From Wednesday 1is January 2025, vaccination against meningococci will expand in France. It will become compulsory for babies. A decision taken in a context of a rebound in infections by these bacteria, the cause of particularly serious meningitis which can be fatal.
What are meningococci?
It is a family of bacteria that causes very dangerous and contagious meningitis, mainly in children and adolescents.
It is far from the only cause of meningitis, a generic term for inflammation of the membranes of the brain or spinal cord. Most of the time, a virus is the cause. But viral meningitis is generally much less serious than bacterial ones.
The latter, which manifest themselves in particular by a high fever and a stiff neck, kill a patient devastatingly if they are not treated. And, when they are, mortality remains 10%, not to mention frequent after-effects: amputation, cognitive disorders, deafness, etc.
Additionally, meningococci are easily transmitted from person to person. They can therefore cause epidemics, which justified the development of vaccines.
Why expand vaccination?
The new recommendations aim “to better protect infants against these serious infections, in response to a worrying resurgence observed in recent years”, recalled the Ministry of Health in a press release in December.
This recovery can be explained by the measures taken against the Covid pandemic in 2020 and 2021. Not only have the restrictions reduced the population’s exposure to meningococci, but they have also weighed down vaccination statistics.
According to the latest figures, provided to theAFP by the National Meningococcal Reference Center at the Pasteur Institute, more than 500 cases have already been recorded between January and November 2024, a slight increase compared to the same period in 2023.
As 2023 had already seen an unprecedented rebound, “this makes 2024 the year with the highest number of cases in twenty years”emphasizes to theAFP infectious disease specialist Muhamed-Kheir Taha, specialist on the subject at Pasteur. Another development is also pushing to accelerate vaccination: the profile of the bacteria involved has clearly changed.
The main meningococci are in fact separated into large families: A, B, C, W and Y. For a long time, B and C remained in the majority. This is still the case for B. But C has become marginal, clearly behind Y and W, the latter being particularly deadly.
The growth of these families has been accompanied by an increase in unusual forms of infection (abdominal forms, bacterial pneumonia, arthritis, etc.), which are sometimes more difficult to diagnose.
Until then, only B and C were concerned by vaccination, a choice which appeared more and more anachronistic to specialists.
What is changing?
Only anti-meningococcal C vaccination was obligatory for those under one year of age, that against B was only recommended. Among older people, vaccine C was recommended up to age 24, only if the person had not received it as planned when they were less than a year old.
From now on, vaccination will become much broader, according to the new schedule effective from 1is January. In infants, vaccination against all strains – A, B, C, W and Y – will be mandatory. In adolescents, a booster dose against A, C, W and Y will be recommended between 11 and 14 years of age, even if they received this vaccine at a young age. This is not an obligation, but the advantage is that the vaccine will be largely reimbursed by Health Insurance.
On the other hand, the anti-B vaccine will remain reserved for the youngest, the High Health Authority having not judged its benefits sufficient beyond two years.
What vaccines?
A single vaccine, called tetravalent, will target A, C, W and Y. In infants, it will be Nimenrix from Pfizer, given in two successive doses, at 6 and 12 months. Some babies are currently between doses. Even if their first dose, given in 2024, was not the tetravalent vaccine, this will be the case for the second in 2025.
The second dose can also be given with the Menquadfi vaccine from Sanofi. For older children, who will only receive a booster dose, it could be Ninmenrix, Menquadfi or Menveo from GlaxoSmithKline (GSK). Given separately in three successive doses at 3, 5 then 12 months, the anti-B vaccine will remain, as currently, Bexsero from Pfizer.
