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Meningococcal group B (MenB)

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Meningococcal disease usually occurs as meningitis or sepsis (blood poisoning).

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Background

Meningococcal disease is a life-threatening infection. Meningococcal disease is the term used to describe two serious illnesses – meningitis and septicaemia.  

Meningitis is a very serious infection which causes inflammation of the lining of the brain and spinal cord.  

Septicaemia is blood poisoning.

These illnesses can:  

  • come on suddenly  
  • progress very quickly  
  • kill in hours, and  
  • leave survivors with lifelong disabilities. 

Meningitis can affect anyone, but is most common in babies, young children, teenagers and young adults. It can cause life-threatening septicaemia and result in permanent damage to the brain or nerves. Meningitis can lead to deafness, blindness, epilepsy (fits), learning difficulties and sometimes death.

There are 12 known groups of meningococcal bacteria (Neisseria meningitidis). Meningococcal group B (MenB) is responsible for about 9 in every 10 meningococcal infections in the UK.  

 

MenB vaccine

The MenB vaccine is the safest and most effective way to help protect against meningitis and septicaemia caused by meningococcal bacteria group B.  

It is important to protect children against meningococcal disease by making sure they get their infant MenB vaccinations and teenagers get their MenACWY vaccination in school.  

Check your child’s red book or with your GP surgery and get your child vaccinated if they are not up to date. 

What is MenB?  

Meningococcal bacteria cause meningococcal disease. This can lead to two serious illnesses – meningitis and septicaemia.  

MenB is short for meningococcal group B bacteria. MenB is one of several types (strains) of meningococcal bacteria. The other most common types include W, Y and C. 

 The MenB vaccine helps protect babies against MenB disease, but it does not protect against other strains of meningococcal bacteria. Another vaccine is offered to teenagers, to help protect them against meningococcal types A, C, W and Y.  

The meningococcal bacteria may cause outbreaks in nurseries, schools and universities.  

Meningococcal vaccinations have been very effective and are our best defence against meningococcal disease, which can be very dangerous. However, many children are still not fully vaccinated. It’s important to protect them because meningococcal disease could develop very quickly and cause serious health problems. 

How do the MenB bacteria cause serious illness?  

MenB bacteria live in the throats of about 1 in 10 of people without causing any problems at all – in fact, they help build up immunity. The bacteria can spread to other people through coughing, sneezing or kissing.  

Sometimes the bacteria in the throat get into the bloodstream, causing septicaemia, or they may get to the brain, leading to meningitis. MenB bacteria can cause both septicaemia and meningitis at the same time. 

Who is most likely to get MenB?  

MenB mostly affects infants and young children. This is because their immune systems aren’t yet fully developed to fight off infection. But meningitis and septicaemia can happen at any age, so it is important to know the signs and symptoms of the diseases. 

Symptoms may appear in any order and some may not appear at all. 

Babies and toddlers 
  • Fever, cold hands and feet 
  • Refusing food and vomiting 
  • Fretful, dislike being handled 
  • Drowsy, floppy, unresponsive 
  • Rapid breathing or grunting 
  • Pale, blotchy skin. Spots/rash (see glass test) 
  • Unusual cry, moaning 
  • Tense bulging fontanelle (soft spot) 
  • Stiff neck, disclike bright lights 
  • Convulsions or seizures 

Source @meningitisnow.org 

A typical meningococcal septicaemia rash doesn’t fade when you press it. To check for it, press the side of a clear glass firmly against the skin. Not all children get this rash. It usually starts as small spots but quickly becomes deep purple patches. 

What should I do if I suspect meningitis or septicaemia?  

Do not wait for a rash.  

If your baby or toddler is ill and getting worse, get medical help immediately.  

A baby or toddler with meningitis or septicaemia could get a lot worse very quickly. Keep checking them.  

Trust your instincts – get medical help immediately.  

Remember – symptoms do not appear in order, and some may not appear at all. If you are in any doubt about the health of your child, get medical help immediately. If you can’t get in touch with your doctor, go to the emergency department of your nearest hospital. 

