Contents

12 Meningococcal disease

12.5 Recommended immunisation schedule

Meningococcal conjugate vaccines are preferred to polysaccharide vaccines in all instances.

12.5.1 At-risk individuals

Meningococcal conjugate vaccines are not on the Schedule but are funded in special circumstances, as described in the shaded section of Table 12.5 below. See sections 4.2 and 4.3 for more information about vaccination of special groups, including recommended immunisation schedules for high-risk individuals with certain medical conditions.

The conjugate vaccines are recommended (but not funded) for other individuals at risk, as described in Table 12.5.

Table 12.5: Meningococcal group C conjugate (MenCCV) and quadrivalent meningococcal vaccine (MCV4) recommendations

Note: Funded conditions are in the shaded rows. See the Pharmaceutical Schedule (www.pharmac.govt.nz) for the number of funded doses and any changes to the funding decisions.

Recommended and funded
MenCCV and MCV4-D are recommended and funded for:
  • patients pre- or post-splenectomy or with functional aspleniaa,b
  • patients with HIV, complement deficiency (acquired, including monoclonal antibody therapy against C5, or inherited) or who are pre- or post-solid organ transplantb
  • bone marrow transplant patientsb
  • patients following immunosuppressionb,c
  • close contacts of meningococcal casesd
Recommended but not funded
MenCCV, MCV4-D or MCV4-T are recommended,e but not funded, for individuals:
  • who are laboratory workers regularly handling meningococcal cultures
  • who are travelling to high-risk countries (see the WHO website), or before the Hajj
  • ​who are adolescents and young adults living in communal accommodation (eg, in a hostel or at boarding school, in military accommodation, in correctional facilities or in other long-term institutions).
a Pneumococcal, Hib, influenza and varicella vaccines are also recommended for individuals pre- or post-splenectomy or with functional asplenia. See section 4.3.4.
b See sections 4.2 and 4.3 for more information.
c The period of immunosuppression due to steroid or other immunosuppressive therapy must be longer than 28 days.
d Only one dose is funded for close contacts of meningococcal cases.
e Quadrivalent meningococcal polysaccharide vaccine is another option for individuals aged 2 years and older.

Before travel

There are areas of the world where the risk of acquiring meningococcal infection is increased. Nevertheless, the risk to travellers to the developing world as a whole has been estimated as being less than one in a million per month. Recurrent epidemics of meningococcal disease occur in the sub-Saharan ‘meningitis belt’, from Senegal in the west to Ethiopia in the east, usually during the dry season (December to June). Epidemics are occasionally identified in other parts of the world and occurred recently in Saudi Arabia (during a Hajj pilgrimage), Kenya, Tanzania, Burundi, Mongolia and Nepal.

MCV4-D or MCV4-T are the preferred vaccines for travel, with 4vMenPV as an alternative option. For website sources for information about meningococcal vaccines for travellers, see the WHO website (www.who.int/ith/en). Quadrivalent meningococcal vaccine is a requirement for pilgrims to the Hajj.

12.5.2 Recommendations for non-high-risk childrenTop

Given the absence of a universal programme, for the protection of non-high-risk children the meningococcal schedule in Table 12.6 below is advised. The predominant meningococcal strains in New Zealand in childhood are B and C. There is no vaccine currently available in New Zealand for B. For those who are likely to travel, the quadrivalent vaccine is preferable because of the differing serotype patterns between countries.

Table 12.6: Suggested meningococcal schedule for non-high-risk children (not funded)

Note: Vaccine immunity is not long-lasting. This suggested schedule is not expected to protect individuals through all of childhood, but is pragmatically focused on offering protection during the ages of highest risk. This schedule does not apply to epidemic situations.

Age at presentation Vaccine options (trade name) Number of doses
<12 months MenCCV (NeisVac-C) 2 dosesa (primary course) plus a booster after 12 months of age
12 months to 2 years MenCCV (NeisVac-C), or
MCV4-D (Menactra) or MCV4-T (Nimenrix)
1 MenCCV, or 
2 MCV4-Da,b doses or
1 MCV4-T
Early adolescence MenCCV (NeisVac-C) or
MCV4-D (Menactra) or MCV4-T (Nimenrix)
1 dose
Late adolescence MenCCV (NeisVac-C) or
MCV4-D (Menactra) or MCV4-T (Nimenrix)
1 dose
a Refer to section 12.4.4 and the vaccine data sheets for the intervals between doses.
b MCV4-D should be administered at least 4 weeks after PCV13.