Hib/MenC vaccine

Vaccine

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The Hib/MenC vaccine used in the UK boosts protection against Hib disease and protects against meningococcal disease caused by group C bacteria. Both are serious diseases which can cause meningitis and septicaemia, especially in babies and young children. The diseases caused by these bacteria can lead to brain damage or death.

In 1991, the year before the vaccine was introduced, there were 759 reported cases of invasive Hib in children under five in England. In 2014, there were only 2 confirmed cases in this age group. Source: Public Health England and the Health Protection Agency Archive.  

The vaccine does not contain any live bacteria and cannot cause Hib disease or meningococcal disease.

The brand name of the Hib/MenC vaccine used in the UK is Menitorix (see the patient information leaflet).

The vaccine can safely be given at the same time as other vaccines in the UK routine schedule. It is a combination vaccine, which reduces the number of injections a child needs.

 

In the UK the Hib/MenC vaccine is given to babies at 12-13 months.

The vaccine is also recommended for people with some long-term health conditions who are at greater risk of complications from Hib disease and meningococcal disease. This includes people with:

  • asplenia or splenic dysfunction (a spleen that is missing or does not work properly)
  • sickle cell anaemia
  • coeliac disease
  • complement disorders (the complement system is an important part of the immune system)

 

The Hib/MenC vaccine used in the UK is called Menitorix. Apart from the active ingredients (the antigens), it contains very small amounts of these ingredients:

  • sodium chloride (salt)
  • sucrose (sugar), used as a stabiliser

The vaccine may also contain traces of these products used during the manufacturing process:

Other brands of Hib/MenC vaccines used in other countries may contain different ingredients. If you are not in the UK, ask for the patient information leaflet for the vaccine you are offered.

 

Very common, affecting more than 1 in 10 people at each dose:

  • redness, tenderness and/or swelling at the injection site
  • fever/raised temperature
  • irritability
  • loss of appetite
  • sleepiness

Common, affecting up to 1 in 10 people at each dose:

  • a reaction at the injection site, such as a hard lump

Uncommon, affecting up to 1 in 100 people at each dose:

  • crying
  • diarrhoea
  • being sick (vomiting)
  • skin allergies or rash
  • high temperature (above 39.5°C)

Rare, affecting up to 1 in 1000 people at each dose:

  • abdominal pain
  • being unable to sleep
  • generally feeling unwell

 

Many of these symptoms can be relieved by giving paracetamol/Calpol if your child is over 2 months, or ibuprofen if your child is over 3 months and weighs more than 5kg. The NHS website has more advice on giving painkillers to babies and children.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but can be treated with adrenaline. Healthcare workers who give vaccines know how to do this.

In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, although no deaths as a result of the reaction were reported.  Around 117 million doses of vaccines were given in the UK during this period. This means that the overall rate of anaphylaxis is around 1 in 900,000.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme.

You can also contact the MHRA to ask for data on Yellow Card reports for individual vaccines. See more information on the Yellow Card scheme and monitoring of vaccine safety.

 

Hib/MenC conjugate

The Hib/MenC vaccine is a conjugate vaccine (see our page on 'Types of vaccine'). This means that sugars (polysaccharides) are taken from the capsule around the Hib bacteria and joined to a non-toxic protein from tetanus.

The protein helps to stimulate the immune system in a broader way to respond well to the vaccine. This gives a better immune response in individuals of all ages.

How well does the vaccine work

The Hib/MenC vaccine was introduced in the UK in 2006, after studies showed that protection against Hib provided by the 5-in-1 vaccine (given at that time to babies at 8, 12 and 16 weeks) waned (decreased) during the second year of life.

In 1991, the year before a Hib vaccine was introduced, there were 759 confirmed cases of invasive Hib in children under five in England. In 2020, there were no cases in children under 5 years of age eligible for immunisation.

total cases of hib by year 1992 to 2020

Source: UK Health Security Agency

Following the introduction of the MenC vaccine in 1999, the number of cases of meningococcal disease caused by group C bacteria fell by over 90% in vaccinated groups. There was a very slight rise in cases since 2014-15. MenC cases then continued to fall, and remain low, with 27 cases in 2019-2020, five cases in 2020-2021, and one case reported in 2021 to 2022.

menc cases

Click here for an accessible text version of this graph

Sources: Public Health England , UK Health Security Agency and the Health Protection Agency Archive 

 

JCVI advice

The Joint Committee on Vaccination and Immunisation (JCVI) is an expert scientific advisory committee that advises the UK government on vaccination and immunisation.

The JCVI has been notified that Menitorix, the Hib/MenC currently used in the UK, will be discontinued by the manufacturer for commercial reasons.

As Menitorix is the only Hib/MenC combination product currently available in the UK, changes to the routine infant schedule are necessary. It is estimated that, based on current UK stocks of Menitorix, the current routine schedule can continue until 2025.

Once current stocks run out, the JCVI advises a change to the immunisation schedule to maintain protection of young children with alternative products:

  • an additional dose of Hib-containing multivalent (containing multiple strains) vaccine should be offered at 12 or 18 months of age – note that giving this at 18 months would require the creation of a new immunisation visit
  • the second dose of measles, mumps and rubella (MMR) vaccine should be brought forward from 3 years 4 months to 18 months of age to improve coverage. The JCVI has also recommended that the vaccine for chickenpox should be added to the schedule at 12 and 18 months of age using the combined MMRV (measles, mumps, rubella and varicella) vaccine.
  • based on the demonstrated decline of invasive meningococcal A, C, W and Y disease in the UK (primarily due to the success of the teenage MenACWY vaccination programme) and the subsequent low number of cases to prevent, the inclusion of a MenC-containing vaccine (such as MenACWY) in the infant schedule is not recommended. Efforts to sustain and improve coverage of MenACWY in adolescents are important to maintain herd immunity.

See the JCVI statement here 

See the JCVI chickenpox statement here
Page last updated Friday, November 24, 2023