Meningococcal Groups ACWY (MenACWY) vaccine in the UK and Ireland

MenACWY vaccine directly protects vaccinated people from four different strains of meningococcal meningitis and septicaemia (groups A, C, W & Y) and also stops them from carrying the bacteria in the back of the nose and throat. 

It is particularly important to protect teenagers because as well as being at increased risk of developing the disease, they are also the most likely to carry and spread the bacteria to others. Vaccinating teenagers is therefore essential to prevent the spread of infection amongst the wider population.

Importance of protection against MenW disease

Since 2009, cases of MenW disease have been rising steeply in England and Wales. For example, in 2014/15 MenW accounted for 24% of cases of meningococcal disease in England compared to only 1-2% in 2008/9.  Ireland experienced a rise in MenW and MenY cases from the year 2015.  Prior to 2015 there was an average of 2 cases of MenW and MenY disease per year, but this increased to an annual average of 9 cases of MenW and 5 cases of MenY disease between 2015 and 2018.

This rapid rise is due to a particularly virulent (harmful) strain of bacteria which is causing severe disease in previously healthy people and has a high death rate. The strain (ST-11) was identified using the MRF Meningococcal Genome Library to be a particular strain responsible for causing high disease rates and very high fatality rates in South America.  Vaccinating teenagers against MenACWY vaccine will protect them and stop the spread of this virulent strain. 

Read more about the rise in cases of MenW

Importance of maintaining protection against MenC (meningococcal C meningitis and septicaemia)

Since introduction of the MenC vaccine in 1999-2000, MenC has been nearly eliminated in the UK.  The vaccine has prevented thousands of cases.  The reason for this success was not just because the vaccine directly protected babies from disease, but because it was introduced with a one-off catch up campaign, which extended to teenagers and young adults, preventing people in this age group from carrying the bacteria in their throats and transmitting it to others.

However, research has shown that the direct protection young children get from MenC vaccination is relatively short lived^1-3. Therefore teenagers who were vaccinated as babies will no longer be directly protected.   Boosting teenagers with MenACWY, will renew their protection, which is important as they are entering a higher risk age group for this disease.  It also keeps disease levels amongst the population at low levels by stopping the spread of bacteria.

England, Wales and Northern Ireland

MenACWY vaccine has been offered to teenagers in school years 9 and 10 (England and Wales) and year 11 (Northern Ireland) since 2015.

If you are over 14 and did not get this vaccine at school or from your GP you can still get the vaccine until you reach 25. Young people of school age who missed out on getting their vaccine can approach their school or GP and ask about how to access the vaccine. Young adults who have left school and missed out should approach their GP.

Scotland

MenACWY vaccine has been offered to teenagers in school year S3 (Scotland) since 2015. Young people living in Scotland who missed out on getting their MenACWY vaccine can still get it if they are in school year S3 to S6 or until they reach 25 if they have never received a MenC containing vaccine.

Young people under the age of 25 who are attending university or college for the first time can also get the vaccine free of charge if they missed getting the vaccine when they were school age.

Young people can approach their school or GP and ask about how to access the vaccine.

Ireland

MenACWY vaccine has been offered to first year secondary students in Ireland since 2019.

There is no MenACWY catch-up programme for older teenagers in Ireland so it is important for school children to take up the vaccine when it is offered. Any age equivalent home schooled students in Ireland will also be eligible for vaccination and cane be vaccinated at HSE clinics.

University students

Because MenC and MenW can spread rapidly in halls of residence, it is important that new starters make sure they have not missed out on getting their MenACWY vaccine before they enrol on their course.

Ideally first year students should arrange to get MenACWY from their GP at least 2 weeks before they go away to study to make sure that they are protected by the time they get to university.

Any eligible first-year students not immunised before they started should get the vaccine as soon as possible by registering with their university health centre or other GP practice.

Students going to Irish universities from other parts of the UK should make sure they get their vaccine at home because they may not be able to access the vaccine when they arrive.

We have been contacted by students and other young people who have had difficulty getting the MenACWY vaccine from their GP even though they were eligible for the vaccine.

Protecting yourself through vaccination is important, so don’t be put off.

If you think you are eligible for the vaccine but are experiencing difficulties in accessing it, call our Freefone helpline on 080 88 00 33 44 (UK)/1800 41 33 44 (Ireland) for assistance.

NHS in the UK

People with asplenia or splenic dysfunction, those with complement disorders, or those on Eculizumab therapy are at increased risk of meningococcal disease.  They are entitled to receive the MenACWY and other meningitis vaccines free of charge on the NHS whatever their age⁴ and anyone with any of these medical conditions should contact their GP to ask about vaccination.

