Meningitis Vaccine: Boost Before College

 

Do COLLEGE STUDENTS really need the Meningitis Vaccine, and didn’t my daughter get this shot during middle school?

YES and probably YES, but read on…

Talk to Jamie Schanbaum, now a paralympic champion and passionate vaccine advocate. Jamie lost her fingers and legs to bacterial meningitis back in 2008, when she was a college sophomore at the University of Texas. Or talk to the family of Texas Aggie Nicolis Williams, who died from bacterial meningitis during college in 2011. These families led the charge that resulted in Texas passing the first legislation that requires the meningococcal vaccine for EVERY college student prior to enrollment.

Meningitis- specifically bacterial meningitis– looms over my shoulder ever day as I treat college students, always a possible diagnosis for nonspecific symptoms.  Why? Because frankly, even if I quickly and correctly recognize this swiftly progressive disease in my patient, it may already be too late. Early symptoms of meningitis appear exactly like the flu: fever, headache, body aches and possibly nausea or vomiting. However, with meningitis, the thin lining around the brain becomes inflamed, causing a progressively worsening headache with a painfully stiff neck (bending the head forward is excruciating) and the person may even be confused or unconscious. As the disease progresses, a very specific RASH can alert clinicians to this dangerous disease- it is dark reddish purple tiny spots that do not whiten if pressed upon. This rash is caused by leakage of blood vessels as the bacteria releases toxins into the blood stream. Bacterial meningitis can steal the life of an otherwise perfectly healthy young person, even after antibiotics have been started, because antibiotics can kill the bacteria causing the disease, but cannot undo damage already caused by toxins released from that bacteria. When people do survive bacterial meningitis, they are often left without fingers, toes or even limbs as a direct result of the toxin-induced damage. This disease can spread quickly where young people are living in close quarters, such as boarding schools, military bases and yes, college dormitories, which is why prevention with immunizations is key.

Who needs this vaccine?  The meningococcal vaccine has updated RECOMMENDATIONS- all adolescents should still receive their first shot (the MCV4) at age 11-12, as previously recommended, but now we know they need a BOOSTER DOSE at or after age 16, before they head off to college or to a military base. Although initially thought to offer protection for a decade, it turns out that the immunity begins to wane in this age group after 5 years. Yes, they still needed that earlier vaccine to protect against the herds of kids joining them in close quarters at school and summer camp, but we want them maximally protected as well when they move into that freshman dorm.

Which meningitis vaccine is best?

One is not “better” than the others. Confusion may exist because there are four vaccines for “meningitis”, so here is the breakdown:

  • ALL adolescents should receive a meningococcal conjugate vaccine at age 11 and again at 16:
    • EITHER brand name Menactra OR brand name Menveo.
    • Both of these vaccines protect against four types of the bacteria that cause meningitis: serogroups A, C, W, and Y.
  • ADDITIONALLY, adolescents MAY also receive additional protection against one more type, serogroup B, by getting a Serogroup B vaccine:
    • Either brand name Bexsero or brand name Trumenba
    • Both of these are given as a two-dose series in adolescents

Please talk with your family doctor to determine what is best for your family, and to go over additional indications/contraindications for these vaccines.

BOTTOM LINE: Protect your adolescent against this rapidly progressive, dangerous disease by making sure they received not only their initial vaccine at 11-12 years, but also their BOOSTER shot before they head off to college! 

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