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Meningococcal disease

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From the Australian government

Meningococcal disease is a life-threatening illness caused by a number of different strains of the bacterium Neisseria meningitidis. This bacterium, spread through coughing, sneezing or close contact with infected people, can cause septicaemia (blood poisoning) and meningitis (inflammation of the membranes around the brain and spinal cord).

Up to one in 10 patients with invasive meningococcal disease in Australia dies. Of those who survive, one in 30 has severe skin scarring or loss of limbs, and one in 30 has severe brain damage.

People with meningococcal disease can become extremely unwell very quickly. As well as causing meningitis and septicaemia – often simultaneously – meningococcal disease can lead to pneumonia (lung infection), septic arthritis, and conjunctivitis (eye infection).

Globally there are 13 strains of meningococcal disease, the most common being A, B, C, W135 and Y. The two most common strains of meningococcal disease in Australia are B and C. The meningococcal B vaccine Bexsero® is available through purchase on the private market. While infection by strains A, W135 and Y is less common in Australia.

Source: Meningococcal Disease

The other side

The meningococcal disease vaccine “Meningococcal C” was introduced in Australia in 2003 mainly to try to reduce meningitis cases, probably due to the Hib vaccine failing to do so after being introduced 10 years earlier.

This  vaccine is one of 3 vaccines now used to combat, respectively, 3 bacterial diseases that can all cause meningitis, septicaemia and pneumonia and other bacterial infections. These bacteria were deemed the most common causes of this range of conditions at the time of introduction of the respective vaccines.

The 3 bacterial diseases, the vaccine and year of introduction of the vaccine are:

  1. Haemophilus Infuenzae type b (Hib vaccine) – 1992-3
  2. Neisseria meningitidis (Meningococcal C vaccine) – 20003
  3. Streptococcus pneumoniae (Pneumococcal vaccine) – 2005

While these bacteria can be linked with illnesses such as meningitis, septicaemia and pneumonia, over 90% of us will play host to the range of bacteria that can cause these conditions without ever showing symptoms of any disease. We have lived with these bacteria for thousands of years and it is only in rare instances that they can make us ill.

Medicine has not sought to discover what the triggers are for turning a normally benign bacteria into a killer. Instead, its answer has been to vaccinate us against the bacteria using a shot whose side effects include suppression of our immune system, leaving us potentially more susceptible to diseases such as meningitis and septicaemia.

Disease naming and vaccine evaluation

The naming of diseases by microbe rather than by clinical symptoms is a departure from traditional disease naming, and it began during in the 1990s as pathology testing became more widely available.

A problem with evaluating the success of eradication programs of diseases named in this way is that the microbes may be wiped out by intervention measures, but that does not necessarily mean the target disease (e.g. meningitis) is wiped out. This is because other microbes can easily take the place of the ones no longer in circulation, and cause just as much disease, or even more (think of how antibiotics have bred super bugs).

Thus the only way to really evaluate success of vaccination programs for these types of diseases is to look at data for the target illness, rather than for the microbe. Despite this, health authorities continue to publish data showing reductions in notifications of cases caused by the Hib bacterium, suggesting vaccination has been a success.

Of the 3 diseases/vaccines listed above, only Hib has been used for long enough to evaluate its success, but the graphs below do show some short-term results for the other two vaccines. It appears the Hib vaccine did nothing to reduce meningitis and septicaemia, and the other two vaccines didn’t help either (all-ages graphs don’t show better results for the vaccines).

meningitis rate Australia

septicaemia rate Australia

Graphs are from Fooling Ourselves: on the fundamental value of vaccines by Greg Beattie

Meningococcal disease

There is no long-term data yet for determining success or failure of the vaccine for meningococcal disease in Australia, in terms of the target illnesses. As there are so many strains and species of bacteria around, it would be reasonable to assume that as the bacteria are eradicated, other microbes will step up to the plate and cause just as much meningitis and so on, as long as children are susceptible.

To illustrate this point, we refer you to a letter published by two high profile Indian paediatricians in the Bulletin of the World Health Organisation in 2008, about another bacterial vaccine, the Pneumococcal disease vaccine.

They discuss the merits of the vaccine, and point out that although it may have an effect on “vaccine-serotype bacteraemic” pneumonia, it does not reduce clinical pneumonia. In other words, regardless of what is reported about the vaccine’s effectiveness against the microbe, it does not reduce the amount of actual illness.

Source: Incidence of pneumonia is not reduced by pneumococcal conjugate vaccine; Sona Chowdhary, Jacob Puliyel. Bull WHO vol.86 no.10 Oct 2008

Vaccine decisions

The Meningococcal polysaccharide serogroups A, C, W-135 and Y conjugate vaccine was just added to the National Immunisation Program in July 2018, it may protect against four of many strains of the bacterium Neisseria meningitidis. The commercial name for the vaccine currently given in Australia is Menitorix, and it includes both the Hib vaccine and the Meningococcal C vaccine in a single dose but the new four strain vaccine is called Nimenrix.

This vaccine is given at 12 months of age (from July 2018 Nimerix will be also given at 12 months).


We suggest you look carefully at ingredients of the vaccines, contraindications and possible side effects. Also have a look at safety studies, and notice the number of subjects and follow-up time period.

Further reading

We suggest you get hold of this excellent book – it is available as a printed book and also as a PDF and has an emphasis on Australia. See chapter 6 for a discussion of the 3 vaccines mentioned on this page.
Fooling Ourselves: on the fundamental value of vaccines by Greg Beattie

See the following page on this website: Hib (Haemophilus influenzae type b) for more discussion of bacterial diseases.

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