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.

hi @Delatron we went to boots today for my teen, he was given Bexsero, and I was told second dose min 4 weeks, and she seemed to expect me to book the second dose of Bexsero for some point in July.

However having read your post, I'm a bit confused, as you seem to suggest one in six months is better? Or is that for a different age range (vs my 13 year old)?

Can I ask was that for the Bexsero, and that advice was from him, to have the first then wait six months for longest cover?

This seems counter to what Boots said.

Honestly everything is a bit confusing! I'd prefer to get longer cover if I can for him.

Hi @doopwoop
Yes Bexsero.

From what I understand if you have the second dose in one month you have to have another dose at month 5. This offers the quickest protection but you need the booster.

With the 6 month schedule you get 75% protection after the first dose and full protection after the second. He then said that would last 5 years.

I would definitely seek clarification. As to whether you’ll need a booster dose. Or whether having the short time between jabs means it wears off faster? I’m sorry I can’t clarify that.

He said if the outbreak got worse we’d do the shorter schedule otherwise the 6 month gap was the best. He’s happy it’s calmed down now. Mine are 16 and 17.

@Delatron thank you that is so helpful, but also seems to be the opposite of what I was told!

I'm wondering if I approach the National Pharmacist's Association they would directly confirm for me. I will.

As from what the lady told me today, after one month, then 2-5 years protection.

I don't want to spend another £120 if I don't have to have a third dose! She said it was a two dose course!

So confusing.

Yes maybe get a second opinion as it’s all so confusing and I have heard so many different things. I think the confusion comes from it being quite a new vaccine.

I would definitely double check it all.

Was the lady a nurse at Boots or a doctor? I’d say check with your GP but a friend’s GP told her she didn’t need to get her kids redone from when they had the vaccine 10 years ago!! So I’m not sure even the GPs are up to date.

Oh my goodness, that was bad advice they got! Really shocking.

Thank you, I will do what I can!

She was not a doctor, just following the Boots protocol, assume she was a nurse or clinical assistant or something.

I’ve looked online and the general advice is two doses at least 4 weeks apart.

So I guess the question is whether if you wait 6 months instead of one month that is better for longer protection. That is what my pharmacist said but I’m not sure that information has filtered through? I do trust him so I’m going with his advice.

I’m sorry it has been so confusing!

Thank you - yes sounds like that's quite new info and hasn't quite got around yet, but as your guy is the Chair of the NPA that sounds very like he's likely to be right. I will do my best to find out.

Phew, such a lot of searching for accurate info these days!

I’m wondering now if the one dose then one 4 weeks later lasts 2-5 years and the one dose now and 6 months later lasts 5. As I very specifically asked him if I should get a booster for either of mine in one or two years before uni and he said that wasn’t needed.

@Delatron I just did some digging online and found the following studies which I asked AI to summarise, they seem to support what you said about 2 doses and 6 months (if you're not needing to get quicker immunity):

• Vaccine: Bexsero (4CMenB / MenB-4C)

• The study is specifically about Bexsero, not another MenB vaccine.
• In 2024, the US FDA changed the licensed adolescent Bexsero schedule from 0 and ≥1 month to 0 and 6 months for healthy adolescents and young adults.

• The CDC's Advisory Committee on Immunization Practices (ACIP) subsequently adopted the same recommendation.

• The reason for the change was that studies showed stronger antibody responses (better immunogenicity) when the second dose was given 6 months after the first, compared with the previous shorter interval schedule.

• The CDC paper explicitly states that the new schedule provides "improved immune protection".

• If rapid protection is needed, the US now recommends a 3-dose schedule (0, 1–2, and 6 months) rather than simply giving two doses one month apart.

• The evidence is based on serum bactericidal antibody (hSBA) responses, which is the accepted way MenB vaccines are assessed, rather than direct measurement of meningitis cases (the disease is too rare for practical efficacy trials).

• The UK and Europe have not yet changed the licence, so Bexsero remains licensed as 2 doses at least 1 month apart.

• Therefore, a 4-week interval is still an approved and evidence-based schedule in the UK, but newer US data suggest that a longer interval (around 6 months) may produce a stronger and potentially more durable immune response.

Key paper:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11637420/
CDC recommendation update:
https://www.cdc.gov/mmwr/volumes/73/wr/mm7349a3.htm
Additional 2024 immunogenicity study comparing Bexsero schedules:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11584413/

I asked if those studies looked reliable, and it seemed to suggest they were.