Bacterial meningitis can be fatal – the risk of death and permanent disability is very high. Anyone who is not vaccinated is at risk of contracting bacterial meningitis through any of the 3 bacteria: Haemophilus influenzae, Streptococcus pneumonia, and Neisseria meningitidis.
The good news is that we have vaccines that can help to prevent infection from these 3 deadly infections.
The first defender: Haemophilus influenzae type B vaccine
In Malaysia, the Haemophilus influenzae type B vaccine is provided for free to all Malaysian children in 4 doses; 3 primary and 1 booster at the following intervals:
- First dose at 2 months.
- Second dose at 3 months.
- Third dose at 5 months.
- Booster dose at 18 months.
Since its introduction into the National Immunisation Programme (NIP), the HiB vaccine has helped to drastically reduce Haemophilus influenzae infections in Malaysia.
The second: Pneumococcal vaccine
Against Streptococcus pneumonia, we have the pneumococcal vaccination. At the moment in Malaysia, there are two types of pneumococcal conjugate vaccines available: the 10- and 13-valent. Babies, from as young as 6 weeks, can be vaccinated against this potentially deadly disease. The 10-valent vaccine is licensed for babies from 6 weeks to 2 years whereas the 13-valent vaccine is licensed from 6 weeks to 5 years as well for those over the age of 50 years. At the moment, pneumococcal vaccination is only available at private hospitals and clinics.
The third: Meningococcal vaccine
Meningococcal vaccination can defend against the threat posed by Neisseria meningitidis.
There are two types of meningococcal vaccination available in Malaysia:
- Meningococcal polysaccharide vaccine.
- Meningococcal conjugate vaccine.
They are currently not included under the NIP and only available at private clinics and hospitals. However, it is a mandatory vaccination for all Muslims who wish to embark on their holy pilgrimages during Hajj or Umrah. This is the Saudi Arabian government’s response to extensive outbreaks of meningococcal disease among pilgrims in the past decade.
All pilgrims must receive their quadrivalent meningococcal conjugate vaccination not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. Pilgrims are also required to produce a certificate of vaccination in order to gain entry into Saudi Arabia.
The implications of Neisseria meningitidis are twofold: it is not only risk for pilgrims but also for their families. Meningococcal vaccination will help to ensure that pilgrims returning home, who may be carrying the bacterium in their throats, do not transmit the bacteria to their children and other members of their families.
There are two types of meningococcal conjugate vaccines available in Malaysia. Both are quadrivalent in that they protect against Neisseria meningitidis types A, C, Y and W-135 – 5 out 6 types most commonly identified in meningitis epidemics:
- One conjugate vaccine is approved for children aged 11 years and above as well as adults in Malaysia in a single dose.
- The other can be given at 9 month old infants up to older adults aged 55. This vaccine is generally recommended in one dose but some individuals may require a second dose after 5 years because the immunity may wane.