Everything you need to know about the Bexsero vaccine

Bacterial meningitis is a very serious infection, which can lead to hospitalization followed by months of rehab—and that’s for someone who recovers well. Not everyone who contracts bacterial meningitis is as fortunate. Thankfully, there are meningococcal B vaccines such as Bexsero that can help prevent this dangerous illness. 

What is meningitis?

Meningococcal disease, caused by Neisseria meningitidis bacteria, is a rare but serious infection. There are at least 12 types, or serogroups, of meningitis. Serogroups A, B, C, W, X, and Y are the primary  causes of infection. 

What is meningitis B?

Serogroup B can lead to meningococcal serogroup B disease, also known as meningitis B. Meningitis B causes meningitis (infection and swelling of the tissue covering the brain and spinal cord) or blood infection. Both types of symptoms can have life-long effects or even be deadly. 

Symptoms of meningitis include:

Sudden onset of:

• Fever
• Headache
• Stiff neck

Other warning signs include:

• Nausea
• Vomiting
• Sensitivity to light
• Confusion

These symptoms may not be present in babies. Instead, babies may appear slow or inactive, irritable, vomiting, or feeding poorly.

The symptoms of a blood infection (sepsis) may include:

• Fever or chills  
• Tiredness (fatigue) 
• Vomiting or diarrhea 
• Cold hands and feet 
• Peeing less than usual
• Severe aches or pain in the muscles, joints, chest, or belly (abdomen) 
• Rapid breathing/pulse
• A dark purple rash

Bacterial meningococcal disease can be treated with antibiotics, but even with treatment, it is fatal in one to two out of every 10 people who contract the condition. 

Seek medical attention immediately if you recognize any of the above symptoms of meningococcal disease. Often, symptoms mimic the flu, so it is best to be safe and get checked out. The best way to prevent the condition is through vaccination.

What is Bexsero?

Bexsero is a non-live, injected vaccine that helps to prevent infection from meningococcal disease caused by serogroup B. While Bexsero will not protect against all forms of meningococcal B disease, the effectiveness of Bexsero is an estimated 66% to 91% of circulating meningitis B strands. 

Do you need a MenB vaccine if you’ve had another meningitis vaccine?

Yes. There are two different types of meningitis vaccines. They protect against different types of meningococcal disease. 

1. Meningococcal conjugate (MenACWY) vaccines, such as Menactra and Menveo, protect against serogroups A, C, W, and Y. These vaccines are routinely given to children between ages 11 and 12, with a booster at age 16.
2. MenB vaccines, such as Bexsero and Trumenba are newer, and were approved at the end of 2014. They protect against serogroup B strains. To be fully vaccinated against the most common strains, you need both a conjugate vaccine and a MenB vaccine.  

Who should get the Bexsero vaccine?

Bexsero is approved for anyone between ages 10 and 25. However, the Centers for Disease Control and Prevention (CDC) recommends the meningococcal group B vaccines (Bexsero and Trumenba) for teens and young adults ages 16 to 25, and anyone else at increased risk of the disease. 

Children and adults are considered high risk, or more likely to become infected, in certain situations, including: 

• A serogroup B meningococcal disease outbreak
• Travel to places with high meningitis exposure risk
• A complement component deficiency
• A damaged spleen or asplenia
• Treatment with Soliris (eculizumab) 

The CDC also recommends MenB vaccines for adults working as microbiologists who are regularly exposed to Neisseria meningitidis.

Who should not get the Bexsero vaccine?

People who are allergic to any of Bexsero’s ingredients or who have had a severe allergic reaction to Bexsero before should not receive the vaccine. Women who are pregnant or breastfeeding should discuss getting the vaccine with a healthcare professional. Animal studies suggest that Bexsero is safe during pregnancy, but not enough information is available to declare it definitively safe for human pregnancies. It is recommended that the Bexsero vaccine be given to expectant mothers only if necessary, for example, if the mother is at high risk. 

