‍Training webinar:

IMAC and NIP presented a webinar on the MenB roll out on 22 Feb 2023, click here to view the recording.

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‍Approval for use

Bexsero is approved for use from eight weeks and over.

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Funded for use

Bexsero is funded for 2 doses and a booster for:

• children up to 12 months of age

• catch up for 13 months to 59 months available until 31 August 2025
• note: booster doses are only recommended for those given their first dose before the age of 24 months and younger than 59 months.

Bexsero is funded for 2 doses for people aged between 13 years and 25 years (inclusive) who are:

• entering within the next three months, or in their first year of living in boarding school hostels, tertiary education halls of residence, military barracks or prisons; or

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Use for high risk patients remains unchanged.

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Notes on funded use

Child over 12 months

• The eligibility criteria allow for three doses for children up to 12 months of age. Children who receive their first two doses while under 12 months of age are still eligible for the third dose, even if their 12 month immunisation visit was delayed and they were older than 12 months when completing the vaccination course.

Child started course through private purchase

• Children who have started their course of MenB through private purchase can continue on with funded MenB from where they are up to if they meet the eligibility for catch-up.

Child turns 5 years

• If the first funded dose is given at age 4 years, then the second dose will be funded even if the child turns 5 years. It is recommended that this second dose is given 8 weeks after the first dose.

Pharmac schedule listing provides more detail.

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National Immunisation Schedule - primary course and booster

Routine childhood schedule: 3 months, 5 months and a booster at 12 months.

Approved alternative schedule (no prescription required): 8 weeks, 4 months and a booster at 12 months. 

On time immunisation is essential for best protection. Do not delay the 6 week event, keep other vaccinations on the normal schedule.

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Vaccine spacing

• Infants aged 2 months to 11 months (at age of first dose) give two doses 8 weeks apart and booster at least 6 months after primary course or at 12 months of age, whichever is later.

• Toddlers aged 12 -23 months (at time of first dose), give 2 doses 8 weeks apart and a booster dose 12-23 months after the second primary dose.

• Children aged from 2 years (at time of first dose), give 2 doses 8 weeks apart.

• Aged 13 years and over, give 2 doses 8 weeks apart.

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Paracetamol for children under 2 years

Prophylactic paracetamol is recommended for children under 2 years because of the risk of high fever, which is more likely when Bexsero is administered at the same time/visit as other vaccines.

Three doses of paracetamol (15mg/kg, using 120mg/5ml solution) are recommended with 4-6 hours between each paracetamol dose, whether the child has a fever or not. Maximum of 4 doses in 24 hours.

The first paracetamol dose can be given 30 minutes before vaccination, but if it has not been given beforehand, just administer the dose at the time of vaccination. Do not delay vaccination.

The second paracetamol dose is given 4-6 hours after the first dose.

The third dose is given a further 4-6 hours later.

• If the infant or child is sleeping when the second or third paracetamol dose is due, it is not necessary to wake the child, the dose can be given when the child wakes up as long as it is at least 4-6 hours since the previous paracetamol dose was given.

In some circumstances (eg infants enrolled in the PIPPA study) iburofen may be given as an alternative to paracetamol.

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Notes:

• Prophylactic paracetamol does not affect other vaccines, they are still effective when given at the same time as Bexsero. The immunogenicity data when MenB plus routine vaccines and paracetamol did not show any lessening of efficacy from giving paracetamol at the same time.

• There is no increase in febrile seizures following Bexsero but fever and discomfort are more common so we recommend paracetamol for the comfort of the infant and to reduce presentation to healthcare following these symptoms.

• Children over 2 years old can have paracetamol for post-vaccine responses including fever. It is not required prophylactically.

• Services without a prescriber - Districts will need to establish their own guidelines. Standing orders are one way to make the work for the first dose. We provide a standing order template for your to edit for your local use, to assist with this.

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‍Bexsero should not be given to:

• Anyone with severe allergy (anaphylaxis) to a previous dose of the vaccine or any component of the vaccine.

• Administration of Bexsero should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation.

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Specialist advice should be sought for:

• Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions.

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‍IMAC resources on, or including MenB Bexsero information:

• Immunisation Handbook for detailed guidance on MenB Bexero information here

• Bexsero: A vaccine to protect against meningococcal group B disease here

• Paracetamol use with Bexsero in children aged under 2 years, more detail here

• Quick answers to frequent questions on meningococcal disease

• Purchase of non-funded meningococal vaccines

• Occupation related immunisation here

• Funded vaccines for special groups here

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MedSafe datasheets

You can search for the latest datasheet on the MedSafe website here.

The datasheets change over time so searching on the MedSafe site is the safest way to get the latest information. You can do that here.

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Information for the public

Leaflets, posters and social media tiles for public audiences are provided by Te Whatu Ora. You can access these in the immunisation dropbox.

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Operational advice

• Bexsero is administered as both a scheduled vaccine and a catch-up programme vaccine.
• When Bexsero is administered alongside other scheduled vaccines, at the same visit, a single administration fee can be claimed.
• When Bexsero is administered to the eligible catch-up cohort, on its own with no other schedule vaccines, a single administration fee can be claimed. If other scheduled vaccines are given opportunistically at the same visit, it is still a single administration fee that can be claimed.
• We will be adding a template for standing orders soon that may be needed for providing prophylactic paracetamol.
• Don't forget to check the expiry dates on Bexsero if it's been in the fridge a while.
• Order vaccines through Propharma using the funded vaccine portal.
• Providers are eligible for two deliveries per month which will be useful for managing fridge space - noting Bexsero vaccine will arrive in single-dose packages until later in 2023 and influenza orders are just around the corner.
• There is no compensation for private market stock but it can continue to be used for private purchase.
• Bexsero vaccine can be entered into the PMS and claimed from 1 March. This will be slightly different for each PMS type and will be communicated to PMS users by PMS vendors.‍

• Opportunistic catch-up Bexsero vaccine administered to the eligible groups anytime from 1 March will be funded.‍
• The Immunisation Handbook has been updated and published with MenB information.

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