents is the Enterovirus.
Even though the symptoms can be quite uncomfortable, such as headaches and vomiting, the treatment is usually simple and often without much specification – just take care of your health in general, allowing the body to recover.
Meningitis can also be caused by fungi and, in this case, they are considered to have a subacute evolution (that is, the patient can remain infected for several months without symptoms or with manifestations that are difficult to diagnose).
One of the characteristic factors of fungal meningitis is that it is not transmissible between people. The most related agent to the disease is Cryptococcus neoformans , usually housed in the feces of birds, soils and vegetables.
Bacterial meningitis is a serious condition that, if not treated, can cause complications and lead to death.
Currently, there is a vaccine for the prevention of bacterial meningitis, meningococcal, pneumococcal and Haemophilus influenzae b .
Although all of them are extremely relevant and efficient, the meningococcal type has a variety of 13 groups of bacteria that cause the disease, which makes immunization coverage difficult.
This variety results in 2 factors: the type is the easiest to be transmitted and the vaccine is not able to promote protection against all of them.
Transmission is through direct contact with the secretions of an infected person. But although we are constantly in contact with infectious agents, it is worth remembering that our organism is often able to fight them and prevent the disease.
Therefore, even when infections occur, not all bactericidal agents have the ability to migrate to the brain region and cause a condition of meningitis.
The infection must be able to reach the respiratory tract and break the blood barrier. When this invasion occurs, infectious agents are able to reach the nervous system and settle in it, triggering the disease.
The bacterium Neisseria meningitidis , responsible for meningococcal meningitis, has 13 different serotypes. It is as if they all belong to the same family, but have some particularity that differentiates them.
So, to facilitate naming and differentiation, the researchers named each group (serotype) of this bacterium with a letter. The 13 known serotypes are A, B, C, D, 29E, H, I, K, L, W135, X, Y and Z, but there are 5 (A, B, C, W and Y) that are responsible for the great most frames.
The bacterium Haemophilus Influenzae has 6 serotypes: A, B, C, D, E, F, which work in the same way, in which the appointment occurs due to changes in the structure of the bacterium.
Pneumococcal meningitis, on the other hand, has more than 90 serotypes capable of triggering the infection. In Brazil, there are 13 most common groups: 14, 1, 6B, 5, 6A, 23F, 19F, 9V, 3,4, 10A, 8 and 7F.
Although the nomination is based on numbering, the principle is the same, being only to differentiate the bacteria belonging to the large group Streptococcus pneumoniae .
That is, the difference between meningitis A, B, C and the others is just the type of bacteria that infected the patient.
The incidence of each meningococcal meningitis serotype (A, B, C, W and Y) may vary according to the region or country, but type C is the most recurrent in Brazil, considering all age groups.
However, if only patients under the age of 5 are considered, cases of meningitis B are more frequent.
After vaccination measures, meningitis has gradually decreased, although the incidence and mortality of the disease are high.
Between 2000 and 2009, meningitis C increased from 15% to almost 40% of cases among children, according to the Brazilian Society of Pediatrics. From 2010, with vaccination, there was a significant reduction until 2014.
In numbers, this means that in 2010, 13 children for every 100 thousand were diagnosed with meningitis C. In 2014, the index dropped to 7 for every 100 thousand. Still, serotype C is the major cause of the disease.
Symptoms and complications of meningitis
In the beginning, the most common symptoms of the infection are drowsiness, nausea, vomiting, body aches, fever , loss of appetite and irritability. In general, these signs usually appear in the first 8 hours of infection, especially in children.
Within a few hours, signs of neck stiffness, headaches, sensitivity to light and spots on the skin can manifest.
However, they are quite mild, which can make the picture difficult to define by the symptoms, especially when the patient is a baby.
One of the aggravating factors of the infection is the ability to evolve quickly, and between 24 and 48 hours the disease can represent great risks to life.
On average, 20% of patients with meningococcal meningitis in Brazil die and, among those who recover, up to 20% may have complications (such as the need for amputations, decreased hearing, brain damage and learning difficulties).
What is the meningitis vaccine for?
The vaccine for meningitis serves to protect the person and the whole society, offering immunization against the bacteria that causes the infection, because in addition to reducing the risk of illness, the injection helps to reduce the contagion and circulation of the agent.
