Meningococcus ACWY vaccine

The meningococcus ACWY vaccine provides protection against serious infections caused by group A, C, W and Y meningococcus bacteria, such as meningitis and blood poisoning.

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To whom is the meningococcus ACWY vaccine administered?

As of 1 August 2020, meningococcus ACWY vaccines are being given free of charge within the national vaccination programme to persons with an increased risk of serious meningococcal infection due to their illness or medication. The risk groups defined by the Finnish Institute for Health and Welfare include those who have

  • a complement deficiency (C3, C5-C9, properdin, factor D, factor H)
  • ekulizumab (Soliris) or ravulizumab (Ultomiris) medication to prevent complement activation
  • spleen deficiency
  • spleen failure, including patients with sickle-cell anaemia and patients with chronic graft-versus-host disease following stem cell transplantation.

The risks of infection associated with the use of ekulizumab and ravulizumab are described in more detail in the product summaries.

Which vaccine is used and what does it contain?

The vaccine program uses the Nimenrix vaccine, which protects against diseases caused by serotype groups A, C, W and Y.

  • it does not contain live pathogens.
  • the active substance consists of surface carbohydrates from four different meningococcus Bacteria (A, C, W and Y) which are covalently attached to the carrier protein.
  • the carrier protein is tetanus toxoid
  • the excipients are salts, sugar and purified water.
  • the vaccine contains no preservatives.

Dosage and schedule

The volume of a single ready-to-use vaccine dose is 0.5 ml.

The Nimenrix vaccine may be administered from the age of 6 weeks.

Infants between 6 weeks and 5 months:

  • The vaccination series includes a total of two doses, with the second being administered 2 months after the first.
  • In addition, one booster dose is given normally at the age of 12 months provided that this is no less than 2 months after the second Nimenrix dose.

Children aged over 6 months, young people and adults:

  • The vaccine series consists of two doses. The second dose is administered no earlier than 2 months after the first dose.

The dosage differs from the recommendation for healthy individuals.

Please note that

Meningococcal vaccinations related to the spleen removal and the initiation of ekulizumab or ravulizumab treatment should be administered in good time, preferably at least two weeks before the procedure or the start of medication.

The meningococcal vaccination series is initiated at the earliest six months after the stem cell transplantation in patients that have experienced chronic graft-versus-host disease. 

Booster doses

Nimenrix may be administered as a booster dose to previously vaccinated persons aged 12 months or over who have previously been vaccinated with the either the same or a different kind of meningococcal conjugate vaccine or meningococcal polysaccharide vaccine.

For patients who have had their spleen removed or who have a complement deficiency or sickle-cell anaemia, booster doses are recommended every five years.

The protection afforded by Meningococcus ACWY vaccines against the serogroup A disease may be of short duration. Therefore, the administering of booster doses can be considered earlier if the risk of exposure to group A meningococcus is particularly high and more than three years have elapsed since the previous dose.

The vaccination recommendations will be updated as more research data is collected.

What are the precautions and contraindications associated with the vaccine?

The vaccine may not be administered to a person who has had a confirmed serious allergic reaction (anaphylaxis) following a previous dose of a meningococcus ACWY vaccine or a vaccine containing similar components.

The vaccination should be postponed if the recipient has a fever or febrile infection.

What are the benefits of the meningococcus ACWY vaccine?

The meningococcus ACWY vaccine provides good protection against serious infections caused by group A, C, W and Y bacteria. Vaccinations can be used to protect persons belonging to medical risk groups and to prevent the spread of meningococcal disease in epidemic situations. Preventing the disease also prevents the serious consequences that result from it.

The vaccine does not provide protection against infections caused by non-capsulated meningococci or meningococci other than those of groups A, C, W or Y, nor against sepsis or meningitis resulting from other causes.

Like other vaccines, the meningococcus ACWY vaccine does not necessarily lead to all vaccinated persons developing protective immunity. Vaccine response may be poor for people with a disease or medication that impairs the immune system.

What are the potential adverse effects of the ACWY vaccine?

Transient local reactions at the injection site, such as pain, heat, swelling, redness and/or rash, are fairly common. Transient generalised symptoms may also occur, such as irritability, drowsiness and fever.

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