By: Mundeep Kainth, DO, MPH, FAAP & Nadia K. Qureshi, MD, FAAP
Meningococcal infections are serious illnesses caused by bacteria. They are not very common, but they can cause healthy teens and young children to quickly get very sick.
Most people get infected at home or in crowded shared spaces like day care centers, schools, college campuses and military recruitment camps.
Before meningococcal vaccines were available, many children developed serious meningococcal disease. This included bacterial meningitis, an infection of the lining around the brain and spinal cord, and sepsis, a bloodstream infection. These illnesses can make children very sick and, in some cases, can be deadly.
Where we stand: meningococcal vaccine for children
The American Academy of Pediatrics (AAP) believes that a federal advisory panel's decision to make the vaccine against meningococcal infections optional for children is dangerous and will put them at risk. AAP still strongly
recommends that all children get all doses of the meningococcal vaccine as part of routine care.
How do you get a meningococcal infection?
Bacteria travel in saliva or mucus droplets from some who is infected to a non-infected person. Most people get infected at home or in crowded shared spaces, where they are close together.
Teens and young adults ages 16 to 20 are more likely to get sick. Children under 2 years old are also more likely to get infected because their immune system is still developing.
Babies who are 1 year old and younger with health conditions that make it hard for their immune systems to resist infections are also at high risk.
Meningococcal germs can spread from person to person through:
Studies show most cases of meningococcal infection in the U.S. start in winter, 2 to 3 weeks after influenza outbreaks begin. The highest number of cases is usually seen between January, February and March.
Some people have meningococcal bacteria in their nose and throat but do not know it. We don’t currently know why one healthy child may get sick or die, while others do not.
Symptoms of meningococcal disease
Symptoms of meningococcal illness start usually about 4 days after contact with the germs. Meningococcal infections can cause sepsis, meningitis or both.
Meningococcal sepsis symptoms include:
Fever
Aches
Loss of appetite
A growing rash
The rash starts as small red dots that turn into large bruises. A child can become very sick in only a few hours. They can go into shock, and their organs may stop working. Many times, antibiotics don’t work for sepsis because it spreads too fast.
If your child has any of the symptoms described, contact your pediatrician immediately. Getting treatment right away is very important.
Symptoms of meningococcal meningitis include:
Fever
Loss of appetite
Irritability
Excessive sleepiness
Stiff neck
Back pain
When older kids and teens have symptoms of meningococcal meningitis, they usually experience a stiff neck, headache and vomiting.
Older teens and young adults may not have any symptoms. If they are not vaccinated, they can get infected without realizing. Then they may spread the disease to others who could experience serious symptoms.
How to protect your child from meningococcal infections
The vaccine against meningococcal infections is one of the AAP recommended childhood immunizations. Here's what to know about it:
There are two types of vaccines your child might get: meningococcal conjugate vaccine (MenACWY) and meningococcal B vaccine (MenB). MenACWY protects against several common types of meningococcal bacteria, and MenB protects against type B.
Teens should get the first dose of MenACWY at ages 11 or 12 years old. They should get a booster when they turn 16.
Your pediatrician will recommend Men B if your child is 10 years or older and at risk of meningococcal B infections.
If your child did not get the vaccine by then, they still have other opportunities to receive it:
If teens got their first dose between ages 13 and 15, they should get a booster between 16 and 18 years old.
If teens got their first dose after turning 16, they might not need a booster. They only need a booster when they are at risk for meningococcal disease.
Young adults ages 19 to 21 can still get one dose later if they didn’t get the vaccine after age 16
Many colleges require proof of MenACWY vaccination within 5 years before beginning school. If needed, you can get both types of the meningococcal vaccine at the same visit.
Why the vaccine against meningococcal disease is important for all of us
Once the vaccine was recommended for children age 11 through 12 in 2005, infections in teenagers decreased by over 90%.
It is true that cases of meningococcal disease began decreasing in the 1990s, before there was a vaccine. That happened because other immunizations—like the one against the flu—helped lower the number of meningococcal infections.
But it was the specific vaccine against meningococcal disease that made the biggest difference. A lot less healthy children suffered or died from this kind of infection.
Children at higher risk for meningococcal infections
Some children have health conditions that make it harder for their bodies to resist infections. They need the meningococcal vaccine. This includes children ages 2 months to 10 years with the following conditions:
Persistent complement deficiency (a lack of or malfunctioning versions of certain proteins involved in the immune system)
Asplenia (lack of a spleen, an organ that filters blood)
Human immunodeficiency virus (HIV) infection
These conditions make it harder to resist infections.
Meningococcal vaccines for kids at higher risk
If your child has one of these conditions, your child’s pediatrician will help you choose the right vaccine and when to get it.
Between 2 and 23 months of age: 4 doses at 2, 4, 6 and 12 months of age
2 years and older: 2 doses between 8 and 12 weeks apart
10 years old: 2 doses 1 month apart
Your child (2 years old and older) should receive 1 dose of the vaccine if there is a community outbreak where you live.
They should also receive 1 dose if they are traveling to a country where the disease is very common (the northern areas of sub-Saharan Africa, for example).
Talk with your child’s doctor
Tell your doctor if your child has known life-threatening allergies. Children with minor illnesses, with or without low-grade fever, can receive meningococcal vaccines, but you should consult first with your doctor.
Also talk with your child’s pediatrician before getting the shot if your child has a weakened immune system from a chronic health condition or medications.
Possible effects after vaccination
Sometimes, people have redness, swelling or soreness where they got the shot. These effects are mild and last only a couple of days. In rare cases, a mild fever can happen.
For any signs that concern you, call your doctor.
If someone has a serious reaction to a vaccine, there are two government agencies that monitor vaccine reactions and safety through the Vaccine Adverse Reporting System (VAERS).
More Information
About Dr. Kainth
| Mundeep Kainth, DO, MPH, FAAP, is a pediatric infectious disease physician at Northwell Health Cohen Children’s Medical Center where she serves as the Medical Lead of the Antimicrobial Stewardship Program. Dr. Kainth is a member of the American Academy of Pediatrics Section on Infectious Diseases.
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About Dr. Qureshi
| Nadia K. Qureshi, MD, FAAP, is a Professor and pediatric infectious disease specialist at Loyola University Chicago in Maywood, Illinois. She cares for patients in both pediatric infectious diseases and general pediatric outpatient settings. Her clinical interests include antimicrobial stewardship, nutrition and vaccines. Dr. Qureshi is actively involved in medical education and trainee mentorship.
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