Key messages

  • Increasing cases of invasive meningococcal disease (IMD) due to serogroup C have been seen across Melbourne since May 2017, almost all in men who have sex with men.
  • Although uncommon, meningococcal disease can become life-threatening very quickly.
  • Menactra® is an inactivated quadrivalent conjugate vaccine, given as a single dose. The vaccine protects against four meningococcal strains; A,C, W and Y. The vaccine effectiveness has been estimated at 80 to 85 per cent.
  • The vaccine is free until 31 December 2018 to all gay and bisexual men and MSM who reside in Victoria.
  • Order vaccine online using the government-funded vaccine order form.
  • Report vaccine doses administered to the Australian Immunisation Register. The Register can also be used to check if your patient has recently received a dose through another provider.

All gay and bisexual men (GBM) and men who have sex with men (MSM) who live in Victoria can access a free meningococcal ACWY vaccine until 31 December 2018.

The vaccine is available through general practice (GP) clinics and other registered immunisation providers in Victoria, including all sexual health clinics.

View the Chief Health Officer alert: Outbreak of invasive Meningococcal C disease in men who have sex with men (MSM).

Increased numbers of meningococcal cases

Between May and November 2017, there have been an increasing number of confirmed cases of a closely related strain of serogroup C infection in MSM notified across Melbourne, Victoria. There have been previous clusters of IMD in MSM worldwide including in Berlin, Paris, Chicago and Los Angeles. Although uncommon, meningococcal disease can become life-threatening very quickly.

GMS and MSM who have not received a vaccine against meningococcal serogroup C are at increased risk in this outbreak.

About the program

It is important that all GBM and MSM are protected against meningococcal disease. HIV positive GBM and MSM in Victoria may be at particular risk.

All GBM and MSM who live in Victoria will be able to access the free meningococcal ACWY vaccine until 31 December 2018 through GP clinics and other registered immunisation providers in Victoria, including all sexual health clinics. Please bulk bill your patient in order to maximise access to this important public health initiative. 

Communications and consent

All eligible GBM and MSM aged 18 years and over can provide their own consent.

A factsheet has been developed to support health professionals and immunisation providers to understand critical health advice for GBM/MSM patients, including recommended vaccines, as well as information on other important health topics for GBM and MSM.

The Victorian Government's consumer health information website the Better Health Channel provides additional information for consumers about the free meningococcal vaccine program.

Vaccine presentation, safety and administration

The meningococcal ACWY vaccine brand supplied is Menactra®, an inactivated quadrivalent conjugate vaccine.

Menactra® presents as a liquid form in a single dose vial. Immunisation providers supply the syringe and needle for each vaccination. Menactra® is administered by intramuscular injection into the deltoid muscle. Menactra® provides protection against the A, C, W, and Y strains of meningococcal disease.

If an eligible GBM/MSM received a dose of meningococcal C vaccine in childhood (due at 12 months of age), do they still require a free dose of Menactra® vaccine?

Yes. A single dose of Menactra® provides protection against A, C, W, and Y strains and will boost immunity in addition to protection they gained against the C strain when vaccinated at age 12 months.

If an eligible GBM/MSM did not receive a dose of meningococcal C vaccine in childhood, do they require a free dose of Menactra® vaccine?

Yes. They should receive a single dose of Menactra® vaccine now as it contains protection against the meningococcal C strain.

If an eligible GBM/MSM has previously received a dose of polysaccharide quadrivalent meningococcal vaccine (Menomune® or Mencevax®), do they still require a free dose of Menactra® vaccine?

Yes. Eligible GBM/MSM are recommended to receive a dose of Menactra®, the conjugate quadrivalent meningococcal vaccine as part of reducing risk in this outbreak, unless they have received such a vaccine within the last five years.

Are there any timing interval considerations for administration of Menactra® vaccine and other meningococcal vaccine products?

The recommended minimum interval is four weeks between doses of any conjugate meningococcal C containing vaccine and six months between the polysaccharide quadrivalent vaccine and Menactra®.

There is no interval requirement for meningococcal B vaccine.

Are there any timing interval considerations for vaccine administration with meningococcal ACWY, hepatitis A, hepatitis B and HPV vaccines?

The meningococcal ACWY, hepatitis A, hepatitis B and HPV vaccines are inactivated vaccines and can be administered on the same day, or at any time before or after, each other using different injection sites separated by 2.5 cm.

If a person who is eligible under this program is living with HIV, are two doses of Menactra® vaccine required?

Yes. Persons who are eligible for vaccination under this program, who are also persons living with HIV, should receive two doses of Menactra® vaccine regardless of stage of disease or CD4+ count.

The doses should be given eight weeks apart. Both doses of Menactra® are provided free of charge under this program.

If an eligible GBM/MSM receives the free Menactra® vaccine, is a booster dose required later?

The current recommendation is that booster doses are not usually required. Booster doses may be recommended for some individuals, including those with high-risk medical conditions and those traveling to areas with high rates of meningococcal disease based on individual risk assessment. Refer to the NCIRS meningococcal fact sheet for further information.

Can Menactra® be administered with other vaccines offered free to GBM/MSM?

Yes. Multiple vaccines can be administered on the same day at different injection sites.
For more information about free vaccinations for MSM download the important health information for men who have sex with men fact sheet.

Ordering

To order vaccine use the government-funded vaccine order form online. Immunisation providers are recommended to order only as many doses of Menactra® as they are likely to require in the coming one month.

Reporting

Administration of Menactra® should be reported to the Australian Immunisation Register in the usual way. The Register can also be used to check if your patient has recently received a dose through another provider.

Important information

Important health information for men who have sex with men: a guide for health professionals and immunisation providers - factsheet
Online vaccine order forms

Consumer information

Better Health Channel: Time to immunise