Nimenrix Vaccine: When Is the Meningitis Vaccine Given and How Many Doses?

Nimenrix is a conjugate vaccine used to protect against serious infections caused by groups A, C, W and Y of the meningococcus bacterium. Although it is commonly called the “meningitis vaccine”, it is important to know which germs it covers. In this article I explain the features of Nimenrix, its age-dependent doses and how it differs from other meningococcal vaccines.

The question “My child has had the meningitis vaccine; are they now protected against all meningitis?” reflects a common uncertainty in vaccination planning. Meningitis has different causes, and no single vaccine covers all of them. The vaccine name and the groups it covers are an important part of the records.

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What is meningococcus?

Meningococcus, scientifically known as Neisseria meningitidis, is a bacterium that can be present in the nose and throat of some people without causing illness. Sometimes it spreads to other parts of the body and causes serious infection.

The two most important conditions are meningitis, an infection of the membranes surrounding the brain and spinal cord, and bloodstream infection. Meningococcal disease can progress rapidly and requires early treatment.

Transmission usually occurs through close or prolonged contact with respiratory and throat secretions. Close contact, such as living in the same household, is important in this respect. ^[1]

Why is the meningitis vaccine important?

Meningococcal disease should not be treated like any common feverish infection. It can lead to serious outcomes despite treatment; survivors may develop hearing loss, neurological damage or other permanent problems.

For this reason, prevention is something to consider before relying on treatment once the disease has appeared. The vaccination decision should be made taking into account the person’s age, health status and risk of exposure. ^[2]

What is the Nimenrix vaccine?

Nimenrix is a MenACWY vaccine developed against meningococcal groups A, C, W and Y. It does not contain live bacteria.

In the vaccine, fragments derived from the bacterium’s capsule structures are attached to a carrier protein. This conjugate structure helps the immune system recognise the target groups.

The purpose of Nimenrix is to protect against invasive meningococcal disease caused by the groups it covers. “Invasive” means that the bacterium reaches areas that should normally be sterile, such as the blood or cerebrospinal fluid. ^[3]

Does the Nimenrix vaccine protect against meningococcal B?

No. Nimenrix does not cover meningococcal group B. Protection against meningococcal B requires a separate vaccine assessment.

This distinction is particularly important when answering the question “are the meningitis vaccines complete?”. MenACWY and MenB vaccines do not have the same content and do not replace each other.

In addition, other bacteria such as pneumococcus and Hib can also cause meningitis. For this reason, protection should be assessed based on the person’s entire vaccination history. ^[4]

Who should get the Nimenrix vaccine?

According to the European product information, Nimenrix can be used from 6 weeks of age. However, the fact that a product can be used at a certain age does not mean it is recommended to everyone of that age on the same schedule.

For babies, children, adolescents and adults, the assessment is based on national recommendations, previous vaccines and individual risks. ^[3]

Situations in which MenACWY vaccination is particularly important include:

• Removal of the spleen or impaired spleen function
• Certain complement deficiencies
• Use of complement inhibitor therapy
• HIV infection
• Travel to regions where the disease is common
• Risk of an outbreak caused by the relevant meningococcal groups
• Some student residence occupants with incomplete vaccinations
• Certain laboratory staff working with meningococcus

Especially in people using complement inhibitors, risk may persist despite vaccination; the protection plan may involve more than the vaccine alone. ^[5]

How many doses of Nimenrix are given?

The number of Nimenrix doses depends on the age at first vaccination. The general schedule in the European product information is as follows:

• Babies from 6 weeks to under 6 months: Two primary doses two months apart.
• Babies from 6 to under 12 months: Usually a single primary dose.
• Babies vaccinated before their first birthday: A booster dose at 12 months of age, at least two months after the last dose.
• People aged 12 months and over: Usually a single primary dose; an additional dose is assessed according to risk status.

Some high-risk babies may need an extra dose in the primary series. For this reason, the question “Is Nimenrix one dose or two?” cannot be answered without knowing the age.

In Turkey, vaccination should be planned according to the current licensing information for the product used and the person’s risk status. ^[6]

Does the Nimenrix vaccine protect for life?

It should not be assumed that protection after Nimenrix lasts for life. Immunity can wane over time, and booster doses may be needed if the risk persists.

The decision on an additional dose depends on the age at which the first vaccine was given, how much time has passed and whether the risk continues. A dose given in childhood should not automatically be considered sufficient for travel or health risks years later. ^[4]

What are the side effects of the Nimenrix vaccine?

Pain, redness and swelling may occur at the injection site. Fever, headache and tiredness are also among the reported side effects. Young children may experience irritability, drowsiness and decreased appetite.

If there is a history of serious allergy related to a previous dose or a vaccine component, this should be shared before vaccination. If post-vaccination complaints are severe or unusual, medical assessment is needed. ^[6]

Frequently asked questions about the Nimenrix vaccine