Any infection caused by the Neisseria meningitidis (N. meningitidis) bacteria is called meningococcal disease. Meningococcal disease is very serious. It can lead to limb amputations, hearing loss, nervous system problems, brain damage, seizures, strokes, or even death. The two most common types of meningococcal diseases are meningococcal meningitis and meningococcal septicemia (a blood infection).
Meningococcal disease is spread by contact with infected respiratory and throat secretions through things like coughing; kissing; sneezing; or shared drinks, eating utensils, smoking devices, or lip makeup. The risk of infection increases with close or prolonged contact with someone who is infected. Family members in the same house, caregivers, or sharing a crowded living situation, such as living in a college dorm, may also increase risk.
Meningococcal disease is preventable, and the key to preventing it is getting vaccinated. For a long time, there were two types of meningococcal vaccines available to protect against meningococcal disease. Meningococcal ACWY vaccines act against certain groups of N. meningitidis bacteria known as A, C, W, and Y. Meningococcal B vaccines act against the B group of N. meningitidis. The newest meningococcal vaccine, Penmenvy, and one other vaccine, Penbraya, basically combine these two types into one vaccine, covering five groups of N. meningitidis.
How Does Penmenvy Work for Meningococcal Disease?
Penmenvy works by triggering the body's immune response to make certain proteins (antibodies) against five groups of N. meningitidis bacteria (A, B, C, W, and Y) that cause meningitis and other serious infections. There are 12 known groups of N. meningitidis bacteria, but these five groups (A, B, C, W, and Y) are responsible for most meningococcal infections. After being vaccinated (two doses separated by six months), if you come in contact with one of these groups of N. meningitidis, your immune system is ready and primed to kick in to help keep you from getting sick because the antibodies help to fight and kill the bacteria.
How Does Penmenvy Compare to Other Vaccines for Meningococcal Disease?
When Penmenvy was studied to see if it was safe and worked to prevent meningococcal disease, it was compared to existing vaccines available for meningococcal disease to make sure it was not less effective.
One study looked to see if the antibody protection with Penmenvy was less than with Bexsero against meningococcal B disease or Menveo against meningococcal ACWY disease in people who had not previously had a meningococcal vaccine.
They measured antibody killing activity against N. meningitidis group B in people between 10 and 25 years old. Measurements were taken one month after the second dose of Penmenvy or the second dose of Bexsero when given as a two-dose series. Two doses of Penmenvy were found to work similarly well and not be less effective than two doses of Bexsero to protect you against meningococcal B disease.
They measured antibody killing activity against N. meningitidis group A, C, W, and Y in people between 10 and 25 years old who had not gotten a previous meningococcal vaccine. Measurements were taken one month after the second dose of Penmenvy or one dose of Menveo. Two doses of Penmenvy were found to work similarly well and not be less effective than one dose of Menveo to protect you against meningococcal A, C, W, and Y disease in people without a previous meningococcal vaccine dose in the past.
Because of the recommended timing of meningococcal vaccination and when different vaccines became available, it is possible that someone could get a dose of meningococcal ACWY vaccine and then have a chance to get a combination meningococcal vaccine that covers ABCWY groups in the future. Therefore, they also looked to see if Penmenvy was safe and effective in people who had already gotten a dose of meningococcal ACWY vaccine. This study looked at the antibody killing activity against N. meningitidis group A, C, W, and Y in people between 15 and 25 years old who had gotten a previous meningococcal ACWY vaccine. Measurements were taken one month after the second dose of Penmenvy or one dose of Menveo. Two doses of Penmenvy were found to work similarly well and not be less effective than one dose of Menveo to protect you against meningococcal A, C, W, and Y disease in people with a previous meningococcal vaccine dose in the past.
The bottom line of these studies is that Penmenvy seems to work similarly compared to Bexsero (meningococcal B disease) and Menveo (meningococcal ACWY disease) in people regardless of whether they had a meningococcal ACWY vaccine in the past.
Penmenvy may not protect everyone who receives the vaccine and may not provide protection against every possible strain of N. meningitidis. Your results may differ from what was seen in the studies.
Who Should Get a Meningococcal Vaccine?
The meningococcal B vaccines do not protect against A, C, W, or Y strains of N. meningitidis. The meningococcal ACWY vaccines do not protect against B strains of N. meningitidis. Penmenvy protects against all five of these strains of N. meningitidis and can be used as a part of routine vaccination instead of using the individual vaccines when both vaccines would be given on the same visit.