You may remember some illnesses that you only have once in your life. That case of measles , for example, which occurred in childhood and, therefore, will not reappear in adulthood.
The process is the same with some vaccines: our immune system is able to remember some agents that it has already fought – whether through illness or the dose of the vaccine.
There are two possible processes. The first is when the immune memory is so efficient that the disease will no longer be able to affect the patient. The other is when there is a need to take constant doses of the vaccine (such as the flu), because the infectious agent changes over time.
But if the body creates defenses when the agent comes into contact with the bacteria and becomes ill, why is the vaccine important?
The first time the body comes into contact with the agent – whether due to the disease or the vaccine – it takes a longer time to act and fight the infection.
Basically, it is as if immunity does not know exactly how to react to the unknown infection, so there is time for the bacteria to settle and cause symptoms.
But as the vaccine is a small dosage of the weakened or dead infectious agent, the bacteria is unable to multiply, spread or weaken the organism. Therefore, the body does not suffer from the symptoms and creates resistance.
It is worth remembering that meningitis is an incubation disease, that is, the patient takes a few days to show symptoms. So if the person comes into contact with the patient and still does not show symptoms, it does not mean that he has not been infected. Therefore, having the vaccine afterwards will not prevent infection.
The ideal is to keep immunization up to date, respecting the correct periods, and to adopt basic preventive measures, such as washing your hands well and avoiding crowded places.
To offer meningitis immunization to the population, there are 3 main vaccines: ACWY (conjugated or quadrivalent) and B and C (isolated, which can be combined in other vaccinations).
Vaccines are available in the National Vaccination Program:
- Pentavalent : in addition to meningitis, the dose provides immunization against diphtheria, tetanus, whooping cough and hepatitis B;
- Pneumococcal 10 valiant conjugate : immunizes against various infections due to the 10 types of the bacterium S. pneumonia ;
- Conjugated meningococcal C : immunizes against meningitis caused by the bacterium N. meningitis C;
- BCG : immunizes against severe forms of tuberculosis (miliary and meningeal).
The conjugated or quadrivalent types (capable of providing immunization for meningitis A, C, W and Y) and for meningitis B are part of the private health network and can be requested by the doctor.
Which meningitis has a vaccine?
They are bacterial meningitis that can be prevented by vaccines . Currently, the public and private health networks offer immunization against meningococcal, pneumococcal and Hib type infections.
Learn more about the vaccine for each of the meningitis:
Meningococcal meningitis
It is caused by a bacterium called Neisseria meningitidis , with a Gram-negative characteristic (a color test allows to differentiate bacteria by the negative / positive color) with a coconut shape.
There are several subgroups of this infection, which are determined by the aspect of the causative agent, in which the shape or structure of the bacterium determines its serotype (to differentiate, the main types of Neisseria meningitidis are subdivided into A, B, C, W and Y).
Pneumococcal meningitis
It is caused by the bacteria Streptococos pneumoniae , of Gram-positive characteristic (in the color test, the bacteria acquire positive colors) also in coconut shape (rounded).
The variety of subtypes is enormous, reaching more than 90 different capsule (or cell wrapper) formats.
However, the vast majority of diseases are caused by approximately 16 types of pneumococci. This infectious agent is also responsible for pneumonia and other respiratory diseases.
Influenzae (Hib) meningitis
The infection is caused by the Gram-negative type Haemophilus influenzae bacteria (in the color test, the bacteria become negative colors), which can be subdivided into 6 types: A, B, C, D, E and F, according to its capsular structure.
This agent can live in the person’s throat and mucous membranes without causing symptoms or triggering the disease. But still, it can be transmitted and, in non-immunized people, trigger symptoms.
The agent is also responsible for diseases such as bronchitis , sinusitis , septicemia, epiglottitis, septic arthritis and otitis.
What are the vaccines against meningitis?
To understand the immunization system, it is necessary to remember that there are several types of bacteria that cause the infection and among them there are 3 responsible for most cases: meningococci, pneumococci and hemophiles (or Haemophilus influenzae of serotype B, or just Hib).
The types caused by meningococci are the most frequent, and they can be subdivided according to the causative bacteria, A, B, C, W and Y (there are others, but these are the vast majority of cases in Brazil).