HSE immunisation schedule Ireland

People with Asplenia or hyposplenia (including haemoglobinopathies and coeliac disease), defects in or deficiency of complement components, including factor H, factor D and properdin, Haematopoietic Stem Cell Transplant recipients, those who are HIV positive, and those with immunodeficiency due to disease or treatment, particularly Eculizumab (Soliris) are all entitled to the MenACWY vaccine and other meningitis vaccines free of charge.

There are three MenACWY vaccines currently licensed in the UK, Menveo®, Nimenrix® and and MenQuadfi®. MenACWY vaccines have been widely used for several years: Menveo® since 2010, Nimenrix® since 2012 and MenQuadfi® since 2020. Nimenrix® is currently used to routinely immunise young people in the UK and Ireland.

MenACWY vaccines have a good safety profile.  As with all drugs, vaccines can cause side effects. Side effects of MenACWY vaccines are similar to other routine vaccines and may include soreness/redness/swelling or hardness of skin at the injection site, fever, headache, nausea, muscle aches, tiredness/fatigue, loss of appetite, generally feeling unwell.

No, quite the contrary. Vaccinating adolescents not only protects them, but reduces their risk of acquiring the bacteria, which commonly live in the nose and throat, particularly in adolescents. By getting vaccinated, adolescents are also protecting younger and older people who are vulnerable to the infections.

Each different group (A,C,W and Y) of meningococcal bacteria has a different type of sugar capsule surrounding the bug. The MenACWY vaccines contain fragments of the sugar capsules of all four groups. The sugar fragments are linked to a protein which makes the vaccine stronger and longer lasting.

All of the vaccine components have been processed and inactivated and are not part of any living bacteria, but can still stimulate the immune system.

Once you are vaccinated with MenACWY, your immune system can recognise and kill bacteria with the same sugar capsule that is contained in the vaccine, so if you are exposed to these types of bacteria you do not become ill.

Other ingredients in the vaccines are used to ensure it is has the same level of acidity and salt concentration as your body.

In Nimenrix® the other ingredients include⁶:

• Sucrose
• Trometamol
• Sodium chloride 
• Water for injections

People who have previously had an anaphylactic reaction to any of the vaccine components listed above should not get the vaccine.

Anaphylaxis to current vaccines is very rare and is estimated to occur in one in a million doses given, although a recent study⁷ found no reports of anaphylaxis following more than 5 million preschool and infant immunisations over an entire year in the UK and Ireland.

People with severe immune system problems cannot have live vaccines, but the MenACWY vaccines are not live. Food allergies are not a reason to avoid vaccination. People often worry that eczema, asthma, epilepsy and a family history of reactions to vaccinations are a reason to avoid vaccinations, but this is not true⁸.

The packaging on both vaccines may contain natural rubber latex.  The risk of developing an allergic reaction is very small, but in case of known severe latex allergy, you should speak to your doctor or nurse before being vaccinated.

A MenC vaccine for 14 year olds was added to the routine schedule in June 2013 to ensure that levels of MenC disease remain low, but this vaccine did not give protection against MenW disease.

The MenACWY catch up programme was recommended for 14 to 18 year olds in response to rise in a harmful strain of MenW disease.

Vaccinating with MenACWY will give vital protection against MenW whilst boosting protection against MenC.

Yes.  The MenACWY vaccine can be administered safely at any interval after MenC vaccine.

No.  There is currently no licensed vaccine that just protects against MenW.

Yes. The vaccine is safe for people who have previously had meningococcal disease, and the vaccine cannot give them the disease. 

There are very few safety reasons for not vaccinating and these are outlined above.

There are many different types of meningococcal disease.  Although someone who has been ill in the past may have some immunity against the strain that caused disease, they would not be protected against other types.  Vaccination is necessary for broader protection and to boost any existing immunity generated from a previous infection. 

Yes.  Meningococcal vaccines may be given to pregnant women.  There is no evidence of risk from vaccinating pregnant women or those who are breast-feeding.

There is no current recommendation for babies to be vaccinated against MenACWY. 

The MenB vaccine Bexsero, which is given to children at 2, 4 and 12 months in the UK, should provide some protection against this particular ST-11 MenW strain that is causing severe disease⁹.

Adolescents are more likely to carry meningococcal bacteria than any other age group and offering MenACWY vaccine to all of them should stop the bacteria from being passed on. This means that even unvaccinated people including babies should eventually also be indirectly protected from catching the disease – an effect known as population protection (or herd protection).