Someone with a fever and a rash that does not fade under pressure needs urgent medical attention. You can use the glass test to check whether a rash fades under pressure. For more information, see www.meningitisnow.org (external site) or call the Meningitis Now helpline on 0808 80 10 388

Can MenB disease be treated?  

Anyone who has MenB disease needs to go to hospital urgently and have immediate treatment with antibiotics. If treatment is started quickly, disability or death are more likely to be avoided.  

Can MenB disease be prevented?  

The MenB vaccine is designed to protect against most MenB infections. Since the MenB vaccine was introduced in 2015, cases of MenB disease in young children fell by over 60% by the third year of the vaccination programme. 

Eligibility for the vaccine

Baby immunisations

As part of the routine immunisation programme in Wales, the MenB vaccine is offered to babies at: 

  • eight weeks; 
  • 12 weeks (see below); and 
  • 12 to 13 months. 

Children are sent appointments for their MenB vaccination. Most surgeries and health centres run special vaccination or baby clinics. 

For information about routine immunisation schedules for Wales, see: Routine immunisation schedules for Wales 

Non-routine immunisations

Some medical conditions increase the risk of severe infections. People who already have these conditions may need the MenB vaccine. The conditions include: 

  • not having a spleen or having a spleen that doesn’t work very well (including due to sickle cell and coeliac disease), and 
  • problems with the immune system (complement disorders). 

Allergies 

The vaccine should not be given to babies who have had a serious (life-threatening) reaction to: 

  • a previous dose of the vaccine, or  
  • any ingredient in the vaccine. 

If your baby has had a serious allergic reaction to the vaccine or its ingredients in the past, speak to the person giving the vaccine. 

If you have any questions about the MenB vaccine, or you are not sure about when your baby or child should have it, you can contact your GP surgery for advice. 

About the vaccine

Babies will normally be given the MenB vaccine as an injection in their upper leg (thigh). Older children and adults will normally have it as an injection in their upper arm. 

The MenB vaccine, Bexsero, is the only vaccine currently available in the UK that offers protection against meningococcal group B bacteria. For more details, go to: 

Babies will need three doses of the MenB vaccine to be fully protected. Children who have missed vaccinations and had less than two doses of MenB vaccine in the first year of life should have further doses before they reach two years of age. 

MenB vaccine is not routinely given to children over two years old unless they are in an at-risk group. For example, children who have certain problems with their immune system.  

What if my baby misses their MenB vaccinations when they are due?  

If your baby misses any of their vaccinations speak to your doctor or practice nurse to rearrange them as soon as possible.  

Remember, it’s important to catch up on most missed vaccinations. If your child has missed a vaccination and is older than the recommended age, talk to your GP, practice nurse or health visitor. 

Safety and effectiveness 

Does the MenB vaccine have any side effects?  

Like all medicines, vaccines can cause side effects. Most of these are mild and short term, and not everyone gets them.  

The most common side effect of the vaccine is fever (a high temperature – above 38˚C). You should give your baby the correct dose of liquid paracetamol to help reduce the risk of fever.  

Other common side effects include:  

  • some redness and soreness where the vaccine was given  
  • feeling irritable  
  • a rash  
  • unusual crying  
  • sleepiness  
  • loss of appetite or feeling sick  
  • diarrhoea, and  
  • a headache. 

It is recommended that babies are given infant liquid paracetamol to prevent fever after vaccination. The nurse will give you more information about paracetamol at your vaccination appointment. 

It is a good idea to have some infant liquid paracetamol at home before the two-month vaccination visit. You can buy it from local pharmacies or supermarkets. Never give babies the higher-strength paracetamol liquid used for older children. Never give medicines that contain aspirin to a baby. 

See the frequently asked questions below for more information about infant liquid paracetamol. 

Other reactions are rare. For more information on common and rare side effects, see:                    

If you are concerned about symptoms, contact NHS 111 Wales (external site) by calling 111. Calls to NHS 111 Wales are free from landlines and mobile phones. 