That is, meningococcus is a large group and meningitis A, B, C, W or Y are determined by the infectious agent.
In summary, there are 3 types of vaccine capable of protecting against meningococcal meningitis, which are B, C and ACWY. While doses B and C are for isolated types of meningitis, ACWY encompasses the four serotypes of the disease.
For the prevention of pneumococcal types, there are the 10-valent, 13-valent and 23-valent VPC vaccines.
But if you’ve looked at a vaccination schedule, you may have noticed that there are other vaccines that can provide protection against meningeal infection, such as BCG, which is actually for tuberculosis .
This is because meningitis can have different causes and, therefore, other vaccines help in immunization and protection against the disease.
The most common types of vaccine in Brazil, including the public and private network, are:
Meningococcal ACWY (conjugated)
Among the ACWY conjugate vaccines marketed in Brazil, are Menveo , Nimenrix and Menactra .
Each has different recommended age groups: Menveo is indicated for children from 2 months, Nimenrix should be used in children from 6 weeks of age and Menactra is indicated for people between 9 months and 55 years of age.
Although it does not participate in the free vaccination schedule, the ACWY type is recommended for babies from 2 or 3 months of age, with the aim of increasing protection against these agents and reducing the transmission of bacteria.
Check below, briefly, the vaccination schedule of ACWY:
- Enter from 2, 6 or 9 months, depending on the laboratory: there are 3 vaccinations, with 2 months interval between doses and 1 booster when completing 2 years of life, at least 2 months after the last dose.
- Between 2 and 10 years it is only 1 vaccination and the boosters are not established.
- From the age of 11 the scheme is the same, with 1 vaccination, with the booster not established.
Meningococcal B (recombinant)
Recently, the Meningo B vaccine, or commercially known as Bexsero , arrived in Brazil , still restricted to private health networks. The dose is specific for type B of meningitis, being indicated from 2 months of age, up to 50 years of age.
In general, the vaccine is composed of sodium chloride, histidine, sucrose and water for injections, in addition to the inactivated bacteria Neisseria meningitidis, which causes meningitis B.
Children between 6 and 11 months of age who were not vaccinated at 2, 4 and 6 months should receive 2 doses, with a 60-day time interval between each injection, and 1 booster dose in the second year of life.
Unvaccinated children between 12 months and 10 years of age should receive 2 doses of the vaccine, with at least 2 months between each application.
Below you can see, briefly, the vaccination schedule for Meningo B:
- Between 2 and 5 months there are 3 vaccinations, with a 2-month interval between each dose. 1 booster should take place between 12 and 15 months.
- Between 6 and 11 months there are 2 vaccinations, with a 2-month interval between each dose. 1 booster when completing 2 years of life after at least 2 months of the last dose.
- Between 1 and 10 years there are 2 vaccinations, with a 2-month interval between each dose. It does not need reinforcement.
- From 11 years of age there are 2 vaccinations, with an interval of 1 and 2 months between each dose. It also does not need reinforcement.
Meningococcal C
The vaccine was implemented in the vaccination schedule, being offered free by SUS in 2010, after an outbreak of meningitis C.
It is recommended to apply at 3 and 5 months, with a booster at 12 months of age. Between 11 and 14 years old, a reinforcement or a single dose is required.
If children have missed the correct immunization stage, dosing can be done up to 4 years, 11 months and 29 days on the same schedule.
The composition of the Meningococcal conjugate vaccine C includes polysaccharide (de-O-acetylated) Neisseria meningitidis group C, aluminum hydroxide, histidine, sodium chloride and water for injections.
Adverse reactions are uncommon, but fever, pain and redness may occur at the application site, fever and headaches within 48 hours.
Below you can see, briefly, the vaccination schedule for Meningo C:
- Between 3 and 5 months there are 2 vaccinations, with a 2-month interval between each dose. 1 booster at 12 months.
- Between 11 and 19 years is a single dose if not vaccinated in childhood. 1 booster if the 1st dose was made in childhood.
Pneumococcal (VPC) 10-valent
The 10-valent VPC vaccine is included in the vaccination calendar of the Ministry of Health. It promotes the immunization of 10 types of pneumococcal bacteria (1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F) .
