Meningitis outbreak

[Flipitoff]

I’m freaking out a bit

DD has been here all day after travelling from uni yesterday. Her housemate is really poorly and now I’ve just seen the news about the meningitis outbreak at her uni.

Her housemate is in the house on her own now - I’ve told DD to call the uni and let them know. Worried that DD has been here with us all day in case she gets sick

Yes Yr4 is a strange year group to be affected. I know it’s not unheard of. The article say they are all in the same social group but Yr4s wouldn’t be out socialising with 6th formers….

I did ask the pharmacist if there was something different about these strains as they seem to be affecting 6th formers more (when it used to be more Uni students) but he said it was down to the behaviour (in terms of sharing vapes and sharing drinks). That’s not applicable to. Yr 4 child though.

Hopefully no more cases.

Anyone can get meningitis. As the pharmacist said it’s mainly (but not always) behaviour that increases risk. There’s absolutely nothing different about a 17 year old 6th former and an 18 year old uni student. If the 17 year olds are attending the same social gatherings and doing the same behaviours etc as you say like sharing vapes and drinks. But that isn’t the ONLY way you can catch it. If, for example, a 17 year old with meningitis was out to dinner with their family including their 8 year old sibling they might share food and cutlery. Maybe even try the others drink. They might offer their sibling a bite of their burger. Who knows. The 8 year old isn’t immune to meningitis because they are not a uni student.

The year 4 child, however, will have been eligible for the childhood vaccine which was first administered 10 years ago.

Which wears off. It isn’t life long protection. They give it to babies and young children as they are most at risk along with university students. There are also different strains of it and from what people are saying on here I’m not sure if both/all strains are covered in the vaccine.

I know that’s not what I was saying. It is a bit more common amongst uni students as they all live together in larger groups that’s all.

It requires prolonged, close contact.
It’s actually quite hard to spread. I know anyone any age can get it but some age groups engage in close contact behaviours more - hence the vaccine recommendations.

The vaccine wears off after 2-5 years. This is my worry - that those whose babies had the men b vaccine think they are protected for life and they aren’t.

And yes there are different strains of men b and two vaccines - the vaccines have a bit of cross over but then they also cover different men b strains to each other..

As I undestand it, both Bexsero and Trumenba are Men B vaccines and both protect againt the B serogroup of the bacteria that causes meningitis, Neisseria meningitidis - of which there can be many strains (subtypes, same B antigens on surface but different genetic lineage). They are not interchangeable, because they are made to target different protein components (B antigens) on the Neisseria Meningitid type B bacteria (developed by different pharamceutical companies, they try and get the most effective vaccines by targeting different combinations of antigens). Trumenba is effective against some strains of Men B that Bexsero is less effective for, so they will use that for specific outbreaks if they are one of the strains that Bexsero is less effective on. All are targetting the B antigens (proteins) on the bacterias surface, but genetic differences in strains will make one or the other way of doing it more or less effective for a particular strain (slightly different size/shape of protein etc). I don't think you would need both unless they were vaccinating people in response to a specific outbreak eg the Kent one.

"Available data on both of the MenB vaccines suggest that protective antibodies decrease quickly (within 1 to 2 years) after vaccination". So really they need a booster the year they go to university - which really wasn't made clear in the UK imo when I did my teens initially!

Perhaps younger kids also need a booster if they do an activity that involves sharing cutlery eg cubs/scouts trips or water bottles really also need a vaccine too and perhaps that is how a Year 4 group has been affected 9who would have had the initial does as babies now). I know it is gross but all my boys played Football and Rugby with water bottles and gum shields for the Rugby and they all forever chucking both on the grass and then running over in a break and grabbing the wrong bottle and sometimes picking up the wrong gum shield - no matter how many times I told them not to. All the boys do, especially at school matches where there's no parents keeping an eye. And of course they need to catch up th eteenagers that have absolutely zero immunity, even weeakend, from the initial one. They do this with the MenACWY booster that teens get, I can't understad why Men B isn't included. Also it is not thought either vaccine provides protection to unvaccinated people through herd immunity so they really should be adding men B to the vaccine schedule for teenagers imo, when they get the HPV vaccine and the MenACWY booster in Year 8/9 and then a booster in year 12/13 for sixth form/uni.

