What Is Meningococcal Disease?
Meningococcal disease is caused by Neisseria meningitidis bacteria and can result in meningitis (inflammation of the lining of the brain and spinal cord) and bloodstream infections (septicemia). It progresses quickly and can be fatal or leave survivors with long-term disabilities.
People with SLE may not fight off this infection as well as the general population due to alterations in the immune system of some patients with SLE, disease activity and/or immunesuppressive medications.
Why Is It Important in Lupus?
SLE patients have increased infection risk, particularly if they have received rituximab, have a complement deficiency, or have had their spleen removed or not functioning. These factors increase the chance of meningococcal disease.
Should I Get the Meningococcal Vaccine?
Vaccination is recommended for lupus patients with risk factors (complement deficiency, asplenia, rituximab, or other B-cell depletion).
In Canada, meningococcal conjugate vaccines (Men-C-C, Men-C-ACYW, Men-B) are available. Adults with risk factors should receive both Men-ACYW conjugate and Men-B vaccine for broad protection.
There are outbreaks especially in high school and young adult age groups and at this time, vaccination may be recommended.
In Canada, 1-year-old children are vaccinated with a meningococcal vaccine (Men-C-C).
When Should I Get It?
Ideally before rituximab or other B-cell–depleting therapy. If you are already immunosuppressed, the vaccine may be less effective but can still provide some protection.
Boosters may be needed every 5 years for high-risk individuals.
You should talk to your specialist(s) about this vaccination if you are uncertain if you are considered a high-risk person.
Side Effects and Lupus Flares
The vaccine is safe and well tolerated. Side effects include mild arm soreness or low-grade fever. It is not associated with lupus flares.
Authors: Daniel Tingey and Doctor Janet Pope
Note: Please consult your healthcare provider or local health authorities for up-to-date vaccine recommendations.