Dosing should be done in 2 doses: at 2 and 4 months, and it is necessary to make a booster at 12 months.
Among the options sold in Brazil is Synflorix , which contains in its formulation the excipients sodium chloride, aluminum phosphate and water for injections.
Its effectiveness is approximately 70% of cases of pneumonia, meningitis and otitis.
Below you can see, briefly, the vaccination schedule for VPC 10-valent:
- Between 3 and 5 months there are 2 vaccinations, with a 2-month interval between each dose. 1 booster at 12 months.
Pneumococcal (VPC) 13-valent
13-valent VPC, like Prevenar 13 , is available in clinics and private health centers and offers immunization against 13 types of pneumococcal bacteria (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F). Its protective capacity rises to 90% of cases of pneumonia, meningitis and otitis.
Adverse reactions are uncommon, but pain and redness may occur at the application site, in addition to low fever within 48 hours.
Below you can find, in a summarized way, the vaccination schedule that should be followed only if recommended by the doctor:
- From 2 years old there is 1 vaccination, with 1 booster after 5 years;
- From the age of 50 there are 2 vaccinations, 6 months apart.
Pneumococcal 23-valent
The Pneumococcal 23 Valente vaccine contains 23 types of inactive bacteria, being recommended for children from 2 years of age at risk for infections (under the express recommendation of the pediatrician) and elderly people from 60 years of age (who are hospitalized or who live in nursing homes) or nursing homes).
Generally, the risk of infection involves patients with:
- Renal diseases;
- AIDS;
- Patients who have removed the spleen;
- Patients suffering from alcoholism.
- Chronic respiratory diseases;
- Moderate or severe persistent asthma;
- Chronic heart diseases;
- Chronic kidney diseases;
- Hemodialysis patients
- Transplanted;
- Patients with cancer or therapeutic immunodepression;
- Mellitus diabetes;
- Disabling chronic neurological diseases.
Despite appearing on the vaccination calendar, the dosage is recommended for indigenous children from 5 years of age, and can be done in adolescence or adulthood as well. In the elderly, the dosage should be applied as a reinforcement.
Its composition contains particles purified from the agents (capsules) of 23 types of Streptococcus pneumoniae (pneumococcus), sodium chloride, water for injection and phenol.
Within 2 days after application, pain, redness and swelling may occur in the area. Low fever, pain in the body, headaches and joints may also manifest.
Check the recommended vaccination schedule:
- From the age of 60 there are 2 vaccinations, 5 years apart.
Haemophilus influenzae B (Hib)
The bacterium Haemophilus influenzae can cause respiratory tract infections such as meningitis and epiglottitis. The vaccine has been available since 1993 and has an efficacy between 95% and 100% against meningitis.
Called the Hib vaccine, the dose is part of the vaccination schedule, making up part of the pentavalent vaccine, but it can also be found in isolation at referral and vaccination centers, when reinforcement or complementation is necessary.
In other words, Hib is applied in a combined manner (pentavalent) in the first months of life.
The Vaccine Against Haemophilus Influenzae B is an option marketed in Brazil, which is safe and should be applied to ensure immunization, but it is important to be aware of the side effects, which may involve skin rashes or injuries, loss of appetite, vomiting, diarrhea , fever, drowsiness and irritability. At the application site, pain, discomfort, swelling, redness and itching may occur.
Check the recommended vaccination schedule:
- Between 2 and 6 months there are 3 vaccinations, with a 2-month interval between each one. 1 booster between 12 and 18 months.
Pentavalent vaccine
Indicated for babies under 1 year of age, the pentavalent vaccine is applied in 3 doses, being necessary to wait 60 days between each application. It is recommended that doses be taken at 2, 4 and 6 months of age.
At 15 months and 4 years, it is recommended to apply a booster dose.
Pentavalent is part of the vaccination schedule and offers immunization against diphtheria , tetanus, whooping cough , meningitis by Haemophilus influenzae type B and polio and among the options marketed in Brazil is Pentaxim .
In the composition, there is usually lactose, sodium chloride, 2-phenoxyethanol, aluminum hydroxide and water for injection. But it is necessary to be aware of the presence of traces of antibiotics ( streptomycin , neomycin and polymyxin B ), formaldehyde and serum albumin of bovine origin, which can generate allergies.