There seems to be lots of knowledgeable people here who have done the research/spoken to pharmacists so I wonder if I could pick brains...

DS (Year 13, going to uni in September) has just had his first dose of Bexero at Boots. He was told to book his next appointment for 4 weeks. I've seen "at least 4 weeks" and "4-8 weeks" online, which concurs, but the photocopy of the patient information leaflet they've given him stated dosing should be at 0 and 6 months, and says that if the interval is less than 6 months you'll need another booster, so I went on to google....

It seems that 0 and 6 months is the best for long-term protection (i.e. the immune response lasts longer) and is what is used elsewhere in the world, but an accelerated programme ("at least 4 weeks") is approved in the UK. The need for a booster later (if doing the accelerated programme) hasn't been properly evaluated so no clear recommendations.

Anyway, as DS is going to uni halls in September, he obviously can't wait for 6 months and will need the second dose before then so he is fully protected upon arrival. So to my question (finally!), in terms of acute protection (I understand you get maximal protection 2 weeks after final dose) and longevity of immune response (to see him through uni), should I ignore Boots' instructions to book for a month from now (June) and instead book for the start of September? Meaning he has a 4 month interval, not 4 weeks. And if so, will Boots have an issue with this?

@Newlittlerescue Your reasoning makes perfect sense. I don’t see why Boots should have an issue with it. I have booked DD’s 2nd dose with them (more than 4 weeks after her first) and, although she hasn’t had it yet, no problem arose during the booking process - and nor should it.

I am fresh from jabs with the Chair of the National Pharmacy Association for DS2.

We are now doing the one dose now and one dose in 6 months as this offers the longest protection. He said last week if this outbreak continued we would do 3 jabs at month 0, month 1 and month 5 - this is the speediest cover but you need the third jab.

I am not sure what happens if you move the 6 month dose to month 4 and whether you would still need a booster. He didn’t present that option.

You have 75% cover from 2 weeks after the first jab and this goes up in to the 90s after the second.

Thank you - knew I could rely on someone on Mumsnet having the inside track!

Think I will go with the 4 month gap then in our situation. I'm less concerned on the question about whether we'd still need a booster or not, given we would with the recommended 4 week interval anyway.

I suppose the only risk is that increased demand/another outbreak might make it hard to find a dose in September, whereas I can see there are plenty of appointments available for a month's time.....Don't suppose the Chair had any insights about supply?

He said demand had obviously just shot up with this outbreak (but very local to us). He had enough stock though and now it seems to have calmed down I think it should be ok. Another outbreak or more cases and I think not.

@Delatron

I've been thrown today we had a boots apt booked but I found one sooner at a local pharmacy and I spoke to them on the phone and said we had bexeeo

When we arrive they offered us the other vaccine which is trumenba !

They said this is the one NHS uses .

But it doesn't mean it's a booster and we start from scratch.

So whoever I spoke to was talking absolute nonsense.

I hope this brand gives us decent protection .

Ah @IsthataNo that’s a bit frustrating. I don’t know enough about what happens if they have the different vaccines. I know they are both effective and they have some cross over with the various strains of Men b.

The latest Reading outbreak is apparently better matched to trumenda that’s all I know but both are effective vaccines generally. I’d maybe seek some advice from your GP about a booster and timings of that.

The lack of info around all this is quite frustrating. The pharmacist told me the vaccine lasted 5 years but I read 2-5 years. And if it wears off after 2 I am
happy to boost. He did say they just didn’t have loads of information as it’s only been around since 2015.