Vaccine Prevention of Bacterial Meningitis

By Tina M. St. John, MD. May 7th 2016

Meningitis. It even sounds serious — and can be fatal in some cases.

The term meningitis refers to irritation, or inflammation, of the meninges. These tissues surround and protect your brain and spinal cord. There are many possible causes of meningitis, which can be infectious or noninfectious. Acute bacterial meningitis is the most life-threatening form of the disease, typically causing a rapidly developing infection that can lead to death within hours to days without immediate, appropriate treatment.

Given the right circumstances, just about any bacteria can cause meningitis. However, a few types of bacteria are particularly prone to infect the meninges and cause acute bacterial meningitis. Even with prompt treatment, acute bacterial meningitis can still cause brain damage, other disabilities or death. Therefore, prevention is the best available medical tool, and vaccines are the cornerstone of bacterial meningitis prevention.

The leading causes of vaccine-preventable, acute bacterial meningitis include:

  • Neisseria meningitidis (meningococcus),
  • Streptococcus pneumoniae (pneumococcus), and
  • Haemophilus influenzae type B (Hib).

Your risk for different types of bacterial meningitis varies according to your age. The recommended timing of preventive vaccines correlates to the relative risk at different ages. Getting immunized against meningococcus, pneumococcus and Hib greatly reduces your risk of developing acute bacterial meningitis. However, each vaccine protects you only against specific types and strains of bacteria. So it is still possible to develop bacterial meningitis caused by other types or strains of bacteria even if you’ve received all of the recommended vaccines.

Hib Vaccine Recommendations

Before the first Hib vaccine was introduced in the U.S. in 1985, Haemophilus influenzae type B was the leading cause of acute bacterial meningitis in children younger than 5 years old. It was also a common cause of pneumonia, and ear, blood and other infections among young children. The Centers for Disease Control and Prevention recommends Hib vaccination for:

  • All infants, usually beginning at 2 months old; and
  • Older children and adults with health conditions that increase their risk for Hib infection.

See the CDC Hib vaccine information statement for additional details about this immunization.     

Pneumococcal Vaccine Recommendations

Although Streptococcus pneumoniae most commonly causes pneumonia, it is also a leading cause of acute bacterial meningitis in people of all ages. Infants and seniors are particularly vulnerable. Pneumococcal vaccines protect against meningitis, pneumonia and other infections caused by Streptococcus pneumoniae. CDC recommends routine pneumococcal vaccination for:

  • All infants,
  • All seniors age 65 or older,
  • All adults who smoke or have asthma, and
  • Anyone age 2 through 64 with a health condition that increases their risk for pneumococcal disease.

Two types of pneumococcal vaccines are available in the U.S. See CDC’s pneumococcal conjugate and pneumococcal polysaccharide vaccine information statements for additional recommendations regarding these vaccines.

Meningococcal Vaccine Recommendations

Anyone can develop meningococcal meningitis but the infection is most common among babies younger than 12 months old, and adolescents and young adults age 16 to 21. CDC recommends routine meningococcal vaccination for:

  • All children, with the first dose given at age 11 to 12;
  • Adults enlisting for military service;
  • Students entering college who will be living in a dormitory;
  • Travelers visiting an area with a high rate of meningococcal disease;
  • Laboratory personnel routinely working with meningococcus; and
  • Anyone with a health condition that increases their risk for meningococcal disease.

See CDC’s meningococcal vaccine information statement for additional facts and recommendations.

New Vaccines Under Evaluation

Just as people are grouped by race, ethnicity and families based genetic similarities and differences, scientists characterize bacteria similarly. When developing a vaccine, the strains of a particular type of bacteria most likely to cause disease are usually included in the formulation. The meningococcal vaccines approved for use in the U.S. as of April 2014 provide protection specifically against what are known as groups A, C, W and Y meningococcus. However, group B meningococcus also causes meningitis and the vaccines currently approved by the U.S. Food and Drug Administration do not provide protection against this variant.

But there is good news. Two vaccines that provide protection against group B meningococcus were granted “breakthrough therapy” status by the FDA in March and April 2014. This designation means the vaccines will undergo expedited FDA review and may soon be available for use in the U.S. One of the group B meningococcus vaccines is already approved for use in Canada, Australia and Europe.

Next Steps

For Patients

  • Review your immunizations with your doctor to be sure you are current with all vaccine recommendations to protect you from acute bacterial meningitis.
  • Talk with doctor if you’re unsure whether you need certain vaccines, especially if you have recently been diagnosed with a chronic health condition.
  • If you or a family member experience symptoms suggestive of meningitis, seek immediate medical evaluation. Common symptoms include fever, headache, neck stiffness, light sensitivity, vomiting, and sleepiness and/or reduced alertness.  

For Family Caregivers

  • Talk with your family doctor or pediatrician to be sure your children have received all the immunizations needed to protect them from vaccine-preventable meningitis.
  • If you help care for elder loved ones, talk with them or their doctor to be sure they have received the vaccines necessary to protect them from acute bacterial meningitis and other infectious diseases. 

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