Wednesday, 31 August 2016

Meningococcal vaccination

For travel purposes we now only use two quadravalent meningococcal vaccines in the UK against the strains A, C, W135 and Y.  These two CONJUGATE vaccines are Menveo (supplied by GlaxoSmithKline) and Nimenrix (supplied by Pfizer - please note Nimenrix is currently still a black triangle drug).  These vaccines are given to travellers going to endemic areas in the meningitis belt of Africa and for travellers undertaking pilgrimage - Hajj and Umrah for which a certificate of proof of vaccination is required, enabling the traveller to obtain a visa for entry to Saudi Arabia.

The annual pilgrimage for Hajj is expected to fall on 9-14 September 2016 this year, and in preparation the Ministry of Health for the Kingdom of Saudi Arabia (KSA) publishes annually its requirements and recommendations for Hajj and Umrah - the latter can be taken at any time but the guidance still applies.  In 2016 the KSA announced new information for the length of time to write on the certificate.  They stated they considered the period of protection for polysaccharide vaccine to be three years and for conjugate vaccines to be eight years.  For either they should not be administered less than ten days before arrival in the KSA.  See under the heading Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj), 2016 on page 2 on the document HERE.  On page 331 of this document it states in an Editorial note, 'this publication in the Weekly Epidemiological Record is to inform visitors of the full requirements for entry into Saudi Arabia; it does not imply an endorsement by WHO of all measures stipulated'.

In the UK because we now only use the conjugate vaccines, it is very important to write the name of the vaccine given on the certificate.

At the present time, there is lack of clarity over the duration of protection these conjugate vaccines provide.  The Green Book states the need for, and timing of boosters has not yet been determined. Neither do the Summary of Product Characteristics (SPCs) for Menveo or Nimenrix clarify the exact duration of protection for these vaccines.

Therefore, although the KSA has determined that the vaccination interval should be 8 years and this can be followed when completing a certificate of quadravalent meningococcal vaccination for visa purposes, at the time of writing this blog, I would NOT INTERPRET this as confirmation the vaccines last 8 years when considering protection for a traveller going to work and live with a local population in sub-Saharan Africa for example.

We need to await update to the official guidance in the Green Book.

Interesting resources and information

  • From Health Protection Scotland, including posters and leaflets here 
  • NaTHNaC Factsheet on Hajj and Umrah here 
  • The Council of British Hajjis here