You should report suspected side effects of vaccines and medicines through the Yellow Card scheme. You can do this online at mhra.gov.uk/yellowcard (external site)  or by calling the Yellow Card scheme hotline on 0800 731 6789 (Monday to Friday, 9am to 5pm).   

Is it safe for my baby to have the MenB vaccine with other vaccinations between 12 and 13 months of age?  

Studies show it’s safe to give the MenB vaccine with other routine vaccinations between 12 and 13 months of age, so your baby can be protected from serious infections right away. 

MenB vaccination – When should I give paracetamol to my baby after their vaccination?  

Your baby may get a fever after any vaccination, but it is more common when the MenB vaccine is given with the other routine infant vaccinations. Giving your baby paracetamol soon after their vaccination and not waiting for a fever to develop will reduce the risk of them having a fever. 

Give the first dose of paracetamol as soon as possible after your baby has had their vaccination. Use only infant-strength (120mg/5ml) liquid paracetamol. For very premature babies (born before 32 weeks), a doctor should prescribe the paracetamol.  

Paracetamol doses after the first two MenB vaccinations 

For babies aged eight weeks to six months, give half a teaspoon (2.5ml) using the spoon or syringe provided with the medicine. 

Age of baby Usually at 8 weeks, up to 6 months of age
Dose 1 One 2.5ml (60mg) dose as soon as possible after vaccination.
Dose 2 One 2.5ml (60mg) dose 4 to 6 hours after first dose. 
Dose 3 One 2.5ml (60mg) dose 4 to 6 hours after second dose.

Follow this schedule after each of the first two MenB vaccinations. 

This information applies after your baby has had the MenB vaccine. If your baby has a fever at any other time, you should follow the instructions and dose advice on the product packaging and patient information leaflet. 

Make sure you have a supply of infant-strength paracetamol at home before your baby’s first vaccination appointment. You can buy it from a pharmacy or supermarket.  

Don’t give the first dose before your vaccine visit, as the nurse needs to check for signs of existing infection, which may mean delaying the vaccination. 

What if my baby still has a fever after having had the three doses of paracetamol?  

  • Some babies might still get a fever after their vaccination, even if they've had three doses of paracetamol. 
  • In the 48 hours after their vaccination, if your baby still has a fever but is otherwise well, you can continue to give them the same 2.5 ml dose (60mg) of infant-strength (120mg/5ml) liquid paracetamol.  
  • Always wait at least four hours between doses and never give more than four doses in 24 hours.  
  • Keep your baby cool by making sure they don’t have too many layers of clothes or blankets and give them lots of fluids. If your baby is breastfed, the best fluid to give is breast milk. 

If 48 hours after their vaccination your baby still has a fever, or if you are concerned about your baby’s health at any time: 

  • trust your instincts and speak to your GP, or 
  • contact NHS 111 Wales by calling 111. 

Does my baby need paracetamol with every MenB vaccination?  

Your child will need paracetamol with MenB vaccinations given under 12 months of age.  

However, paracetamol is not routinely needed after the MenB vaccine given at 12 months. This is because by this age, the risk of fever is less.  

! Never give medicines containing aspirin to children under 16 years. 

Can my baby still get meningococcal disease when they are vaccinated?  

Vaccination is one of the most effective ways to prevent severe illness caused by MenB bacteria. No vaccine is 100% effective, so it is still important to know the signs and symptoms of meningococcal disease (meningitis and septicaemia), even if your child is vaccinated.  

More information is available at:  

See the routine immunisation schedules for Wales. 

 

Resources

If you would like to learn more about the MenB vaccine or the diseases it protects against, a number of information resources are available to help. You can also call NHS 111 or your GP surgery for advice if you have any questions. 

 

 

 

MenB outbreak 

More information 

Meningitis Research Foundation (external site) is a leading UK, Irish and international charity that brings together people and expertise to defeat meningitis. 

Meningitis Now (external site) is a national meningitis charity based in the United Kingdom.