Among the adverse reactions, pain, redness, itching and swelling may occur at the application site even after 10 days. Even more rarely, symptoms of irritability, low fever and lack of appetite may appear even in patients without a history of allergy .
Check the recommended vaccination schedule:
- Between 2 and 6 months there are 3 vaccinations, with an interval of 2 months between each dose. 2 reinforcements should be made between 15 months and 4 years.
Vacina BCG
The vaccine is composed of weakened Mycobacterium bovis agents . It is recommended that the application be done as soon as possible, preferably shortly after birth, until 5 years of age.
Among the options found in Brazil is BCG – Fundação Ataulpho de Paiva .
Non-immunized patients and those with immunodepressive diseases or who are using medications capable of affecting immunity, with suspicion or confirmation of tuberculosis are contraindicated to vaccination.
Pregnant women, patients being treated for infections or using antibiotics should talk to their doctors and assess the need and possibility of receiving the BCG dosage.
Check the recommended vaccination schedule:
- 1 dose should be applied at birth.
How are they made?
There are two ways to produce vaccines: by weakening infectious agents or by inactivating them.
Meningitis vaccines are produced with fragments or particles of bacteria, that is, they are dead parts that do not cause infection in the patient.
In addition to the infectious agent, vaccines contain other elements, such as:
- Suspension liquid : usually constituted of distilled water or physiological saline solution, containing proteins or cell cultures;
- Preservatives, stabilizers and antibiotics : vaccines may contain small amounts of antibiotics or substances that prevent the growth of bacteria and fungi. As stabilizers can be added, these are the components that most present allergic reactions;
- Adjuvants : they are usually products containing aluminum to increase the action of some vaccines, increasing the capacity of immunization.
Who should take it?
Except for the groups and patients contraindicated by the doctor, the age groups have the recommendation to carry out the following vaccinations:
Premature babies
Children who were born prematurely should follow the following recommendations according to the Brazilian Society of Immunizations:
- BCG: when the newborn child weighs 2 kg or more;
- Pneumo C: when the premature child reaches 2 months of life, as early as possible;
- Haemophilus influenzae B (Hib): should be applied preferentially.
Kids
All children should receive the vaccines on the Ministry of Health calendar, except for those with allergies to the dose components.
Preferably, the indicated periods of immunization should be respected, but if any dose is no longer applied at the correct age, it should be done on the next visit to the vaccination unit.
- ACWY: children between 3 months and 11 years old;
- Meningo B: children from 2 months and 11 years old;
- Meningo C: all children from 2 months;
- 10-valent VPC: all children, between 2 months and 5 years;
- 13-valiant VPC: all children between 2 months and 5 years;
- 23-valent VPC: children with chronic illnesses who receive medical advice;
- Haemophilus influenzae B (Hib): children from 2 months;
- Pentavalent: all children from 2 months of age;
- BCG: all children, as soon as possible.
Teenagers
Teenagers should keep their vaccination schedule up to date. If any dose has been missed or there is no confirmation of the application, it is necessary to be vaccinated as soon as possible.
Between 11 and 19 years old, the Brazilian Society of Immunizations recommends the following vaccines:
- ACWY: all adolescents must receive the booster dose or 2 doses for unvaccinated adolescents;
- Meningo B: all adolescents;
- 23-valiant VPC: adolescents with chronic diseases who receive medical advice or in cases of an outbreak of the disease.
Adults
For adults who have been properly vaccinated and are up to date, the recommendations depend mainly on the risks of the epidemic.
- ACWY: adults should receive the vaccine or booster when there is a risk of outbreaks of meningitis A, C, W or Y. Pregnant women should consider receiving the vaccine when there are situations of increased risk;
- Meningo B: adults at risk of contracting the disease or in episodes of outbreaks of meningitis B. Pregnant women should consider vaccination when there is an increased risk.
Seniors
- ACWY: in cases of disease outbreak or when the elderly person is going to travel to risk regions;
- Meningo B: if there are outbreaks of the disease;
- 13-valiant VPC: all elderly people should receive a dose, especially if they are at risk groups (patients with chronic diseases, for example);
- 23-valent PCV: all elderly people should be vaccinated as a complement to 13-valent PCV.
