Meningococcal Vaccine for Adults成人应接种疫苗之脑膜炎球菌疫苗

The meningococcal vaccine protects you from four types of bacteria that cause meningococcal disease. This illness can cause meningitis, an infection of the lining around the brain or spinal cord. It can also cause a blood infection(meningococcal bacteremia),pneumonia, and other problems. Ten percent to 15% of people who are infected with the disease die from it, even if they were treated with antibiotics. As many as 20% of those who survive may have lasting problems such as hearing loss, brain damage, seizures, or loss of limbs.Because this illness is serious, it's important you get vaccinated if you are at risk.You can catch meningococcal infection through close contact with someone who has the bacteria in his or her throat or nose. Early symptoms of both meningitis and blood infection can be confused with the flu or a cold, but symptoms can rapidly become more severe and may include:

• Sudden high fever
• Headache
• Stiff neck
• Aches
• Fatigue
• Purplish rash on arms and legs
• Other symptoms such as nausea, vomiting, and changes in mental state

Which adults should receive the meningococcal vaccine?

The CDC recommends you get the vaccine if you are an adult and:

• Are living in a dorm as a first-year college student
• Work with meningococcal bacteria in a lab
• Are in the military
• Are traveling to or living in a country where meningococcal disease is common, such as in certain parts of Africa
• Have a damaged spleen, or it's been removed
• Have an immune system disorder called terminal complement deficiency 
• Are taking eculizumab (Soliris)
• May have been exposed to meningitis during an outbreak

If you are age 55 or younger, you should have the meningococcal conjugate vaccine (MCV4). It should also be taken if you are traveling or living in a country where meningococcus is common or you are part of population with increased risk of outbreakIf it is not available, you can also have the meningococcal polysaccharide vaccine (MPSV4).If you are age 56 or older, you should have the MPSV4, the only approved vaccine for this age group.

Are there any adults who should not get the meningococcal vaccine?

You shouldn't have either type of meningococcal vaccine if you:

• Are moderately or seriously ill. Wait until you recover.
• Have had a serious allergic reaction (called anaphylaxis) to a previous dose
• Had a severe reaction to any part of the vaccine

If you are pregnant or have other concerns, ask your doctor which meningitis vaccine is right for you.

How and when should you receive the meningococcal vaccine?

You receive the MCV4 as a single dose, injected into a muscle. You receive the MPSV4 as a single dose injected under the skin.In most cases, adults only need one dose. But if you remain at risk, you may need a booster.

关于脑膜炎球菌性脑膜炎
脑膜炎球菌性脑膜炎是一种细菌形式的脑膜炎，由于围绕大脑和脊髓的很薄的内皮发生严重感染而造成。该病可对大脑带来严重损害，若不加治疗，50%的病人将失去生命。 几种不同的细菌可引起脑膜炎，脑膜炎奈瑟菌是可能造成大规模流行的细菌。已经确定了脑膜炎奈瑟菌的12个血清群，其中有6个（A、B、C、W、X和Y）可引起流行，地理分布及引发疫情的能力因血清群而异。

传播途径及症状

细菌通过携带者的呼吸道或者咽喉分泌物飞沫在人间传播。密切接触及长时间接触，比如接吻、打喷嚏或者面向别人咳嗽，或者与感染者（携带者）一起近距离生活（如住在一个宿舍，共用餐饮用具），易于引起疾病传播。潜伏期平均为4天，但可为2天或10天不等。脑膜炎奈瑟菌仅感染人类，不存在动物宿主。这种细菌可以留在喉咙部位，有时，由于尚未完全了解的原因，病菌可以突破身体的防御，使感染通过血流扩散到大脑。据认为，10%至20%的人群咽喉部一直携带脑膜炎奈瑟菌。然而，在发生疫情时，病菌携带率可能会更高。

脑膜炎球菌疫苗（流脑疫苗）

目前可用几种疫苗来控制这一疾病，它们是：A群脑膜炎球菌结合疫苗、C群结合疫苗、四价（A、C、Y和W群）结合疫苗和脑膜炎球菌多糖疫苗。

我国已上市疫苗种类：• 脑膜炎球菌多糖疫苗（包括：A群单价,A群C群二价和ACYW135群四价）• A群C群脑膜炎球菌结合疫苗• A群C群脑膜炎球菌+b型流感嗜血杆菌联合疫苗国际上已上市疫苗种类：• 脑膜炎球菌多糖疫苗（包括：A群、B群、A群C群二价、ACYW135群四价、联合疫苗等）• 脑膜炎球菌结合疫苗(包括:C群单价, C群脑膜炎球菌+b型流感嗜血杆和ACYW135群四价)

哪些成人应接种脑膜炎球菌疫苗？

推荐以下成人应接种:

• 与大一新生共处；
• 从事与脑膜炎球菌相关的实验室工作人员；
• 军队服役人员；
• 前往或居住于脑膜炎球菌性脑膜炎多方地区，如非洲部分地区；
• 患有脾损伤或者移除者；
• 免疫系统紊乱者；
• 疫情爆发期可能发生暴露者；

如果年龄低于55周岁（含），应接种四价结合疫苗，如暂无此类疫苗，可使用四价多糖疫苗代替；如果年龄高于56周岁（含），应接种四价多糖疫苗（仅此类疫苗批准用于高年龄组人群）。

是否有部分成人不能接种脑膜炎球菌疫苗？

以下人群不能够接种：

• 患有中度或严重疾病者，应等痊愈后再接种；
• 以往接种时有严重过敏反应者；
• 对疫苗任一组分有严重反应者；

如果是怀孕期或有其他症状时，应遵照医生建议选择接种疫苗类型。

应如何接种脑膜炎球菌疫苗？

四价脑膜炎球菌结合疫苗经肌肉注射接种1剂，四价脑膜炎球菌多糖疫苗经皮下接种1剂。多数情况下成人仅需接种1剂，但若处于高风险环境下，应需加强1剂。

资料来源

1. WHO网站“脑膜炎球菌性脑膜炎”实况报道 第141号

2.美国疾控中心网站

同步发布于中国疫苗网