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CMAJ
CMAJ
9711805
CMAJ : Canadian Medical Association Journal
0820-3946
1488-2329
CMA Impact Inc.

39284607
10.1503/cmaj.231807
196e1041
Practice
Five Things to Know about …
Meningitis B vaccination
Rani Savita MD MPH
Coletto Sylas RN MScN
Hasselback Jasmine MD MPH
Department of Community Health & Epidemiology, College of Medicine (Rani, Hasselback), University of Saskatchewan; Saskatchewan Health Authority (Rani, Hasselback), Idylwyld Centre, Saskatoon, Sask.; School of Nursing, Faculty of Health Sciences (Coletto), University of Ottawa, Ottawa, Ont.
Correspondence to: Savita Rani, savita.rani@usask.ca
16 9 2024
16 9 2024
196 30 E1041E1041
© 2024 CMA Impact Inc. or its licensors
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
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pmcAmong the 5 serogroups of Neisseria meningitidis, serogroup B causes the highest incidence of invasive meningococcal disease (IMD) in Canada1,2

Invasive meningococcal disease causes meningococcemia and meningitis. The incidence of serogroup C decreased markedly with the introduction of meningococcal C immunization programs, from 0.13 per 100 000 people in 2006 to 0.01 per 100 000 people in 2011.2 From 2012 to 2022, serogroup B caused 0.14 cases of IMD per 100 000 people.1 Serogroup B disproportionately affects children younger than 5 years and people aged 15–24 years, and has a case fatality rate of 5.5%.2

A serogroup B meningococcal vaccine should be offered to people with underlying medical and environmental risk factors for IMD

Risk factors include being immunocompromised, travelling to endemic areas and living in overcrowded conditions (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.231807/tab-related-content).3

Two meningitis B vaccines, 4CMenB and MenB-fHBP, have been approved by Health Canada

These vaccines are not interchangeable — the same product must be used for all doses in a series.3,4 Either vaccine may provide protection for as long as 4 years post-immunization.1 The only serogroup B meningococcal vaccine approved for children younger than 10 years is 4CMenB. Those aged 2–5 months receive 3 doses of 4CMenB and those aged 6–11 months receive 2 doses, with an additional dose between the ages of 12 and 23 months; doses should be administered 8 weeks apart.3 Children aged 12 months to 9 years receive 2 doses of 4CMenB at least 8 weeks apart.3 Those aged 10 years or older receive 2 doses of 4CMenB at least 4 weeks apart or a 3-dose series of MenB-fHBP.3

For post-exposure prophylaxis, previously vaccinated people aged 2 months and older should receive 1 booster dose of an age-appropriate vaccine3

For unvaccinated people, post-exposure prophylaxis can be offered for close contacts or outbreak control as per age-based schedules.3

Publicly funded programs for meningitis B vaccination vary by jurisdiction5

Vaccination for people with high-risk conditions or exposure is publicly funded in many jurisdictions. Nova Scotia has the most expansive eligibility criteria for meningitis B vaccination, in response to recent changes in local epidemiology.1

Competing interests: Jasmine Hasselback is a member of the Saskatchewan Committee on Immunization. No other competing interests were declared.

This article has been peer reviewed.

Disclaimer: Savita Rani is an associate editor for CMAJ and was not involved with the editorial decision-making process for this article.
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References

1 Pham-Huy A Zafack J Primeau C . Deeks S on behalf of the National Advisory Committee on Immunization. A National Advisory Committee on Immunization (NACI) update on invasive meningococcal disease (IMD) epidemiology and program-relevant considerations for preventing IMD in individuals at high risk of exposure. Can Commun Dis Rep 2023;49 :358–67.38463903
2 Invasive meningococcal disease. Ottawa: Public Health Agency of Canada; 2023. Available: https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/invasive-meningococcal-disease/health-professionals.html (accessed 2023 Sept. 10).
3 Canadian immunization guide: meningococcal vaccines. Ottawa: Public Health Agency of Canada; 2023. Available: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-13-meningococcal-vaccine.html#high (accessed 2023 Sept. 10).
4 Meningococcal B vaccines. Immunize.org; 2023. Available: https://www.immunize.org/askexperts/experts_meningococcal_b.asp#precautions (accessed 2023 Sept. 10).
5 Summary of updates of National Advisory Committee on Immunization advice on invasive meningococcal disease in the Canadian Communicable Disease Report: September 25, 2023. Ottawa: Public Health Agency of Canada; 2023. Available: https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/national-advisory-committee-immunization-summary-updates-invasive-meningococcal-disease-ccdr.html (accessed 2024 Feb. 24).