Other cases
Health professionals, military personnel, firefighters, police officers, professionals who travel constantly, volunteers, refugees and professional athletes should be vaccinated with the vaccines:
- ACWY;
- Meningo B;
- Meningo C.
Vaccination schedule for meningitis
Below you can see which vaccines for immunization against meningitis are recommended by the Brazilian Society of Immunizations, which are offered by the National Immunization Program (PNI) and which are the right periods for application:
- At birth : BCG (public network);
- 2 months : 1st dose of Pentavalente and Pneumo 10 (public network).
- 3 months : 1st dose Meningo C (public network), 1st dose Meningo B (private network);
- 4 months : 2nd dose of Pentavalente, 2nd dose of Pneumo 10 (public network);
- 5 months : 2nd dose Meningo C (public network), 2nd dose Meningo B (private network);
- 6 months : 3rd dose of Pentavalente (public network);
- 7 months : Meningo B (private network);
- 12 to 15 months : 1st reinforcement Meningo C (public network), ACWY and Meningo B (private network);
- 15 months : 1st Pentavalente reinforcement (public network);
- 4 years : 2nd Pentavalente reinforcement (public network);
- 5 to 6 years : Meningo ACWY (private network);
- 11 to 14 years old : 2nd reinforcement Meningo C (public network), Meningo ACWY (private network).
Vaccination in adults
Meningo B and ACWY vaccines, in general, are not recommended for the elderly, as the age group has already left the risk group. Although there are still risks of infection, the incidence is quite small and the need for an injection should be discussed with the doctor.
As vaccines are not part of the public health system and the values are quite high (Meningo B costs from 250 reais per dose), it is recommended that only specific cases be vaccinated (if there is an outbreak, travel to risky places or aggravating factors to health).
The ACWY and B vaccine for young people and adults, on the other hand, is recommended for cases in which the person will travel to high-risk regions or present health problems that cause low immunity (such as chronic diseases or AIDS ).
In adults, the scheme to be followed is:
- 13-valent tire : single dose;
- 23-valent tire : single dose, with reinforcement after 5 years;
- Meningo C : single dose;
- Meningo ACWY : unique dose.
Care before and after vaccination
In general, there are no specific recommendations prior to vaccination for meningitis and, except under medical advice, all children should follow the vaccination schedule and receive immunization against infection.
Children with a high fever may be advised to wait for the fever to improve before immunizing. So, since delivery, it is important to carry out pediatric follow-up and keep the vaccination card up to date.
During application, young children may be agitated, afraid or nervous, causing difficulties in administering the dose. This is probably one of the biggest complications in relation to the vaccine.
At this point, the most important thing is to keep the child calm and immobile, so that the injection is correctly applied.
After applications, symptoms may appear, including minor irritations at the application site, fever or malaise. It is worth remembering that none of these symptoms are due to meningitis, but only to adverse reactions.
When there is itching, redness, swelling or pain in the area, cold compresses (cotton moistened with water or cold thermal bags) are recommended.
If fever, vomiting, headaches or other persistent severe symptoms are present, medical attention should be sought.
It is possible that medications are administered to alleviate the manifestations and improve the patient’s condition, but only under medical prescription.
Contraindications
Patients who are allergic to the components of the vaccine, who have experienced an intense reaction at previous dosages (such as anaphylaxis ) or who have inflammation and fever need to talk to the doctor or pediatrician before receiving the vaccine.
If there is knowledge about allergy to the components of the composition, clotting problems, use of blood thinners or medications that reduce immunity, it is necessary to inform the doctor before administering the dosage.
Pregnant or lactating women should always talk to their doctor before using any medication or receiving vaccines. In principle, vaccines for meningitis should not be given to pregnant or lactating women unless there are outbreaks or increased risks of contamination.
In cases of necessary vaccination, the risks and benefits must be assessed by the health professional according to the patient’s condition.
