Meningococcal vaccination in the UK: MenB, MenACWY and who is offered them

Meningococcal bacteria are divided into groups. NHS inform lists groups A, B, C, W, X, Y and Z as causes of meningitis, and the UK Health Security Agency explains that meningococci are classified by the polysaccharide capsule into capsular groups. Because the groups differ, a single vaccine cannot cover them all, which is why the UK programme uses a MenB vaccine in infancy and a MenACWY vaccine in adolescence.

The NHS says that before the MenB vaccine was introduced, group B bacteria were the biggest cause of meningitis and sepsis in the UK, and that since it has been used there has been a big drop in the number of young children getting MenB illnesses. It adds that the vaccine works very well against most types of group B bacteria in the UK.

The table below draws on the NHS pages for each vaccine and the NHS vaccination schedule. Always rely on current NHS guidance or your GP surgery for your own situation, because programmes and eligibility dates change.

The NHS describes MenACWY as protecting against 4 types of bacteria linked to meningitis, namely groups A, C, W and Y. It is given as an injection, usually in the upper arm, and most people need one dose. People who need it for their job may need a booster every 5 years. It can be given at the same time as other vaccines, including MMR and the Td/IPV teenage booster.

Beyond teenagers, the NHS says the vaccine is also available for some people at increased risk because of a medical condition, work, travel, or close contact with someone who is infected. The NHS points travellers to the TravelHealthPro website to check the risks of a country they are visiting.

Students are a specific focus. The NHS says meningitis can spread very quickly in places like universities and colleges, and that those under 25 who have not had MenACWY should ideally have it at least 2 weeks before starting; if they have already started, they should get it as soon as possible, for example through the campus health centre or by registering with a GP.

For infants the NHS offers three MenB doses as part of the schedule. Most children can have it; the only reasons they cannot are a serious allergic reaction to a previous dose or to an ingredient. A child with a high temperature should wait until they feel better, but a minor illness without a fever is not a reason to delay.

The NHS recommends giving infant paracetamol after the MenB vaccines at 8 weeks and 12 weeks to prevent or treat fever, in a set pattern of three doses spaced at least 4 hours apart. Follow the instructions on the NHS page and the product label. The NHS also advises seeking an urgent GP appointment or NHS 111 if a baby under 3 months has a temperature of 38C or more, a baby of 3 to 6 months has 39C or more, a high temperature persists more than 48 hours after the vaccine, or you are worried.

The NHS also describes a time-limited MenB programme for some older teenagers and young adults. For up-to-date eligibility, use the NHS wording on dates of birth and starting study, as it is time-limited and the rules can change.

For MenACWY the NHS lists common side effects as a reaction at the injection site (pain, swelling or itchiness), headache, nausea, rash, irritability, drowsiness, loss of appetite and generally feeling unwell. Most are mild and short-lived. For MenB in children, common effects include swelling or pain at the injection site, a high temperature, tiredness or irritability, loss of appetite and diarrhoea, usually better within 1 or 2 days.

Severe allergic reactions are very rare and usually happen within minutes, and the NHS says the person vaccinating is trained to treat them immediately. The vaccine should not be given to anyone who has had anaphylaxis to a previous dose or to an ingredient. The NHS adds that MenACWY can be given to someone who is unwell without a high temperature, but anyone with a high temperature should wait until they feel better.

The NHS is explicit that MenACWY does not prevent all types of meningitis, and that MenB does not protect against other causes of meningitis and sepsis. Pneumococcal bacteria, Hib and viruses can also cause meningitis, which is why the NHS schedule also includes the 6-in-1, pneumococcal and MMRV vaccines for children.

Because of this, vaccinated people should still know the warning signs and seek emergency help if they appear. The NHS meningitis page describes fever, severe headache, stiff neck, light sensitivity, confusion, drowsiness, seizures and a rash that does not fade under a glass, and says to call 999 or go to A&E if you think you or your child may have meningitis.

The NHS says you can check vaccination history in the NHS App or by asking your GP surgery. If a vaccine was missed, the NHS says to contact the GP surgery to catch up, and that it is best to have vaccines on time but most can still be caught up. Private clinics may also offer meningococcal vaccines, for example for travel or outside NHS eligibility; the principle is the same, that the vaccine does not replace vigilance for symptoms, and a clinician should record the vaccine in your health record.