What are the vaccines against meningitis?What forms of protection do they offer and when can they be expected to return?Guide |

The cases of the 51-year-old woman who died in Pescara from an aggressive and rare form of meningitis, and the 15-year-old boy who was admitted to intensive care for meningococcal meningitis, revived attention to the disease.From which we can protect ourselves with vaccinations

What are the meningitis vaccines?In what forms are they protected and when is the recall expected?The guide

The cases of a 51-year-old woman who died in Pescara with an aggressive and rare meningitis and a 15-year-old boy hospitalized in the intensive care unit with meningococcal meningitis again drew attention to the disease.What can we protect against with vaccines?

Last Saturday, a 51-year-old woman died in a Pescara hospital from an extremely rare and aggressive form of meningitis.And in a hospital in Pescara, a 15-year-old boy from Chiti remains hospitalized in critical conditions in the pediatric intensive care unit, suffering from meningococcal meningitis, the only form that can be transmitted through the air.And on April 3, the meningococcal boy who tested positive for meningitis is in the intensive care unit at the Maggiore Hospital in Parma.

These are the latest three cases of meningitis reported in Italy, which have brought renewed attention to meningitis following recent outbreaks in the UK.Epidemiological data show that the overall incidence of the disease in Italy has remained relatively low and stable, regardless of the configuration of the epidemic situation.

This does not mean that it is not a terrible pathology: especially in the form of invasive bacteria, it can evolve rapidly, even in a few hours, with serious or fatal results.

Different "types" of meningitis.

According to experts, vaccination is currently the "most effective weapon" to prevent these infections, especially among high-risk groups such as young children and teenagers.

But what vaccines are currently available and what type of protection do they provide against meningitis?A fundamental element in understanding the role of vaccines is the fact that meningitis is not a single disease, but a group of diseases caused by various factors.The most important bacteria in Italy include meningococci (Neisseria meningitidis), pneumococci (Streptococcus pneumoniae) and Haemophilus influenzae type b.

Added to these are several viral forms, more frequent but generally less severeThese are several factors that explain why there is no single "meningitis" vaccine, but a variety of vaccines, each targeting a specific agent or serogroup.

Vaccines for different species

There are several vaccines specific to different strains of bacteria:

- Antimeningococcal B: protects against serogroup B, which is especially common in newborns

- Anti-meningococcal C (or quadrivalent ACWY): the quadrivalent vaccine provides protection against four strains (A, C, W135, Y) and is often recommended for adolescents

- Anti-pneumococcal: protects against meningitis caused by Streptococcus pneumoniae, which is common in children and the elderly.

- Anti-Hemophilus influenzae type b (Hib): usually included in hexavalent vaccines given in the first year of life.

The "History" of Vaccinations

The first major breakthrough in preventive vaccination was the introduction of the Haemophilus influenzae type b (Hib) vaccine, which has been given in the first months of life as part of childhood immunization since the 1990s.The vaccine has nearly eliminated the most common form of meningitis in young children in countries with high coverage.However, protection is limited to that specific bacterium and not to other agents.

A major chapter is represented by the prevention of meningitis, which remains one of the most feared forms due to its unknown and severity.

There are three main types of meningococcal vaccines: serogroup C vaccine, quadrivalent vaccine (A, C, W, Y) and serogroup B vaccine.

This difference is fundamental because each vaccine only protects against serogroups that include: for example, the meningococcal C vaccine does not protect against type B and vice versa.

Italian vaccination calendar

In Italy, the prevention of meningococci of serogroups A, C, W and Y includes a dose of 12 months of life of the quadrivalent meningococcal vaccine (MenACWY), together with MPRV / MPR + V (measles, mumps, rubella and varicella. Vaccination of children with mixed vaccines (MenC or MenACWY).

The PNPV (National Plan for the Prevention of Vaccination) 2023-2025 provides for vaccination with the MenACWY conjugate for subjects at risk of pathological conditions and those living with them.

in subjects at risk;Immunization with the combined MenACWY can begin at 2 months of age with a three-dose vaccination cycle over one year of age.A recall after 5 years is recommended if increased risk status persists.Efficacy objectives were >90% for 1 dose of conjugated MenACWY at age 24 months and >95% at age 15 years for Booster.

Meningococcal B vaccine is a relatively recent development, only available since 2013-2014, and is particularly important because this serogroup is now most common in Europe and Italy.To prevent meningococcal B infection, 2 new generation vaccines are available:

- The 4-component medicine 4cMenB is approved from the year before 2 months

- 2-component vaccine (two fHbp variants) with two 2- or 3-dose schedules possible, starting > 10 years.

In addition to meningococcus, another related agent is pneumococcus, an important cause of bacterial meningitis today, especially in adults and the elderly.Even in this case, there are effective vaccines, introduced in the 2000s, but protection is not complete because they only cover some of the many serotypes of the bacteria.Available vaccines have greatly reduced the incidence of many serious types, but each covers only a fraction of the possible causes of the disease.

Therefore, viral meningitis, bacterial forms due to serogroups not included in vaccines, or cases in non-vaccinated individuals or people with a suboptimal immune response remain possible.

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