Side effects
After application, side reactions may appear, but they tend to be mild and mild. Among the adverse effects and the average duration of time shared by the different meningitis vaccines are:
- Redness at the application site: for up to 2 days;
- Pain: for up to 2 days;
- Itching: between 1 and 2 days;
- Swelling: between 1 and 2 days;
- Mostly mild fever, but it can also be moderate: for up to 2 days;
- Malaise: between 3 and 7 days;
- Joint pain: up to 7 days;
- Headache: up to 7 days;
- Nausea: between 3 and 7 days;
- Irritability: up to 2 days;
- Loss of appetite: between 2 and 3 days;
- Drowsiness: up to 2 days;
- Paleness: between 1 and 2 days;
- Diarrhea: between 3 and 5 days;
- Vomiting: between 1 and 2 days;
- Skin rashes: between 2 and 3 days;
- Fainting or feeling faint: up to 2 days;
- Seizures: between 1 and 2 days.
Some symptoms may arise related to stress , such as feelings of fainting, agitation and redness of the skin. In general, they are more frequent conditions in children or people with fear or needles phobia.
Although there are cases in which symptoms persist for up to 7 days, when the malaise or side effects exceed 3 days or are severe, it is recommended to inform the unit of application and seek medical assistance.
Where to find vaccines for bacterial meningitis?
In the public network, the vaccines Meningo C, Pneumo 10-valent and Hib (combined in Pentavalente) are available. In cases of epidemic or special condition of the patient, children from 2 months and adults can find Meningo C also in the CRIEs (Reference Centers for Special Immunobiologicals).
In the private network, vaccines are available for Meningo C, in addition to Meningo ACWY and Meningo B. The 23-valent and the isolated Hib vaccine are available in CRIEs, being available to risk groups or epidemic conditions.
How much do meningitis vaccines cost?
The values vary widely and depend on factors such as availability, rate of infections, seasonality (periods with higher levels of demand tend to raise prices) and laboratory.
But in general, the private network offers the following values:
- Pneumococcal 13-valent vaccine : on average, between 230 and 280 reais;
- ACWY meningitis : on average, between 280 and 350 reais;
- Meningitis B : on average, between 350 and 780 reais.
Why vaccinate?
Meningitis has a mortality rate of up to 90% in untreated patients and prevention is always the most appropriate way to reduce risks and improve public health.
In addition to assisting in their own protection, vaccination helps to decrease the circulation of infectious agents and, consequently, to minimize contagion, especially from people who cannot receive the vaccine.
Thanks to immunization policies and incentives, contagion rates are reduced. For example, cases of meningitis C reached 70% of all diagnoses, but after immunization campaigns, the rates dropped to 28% in 2017, according to the Brazilian Immunizations Society.
In the first year of life, children are more vulnerable to infection from meningitis, presenting severe conditions of the disease, which can lead to death.
Especially in this age group, it is difficult to maintain care with the correct hygiene and protection, as soon as children tend to keep their hands in their mouths frequently.
But, if properly vaccinated, the risks of contracting the infection are considerably lower and the health of the whole family is protected.
Other ways to prevent
Meningitis is a disease transmissible by contact with droplets of saliva when a person speaks, coughs , sneezes or kisses.
But it is necessary to remember that the person does not need to appear to be sick in order to have the bacteria, as there are cases in which the infectious agent is hosted in the person, but without manifesting symptoms (called healthy carriers).
So, all preventive measures are valid and useful for reducing disease rates. Between them:
- Avoid agglomerations and closed places, with little air circulation;
- Wash your hands and avoid getting them in your eyes and mucous membranes;
- Take care with the sharing of objects;
- Taking care of health as a whole;
- Avoid getting close to infected patients.
It is babies, the elderly, patients with chronic diseases and people with weakened immunity who have the greatest risk of contracting the infection. Therefore, care with the disease must be redoubled in these groups.
In addition, adopting these attitudes routinely helps to reduce the risk of other infections and diseases, such as flu and conjunctivitis .
Common questions
What are polysaccharide and conjugate vaccines?
Meningitis vaccines are produced with fractions or parts of the dead (inactive) bacteria, making them very safe because there is no possibility of bactericidal multiplication, which would cause the disease.
However, the immune response tends to be lower and, therefore, it usually takes 2 or 3 doses for the body to be adequately protected.
To produce these vaccines, polysaccharides from the bacterium’s structure are used, but there is still a difference between polysaccharides and conjugated polysaccharides.
While the first type is not effective for children under 2 years and does not induce immunity for a long period, the second type (conjugated) shows more effective results. This is because together with the polysaccharide, there is a conjugation of a carrier protein.