Babies are at the highest risk of contracting meningococcal disease with peak incidence at around 5 months of age.  All babies are now immunised with the MenB vaccine Bexsero which should provide some protection against this virulent ST-11 MenW strain⁹. 

Children older than 5 months of age are still at risk of disease, but their risk is substantially lower than that of younger babies. UK incidence of meningococcal disease amongst the under 1s in 2017 was 16 per 100,000 (or 1 baby in 6,250) and in Ireland 24.1 per 100,000 (one baby in 4,150), reducing to 4 per 100,000 for children aged 1-4 (1 child in about 25,000) in the UK and 5.6 per 100,000 in Ireland (1 child in 17,850).  The incidence of disease amongst people older than age 5 in the UK and Ireland is substantially less.

Vaccinating adolescents should stop the bacteria from being passed on which means that even unvaccinated people should be indirectly protected from catching the disease.

However, meningococcal disease is such a deadly and disabling disease that some may wish to be protected however small the risk of them contracting disease. The vaccine is available privately for those who wish purchase it.

As a guideline, the purchase price of the MenACWY vaccines for vaccine providers is £30 per dose in the UK and €42 per dose in Ireland excluding VAT. A fee is also charged for administering the vaccine and this can be different according to clinic, so overall prices vary.

Unfortunately yes, although it is much less likely. Meningitis vaccines are excellent, but they do not protect against all strains. For example MenB has been the most common kind of meningitis for decades. A new MenB vaccine has recently been recommended for routine use in babies the UK which should prevent many more cases of meningitis (see www.meningitis.org/MenB). However, there is currently no recommendation for this vaccine to be offered to teenagers and there are still some kinds of meningitis that cannot be prevented, so it is important to know the symptoms. Visit our symptoms page.

1. Snape, M.D. and A.J. Pollard, Meningococcal polysaccharide-protein conjugate vaccines. Lancet Infect Dis, 2005. 5(1): p. 21-30.

2. Khatami, A., M.D. Snape, T. John, S. Westcar, C. Klinger, L. Rollinson, D. Boutriau, N. Mesaros, J. Wysocki, A. Galaj, L.M. Yu, and A.J. Pollard, Persistence of immunity following a booster dose of Haemophilus influenzae type B-Meningococcal serogroup C glycoconjugate vaccine: follow-up of a randomized controlled trial. Pediatr Infect Dis J, 2011. 30(3): p. 197-202.

3. Ishola, D.A., Jr., R. Borrow, H. Findlow, J. Findlow, C. Trotter, and M.E. Ramsay, Prevalence of serum bactericidal antibody to serogroup C Neisseria meningitidis in England a decade after vaccine introduction. Clin Vaccine Immunol, 2012. 19(8): p. 1126-30.

4. Department of Health. Meningococcal: the green book, chapter 22.  [cited 2016 February]; Available from: https://www.gov.uk/government/publications/meningococcal-the-green-book-chapter-22

5. GSK. Menveo.  Summary of product Characteristics.  Cited February 2016.  Available https://www.medicines.org.uk/emc/medicine/27347

6. Pfizer.  Nimenrix.  Summary of Product Characteristics.  Cited February 2016.  Available from https://www.medicines.org.uk/emc/medicine/26514

7. Erlewyn-Lajeunesse M, Hunt L.P, Heath P.T, Finn A, Anaphylaxis as an adverse event following immunisation in the UK and Ireland. Arch Dis Child, 2012. 97:487-90.

8. Department of Health. Contraindications and special considerations:the green book, chapter 6.  2013  [cited 2013 November ]; Available from: https://www.gov.uk/government/publications/contraindications-and-special-considerations-the-green-book-chapter-6.

9. Ladhani S.N, Giuliana M.M, Biolchi A, Pizza M, Beebeejaun K, Lucidarme J, Findlow J, Ramsay M.E, Borrow, R, Effectiveness of meningococcal B vaccine against endemic hypervirulent Neisseria meningitides W strain, England.  Emerg infect Dis. 2016 Feb;22(2):309-11. doi: 10.3201/eid2202.150369.

10. Public Health England. Invasive meningococcal disease in England: annual laboratory confirmed reports for epidemiological year 2017 to 2018. 2018  [cited 2019 September]; Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/751821/hpr3818_IMD.pdf.

11. HSE Health Protection Surveillnace Centre. Annual Epidemiological Report, Invasive Meningococcal Disease, in Ireland, 2017. 2018  [cited 2019 Seeptember]; Available from: https://www.hpsc.ie/a-z/vaccinepreventable/invasivemeningococcaldisease/surveillancereports/Meningo%20Annual%20Summary%202017%20v2.1.pdf.

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