A Review of Global Questions and Answers:
By Susan Bath RGN RMN ICU, Helpline Services Manager

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The Helpline service of the Meningitis Trust receives calls and e-mails from all over the world. Questions are received on all causes of meningitis, on treatment of the disease, after-effects and vaccines. These questions come from health care professional, members of the public as well as people affected by meningitis. Here I review a small selection of the most commonly asked questions.

The question we receive most often is on the availability and suitability of the current vaccines against different causes of meningitis; conjugate vaccine for Haemophilus influenzae type b (Hib), conjugate vaccine for Streptococcus pneumoniae, divalent (A+C) and quadravalent (A+C+Y+W135) polysaccharide vaccines for Neisseria meningitidis and the conjugate vaccine for N. meningitidis Group C.

There is often considerable confusion between the conjugate vaccine for one organism and another, for example;


Question 1.
``My children have received the Meningitis C vaccine while in Britain, on moving to the United States they have been offered a pneumococcal conjugate vaccine. Is this the same vaccine?''

Answer
These vaccines, although manufactured using similar technology, are directed against different organisms, both of which cause meningitis.
Students coming to study in the UK are concerned about which vaccine they should receive and whether it is cost effective. The Department of Health in the UK recommends that students coming from overseas should receive the divalent (A+C) polysaccharide vaccine for N. meningitidis before they arrive in the U.K in order to allow the vaccine to take effect. The vaccine currently being offered to U.K. first year students is the conjugate vaccine for N. meningitidis Group C, however this vaccine is only available in the U.K. First year university students are in a raised-risk group, therefore the cost of the vaccine is far outweighed by the benefits of being protected against meningococcal disease caused by the Group C serotype.


Another common question concerns the time period between receiving the conjugate vaccine for N. meningitidis Group C and the divalent (A+C) polysaccharide vaccine;


Question 2.
``My son will be coming with us to Africa, he recently received the Men C vaccine at school, now the clinic want to administer the A+C vaccine. How long should we wait before having this done?''

Answer
Children can receive the A+C (polysaccharide) vaccine following the Men C (conjugate) vaccine, and the recommendation is to have a four-week gap between them if given in this order.


Question 3.
``My three year old child has come with us from Sri Lanka, before leaving we gave him the A+C vaccine. We are now registered with a GP in the UK and she wants to give my child the Men C vaccine. Is this all right?''

Answer
If a child under five years old enters the UK after having received the A+C vaccine then they are able to receive the conjugate vaccine after a two-week gap. This is because very young children do not respond well to the A + C polysaccharide vaccine.



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