In general, polysaccharide vaccines show a reduction in immunization after 3 years of application and, with each new dosage, side effects tend to be more intense with less effective immunization.
Although all vaccines for meningitis are produced with the inactive agent (polysaccharides), there are conjugated and non-conjugated versions. Always check the information with the manufacturer.
Should I take or give my child the meningitis B vaccine?
The Brazilian Society of Immunizations has, in its calendar, doses of the vaccine against meningitis B. Although not offered by the public network, immunization can be recommended in cases of risk or if there are outbreaks of the disease.
However, the vaccine has a high commercial value and, therefore, it becomes inaccessible to a large part of the population. If there is a possibility, talk to the doctor or pediatrician and assess the need for the dose.
Why does the public health system not provide other vaccines for meningitis?
Public policies for prevention, vaccination and health care aim to meet the most urgent and immediate demands.
The Brazilian vaccination calendar is one of the most complete in the world, offering a series of vaccines capable of protecting children from the main current diseases.
Over the years, vaccines have been included and adjusted to the calendar as needed (cases, epidemics and deaths).
Can AIDS or HIV patients get a vaccine for meningitis?
-Yeah . It is known that the chances of contracting meningitis in patients with AIDS or HIV are not greater than in healthy patients, unless there are specific or identified risks.
For the Brazilian Society of Immunology, in these cases the recommendation to be followed is:
- BCG : for all children (with HIV or not) shortly after birth;
- Haemophilus influenzae : normal application according to the vaccination schedule;
- Influenza and antipneumococcal : indicated for all patients with HIV.
For other vaccines, it is necessary to talk to the accompanying doctor.
Is there a risk of getting meningitis with these vaccines?
No . It is worth remembering that, despite being produced with the infectious agent, vaccines are quite safe, as they are produced with fragments of the bacteria (that is, dead bacteria).
Reactions to the vaccine resulting from the immunization process and the creation of antibodies may occur, but they are not symptoms related to meningitis.
Are there any risks of getting meningitis even with all the vaccines?
-Yeah . Unfortunately, vaccines for meningitis considerably reduce the risk of getting the infection, but since several infectious agents can trigger the disease, it is not possible to guarantee immunization against all of them.
By keeping the vaccination schedule up to date, you considerably reduce the chances of getting meningitis, as it is worth remembering that there are non-specific vaccines that help with immunization (for example, BCG against tuberculosis that protects against tuberculous meningitis).
Vaccines are safe and effective, as long as medical recommendations are followed.
Specific patient conditions, such as immune reaction, time of antibody production and sensitivity of the organism can influence the percentage of protection, but it is important to note that, for example, meningitis C has had marked drops in infection rates since the vaccine started. the public health calendar.
Can meningitis affect people of any age?
-Yeah . The disease manifests itself more severely in children and the elderly, but all ages can be infected.
If I have contact with someone who is sick and get the vaccine right away, will I be protected?
No. Although the symptoms usually take time to appear, the bacteria may have installed itself in the body. This is because there is the so-called incubation period (no symptoms appear, but the infection has already occurred).
In addition, the body takes some time to create antibodies against meningitis. Therefore, the ideal is to respect the correct vaccination time and reduce the risk of infection.
Can you give the meningococcus B vaccine together with other vaccines?
-Yeah . It is possible that vaccines will be applied on the same day. There are dosages that are administered together, to optimize the vaccination process, reduce bites and improve coverage levels (for example, with pentavalent vaccines).
But it is always necessary to consult a specialist and assess whether the vaccines can be administered together.
Can pregnant women get the vaccine?
There is no evidence that the administration of vaccines – whether those with inactivated or weakened bacteria – causes risks to the pregnant woman or the baby.
Care should be taken in cases of live vaccines (such as measles, rubella , mumps , yellow fever and BCG), as there may be contraindications in pregnant women.
Vaccination is a safe and effective way to reduce the circulation of diseases and infectious agents.
The vaccination schedule always takes into account the region and the current epidemiological context. That is, each location will adapt vaccination policies to offer the most effective protection to society.
The public health system provides some of the main vaccines free of charge, including special cases (such as disease outbreaks or patients at risk).
Therefore, by keeping the vaccination card up to date, you guarantee more health for you and for the whole society.
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