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

The FTM Hub

The Faculty of Travel Medicine have just posted a notice on Facebook as follows:

Our free of charge, online travel health education is being offered as a special ‘one off’ opportunity by our Faculty of Travel Medicine. The FTM Hub is a pilot interactive educational journal which was launched in June 2016, providing easily accessible, visually attractive education which can be undertaken at the user’s own pace and time availability. Created and designed by Jane Chiodini, Director of Education for the Faculty of Travel Medicine, the material is developed in an e learning programme which offers the capability of providing the user with many different forms of interactions, including videos for a travel health update, live links to related resources online, case studies and much more. To access click HERE  and in return please complete the anonymous evaluation survey which will help inform the Hub’s further development. The survey will take about 5 minutes to complete. To complete the survey click HERE

Please note, all the information in the Hub was up to date at the time of production.  In the section on Zika within the hub, information about male travellers with no Zika symptoms were originally  advised to use condoms for 4 weeks following travel to an area with active Zika virus transmission to prevent sexual transmission but this period of time is currently extended to EIGHT WEEKS.  See HERE for more details.  

It is planned that if the Hub is developed further, it will be made available to all members of the Faculty of Travel Medicine.  Those who prefer not to undertake formal training in travel medicine can still join within the Affiliate category.  The annual fee is £30 which would provide access to the Hub every 6 months, receipt of two printed copies of Emporiatrics per annum, access to the Journal of Travel Medicine and Infectious Disease and also reduced delegate rates to FTM educational events.  For more details click HERE. Alternatively, learners could access the Hub for a small fee from an online portal as a standalone programme which will be posted HERE in the future.