The tip caps used for the prefilled syringes contain natural rubber latex, which may cause an adverse reaction in latex-sensitive individuals.

People who are acutely moderately or severely ill should wait until they are better to get the vaccine.

Bexsero may be safely given to individuals who are immunocompromised, but their immune system may respond weakly or have less of an immune response, which can reduce efficacy. 

How many doses of Bexsero are needed?

Bexsero is administered intramuscularly—it’s injected into the muscle via syringe. Two doses of 0.5 ml are required for maximum protection, according to U.S. Food & Drug Administration (FDA) guidelines. The doses should be given at least one month apart. 

It’s best to get the second dose on schedule, meaning as close to one month after the first dose as possible. The second vaccine dose is still effective when more than a month has passed since the previous dose of Bexsero. However, the effectiveness of the first dose wanes with time, so receiving the second dose in a timely manner helps make sure you’re fully protected, faster.

Can Bexsero be given with other vaccines?

The CDC says the MenB vaccine can be given at the same time as Tdap, HPV, and MenACWY vaccines. If given during the same visit, the vaccines should be administered in a different injection site and with different syringes. 

Bexsero should not be used interchangeably with other MenB vaccines to complete a vaccination series. The first dose of Bexsero must be followed by a second dose of Bexsero specifically.

Bexsero side effects

Some of the reported side effects of the Bexsero vaccine include:

• Pain at the injection site
• Myalgia (muscle pain)
• Erythema (redness)
• Headache
• Nausea
• Fatigue
• Induration (a hardened formation under the skin)
• Arthralgia (joint pain)

These adverse events are usually mild and short-lived for vaccine recipients.

Is Bexsero safe?

Yes. Based on clinical trials and postmarketing studies involving more than 37,000 participants, Bexsero has a demonstrated safety profile.

Bexsero vs Trumenba

Bexsero and Trumenba are both recombinant serogroup B meningococcal vaccines. Both are licensed in the United States for people ages 10 to 25. The Advisory Committee on Immunization Practices (ACIP) does not state a preference between them.

The side effects for both are similar, with injection site pain, fatigue, headache, muscle pain, and nausea among the most common. 

Though the two vaccines are similar, they are not interchangeable. Bexsero is a GlaxoSmithKline (GSK) brand while Trumenba is made by Pfizer. 

Bexsero follows a two-dose schedule with one 0.5 ml dose followed by a second 0.5 ml dose administered one month later.

Trumenba has either a two-dose schedule or a three-dose schedule. Anyone ages 10 and up who is at an increased risk for serogroup B meningococcal disease should follow the three-dose schedule. After the initial dose, a second dose should be given at 1 to 2 months following the first dose, and a third dose should be given six months after the first dose. Healthy adolescents and young adults ages 16 to 23 who are not at increased risk for meningococcal disease should receive one dose followed by a second dose six months later.

Which one is more cost-effective depends on the number of doses required. A full course of Bexsero costs approximately $341.50. Trumenba costs approximately $279.04 for the two-dose schedule, and approximately $418.56 for the three-dose schedule.

The most important thing to remember about the two vaccines is that brands cannot be switched between doses. Whichever vaccine is given for the first dose must be used for any following doses.

How much does Bexsero cost?

The CDC lists the cost of Bexsero for the private sector as $170.75 per dose, but this price can vary by pharmacy. The cost can also be reduced by using a SingleCare coupon at participating pharmacies. The Vaccines for Children (VFC) program will cover the cost of the MenB vaccine (as well as other vaccines) for those who are: 

• 16 through 18 years of age
• 10 through 18 years of age and identified as being at increased risk due to a medical condition
• 10 through 18 years of age and identified as being at increased risk due to serogroup B meningococcal disease outbreak

Meningococcal disease is scary, and adolescents and young adults have a higher chance of being infected. Following the proper vaccine protocol can help protect them.