According to the CDC, one dose of the meningococcal ACWY vaccine is recommended for all children between 11 and 12 years old. A second dose (also called a booster dose) is recommended for teens when they turn 16 years old. There are two meningitis ACWY vaccines available: Menveo and MenQuadfi. These vaccines are considered interchangeable.
The meningitis B vaccine is recommended for certain children and young adults between the ages of 16 and 23 who are more likely to get infected with the B strains of N. meningitidis. Examples of people who are considered high risk include the following.
- Attending a four-year university, especially if you are a freshman
- Living in crowded conditions, such as when in a jail or prison, a dorm, or military training site
- Are a part of a large social group, such as a fraternity of sorority
- Working with meningococcal bacteria in a lab
- Are in the military
- Travel to or live in a country where meningococcal disease is common, such as in certain parts of Africa
- Have a damaged spleen, or it has been removed
- Have an immune system disorder called terminal complement deficiency
- Are taking eculizumab (Soliris) or ravulizumab (Ultomiris)
- May have been exposed to meningitis during an outbreak
- Have HIV
The meningitis B vaccine is usually given as a two-dose series, separated by six months. A three-dose series can be used when a quick response is needed, such as during an outbreak of meningitis or when the vaccine series is being started less than six months before you start college. There are currently two meningitis B vaccines available, Bexsero and Trumenba. These vaccines are not interchangeable.
What Is the Place in Therapy for Penmenvy?
Let us say that you have a 16-year-old going in for their wellness check with their health care provider. They had one dose of a meningococcal ACWY vaccine when they were 12 years old. Today, they are due for a booster dose of meningococcal ACWY vaccine. After discussing things with the health care provider, it is decided that it is a good idea for your child to get a meningococcal B vaccine. When the individual ACWY and B vaccines are used, they can be given on the same day, but it is recommended that different injection sites are used for each vaccine. Penmenvy can be used in place of both separate vaccines (when they are to be given on the same day), reducing the number of shots that are needed from two to one.
Below is an illustration of how Penmenvy can be used to replace two vaccines.
11 to 12 years old | 16 to 23 years old (ideally 16 to 18) | ||
| Meningococcal ACWY vaccine | Meningococcal ACWY vaccine | Meningococcal B vaccine | Meningococcal B vaccine |
| Penmenvy can be used in place of the two vaccines above. | |||
Getting Your Vaccine: What to Expect
Penmenvy is a shot that is given into your muscle, usually in your upper arm. It is given as a two-dose series. If you do not get both doses, you may not be well protected against meningococcal disease. To maximize the benefits of Penmenvy, it is important that you get both doses and to get them on schedule. You should get your second dose of Penmenvy six months after receiving the first one. If you miss an appointment to get your second dose, call and get it rescheduled as soon as you can.
What Are the Most Common Side Effects of Penmenvy and How Can I Manage Them?
The most common side effects of Penmenvy include pain, redness, or swelling near where the needle went in, feeling tired, headaches, muscle or joint pain, or nausea. Fainting has also happened after receiving several vaccines, including Penmenvy. The risk of dizziness or fainting, which may lead to a fall, is the highest within the first few minutes after getting the vaccine. Your health care provider may want to watch you during this time to ensure your safety.
Here are some things you can do that may help to reduce your risk of fainting when you get your Penmenvy doses.
- Try to eat and or drink before you get your vaccine. If you are hungry or thirsty, you may be more likely to feel faint when you get your vaccine.
- Let the person giving you the vaccine know if you have a history of dizziness or fainting with other vaccines or shots.
- Sit or lie down to get your vaccine. Stay put for about 15 minutes after getting the shot.
- Distract yourself with a game or app on your phone or tablet.
- Breathe slowly, taking deep breaths before, during, and after getting your vaccine.
- Talk about something with the person giving you the vaccine or whoever is with you.
If you feel like you are going to faint after receiving Penmenvy, stay where you are and let the person giving you the vaccine know so they can help to keep you safe and prevent a fall.
What Are Other Unique Considerations to Be Aware of With Penmenvy?
Two vaccine parts are mixed together before you get a dose of Penmenvy.One part tells your body to make antibodies against the A, C, W, and Y strains of N. meningitidis. This is like the available vaccine known as Menveo. The other part tells your body to make antibodies against the B strains of N. meningitidis. This is like the available vaccine known as Bexsero.
If in the future you need a booster dose of a meningococcal vaccine (such as because of an outbreak), you should get a booster that matches the type of vaccine you had before. So if you got Penmenvy, and you need a meningococcal B booster, Bexsero is what is recommended for your booster. If you need a meningococcal A, C, W, Y booster, any available vaccine can be used as they are interchangeable.
