Meningococcal disease is a disease caused by a bacterium, the meningococcus. There are several types of this bacterium. In most cases, it does not make you ill. Occasionally, the bacterium penetrates further into the body, where it can cause meningitis or septicaemia. Since 2015, there has been an increase in the number of people who fall ill as a result of meningococcal type W. To prevent further spread of these meningococci, RIVM is joining forces with the Youth Health Care Office, providing a vaccination for toddlers and teenagers.
Increase in meningococcal disease type W
Meningococcal disease is a serious disease caused by multiple types of meningococcal bacteria. These bacteria can cause meningitis or septicaemia. Not everyone who is infected with the meningococcal bacteria will actually get sick. The disease occurs at all ages, most commonly in young children up to 4 years of age, teenagers and the elderly. Since 2015, there has been an increase in the number of cases caused by meningococcal type W. It is impossible to predict whether this increase will continue. The chance of becoming ill is still very small. At the moment, mid-2018, there are 10 to 14 patients every month. That is less than 1 patient for every million inhabitants in the Netherlands. In order to prevent an increase in the risk of becoming ill, RIVM, together with the Youth Health Care Office, is starting to vaccinate.
Who is offered the Meningococcal ACWY vaccination?
As of 1 May 2018, toddlers aged 14 months receive a vaccination that protects against meningococcal types A, C, W and Y. They were already receiving the Meningococcal C vaccination at this age. Since 1 May, this has been replaced by a combination vaccine that offers protection against types A, C, W and Y. For this group, this therefore means a change of vaccine. The age at which they are offered the vaccination has not changed.
It is well known that young people play a major role in spreading the meningococcal bacteria. It is thought that one of the reasons for this is that young people have a lot of social contacts. They move in many different social groups and are therefore more likely to become infected and unconsciously spread the bacteria themselves. The quickest way to reduce the spread is to vaccinate 14-year-olds. The vaccine protects for about five years against meningococcal disease caused by types A, C, W or Y. For this reason, as of 1 October 2018, all teenagers who turn 14 this year between 1 May and 31 December will receive a vaccination against meningococcal types ACWY. In 2019, all young people who turn 14 in that year will receive an invitation for vaccination.
Why aren't all children offered a vaccination?
In an advice to the Minister of Public Health, experts have stated that vaccination for children of 14 months and young teenagers is the best way to prevent meningococcal disease from increasing in the Netherlands. That risk is currently very small (less than 1 in a million people). Also, the risk of disease and the spread of the bacteria is not the same for all age groups. Very few cases of the illness are found among children of primary school age. Very young children also hardly play a role in the spread of the disease. Due to the media attention in recent days, there is a lot of demand for a vaccination. At the moment, the vaccine is hardly available for groups other than the above.
A vaccination offers immediate protection against an infection with meningococcal type W. Also, if you have been vaccinated, you cannot infect another person. The more teenagers are vaccinated, the less risk the bacteria has of spreading to their peers, but also to all other people. This builds up group protection over the period of a few years. As a result, people who have not been vaccinated themselves are also less likely to become ill. This is the most efficient way to stop the increase with a limited amount of vaccines.