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Why People With Myasthenia Gravis Should Check Their Meningococcal Vaccine Status

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By Editorial Team

Last Updated:

4 min read

Myasthenia gravis (MG) is a long-term autoimmune condition. It causes weakness in the muscles that you control. Treatment for MG often uses drugs that calm down the immune system. These drugs are very important for controlling the disease. But they also increase the risk of getting infections. This includes meningococcal disease, which is caused by a bacteria.1

Why checking vaccine status early is important

It is very important to check your meningococcal vaccine status early. The best time is when you are first diagnosed with MG. This allows time for vaccination before you start any immune-suppressing drugs. This early step protects you as soon as possible. It also prepares you for other treatments you might need later. Some of these treatments, called complement inhibitors, have a much higher risk of meningococcal disease.2

Which MG treatments increase risk?

People with MG who take certain drugs have a higher risk of meningococcal disease. The risk is very high for those using drugs called complement inhibitors. These include:1,2

  • Eculizumab (Soliris®)
  • Ravulizumab (Ultomiris®)

These drugs work by blocking a part of your body's immune system. This part of the immune system is needed to fight off the meningococcal bacteria. Even with vaccination, the risk is not completely gone. Doctors must watch for symptoms very carefully in people taking these drugs.1,2

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Other common MG drugs also increase risk. These include prednisone, azathioprine, or mycophenolate. These drugs create general weakness in the immune system. This makes it harder for your body to fight all kinds of germs, including the meningococcal bacteria.1

What are the symptoms of meningococcal disease?

Meningococcal disease is very serious. It can cause meningitis, which is swelling around the brain and spinal cord. It can also cause a blood infection. It can lead to severe long-term problems or death. At first, the symptoms may seem like the flu. Look for:3,4

  • Fever
  • Headache
  • Stiff neck
  • Nausea
  • Vomiting
  • Confusion
  • Rash

When should you get vaccinated?

The best time to check your vaccine status is as soon as you can. Ideally, this should happen right when you are diagnosed with MG. This allows you to get the vaccines before starting any drugs that weaken your immune system.1,2

The Advisory Committee on Immunization Practices (ACIP) strongly urges vaccination for people at high risk. This includes people taking complement inhibitors.2

Vaccination before complement inhibitors

If you are starting a complement inhibitor, you need 2 types of vaccines. These are the MenACWY vaccine (protects against groups A, C, W, and Y) and the MenB vaccine (protects against group B). Doctors recommend finishing all the vaccine shots at least 2 weeks before your first dose of the drug. This 2-week gap gives your body time to build up protection.1,2

Sometimes, treatment is too urgent to wait. If this happens, your doctor may give you antibiotics to help protect you. You should still get the vaccines as soon as it is safe to do so.

Thinking ahead: Vaccinating all MG patients early

It can take 6 months to finish the full vaccine series for both MenACWY and MenB. Because this takes time, doctors should think about vaccinating all MG patients early. Many people with MG may need a complement inhibitor later, even if they start on other drugs. If you are already vaccinated, you can start these powerful drugs right away. This "think ahead" plan helps avoid delays in getting the care you need.1,2

Why you must keep checking your vaccine status

MG treatment plans often change. This means checking your vaccine status is not a one-time event. You might switch from one drug to another. These drugs can affect your immune system differently.1,2

For example, you might start on a low dose of steroids. If your MG is not controlled, your doctor may need to increase the dose. Or your doctor may add a new drug. This change means your doctor must look at your vaccine needs again.1,2

Do not forget booster shots

Booster shots are also very important. People taking complement inhibitors need a MenACWY booster shot every 5 years. They also may need a MenB booster shot every 2 to 3 years. Your doctor should keep track of your vaccine records. This helps them plan for your boosters to keep you protected.1,2

Your health is a team effort

Your doctor should explain your risk. You and your caregivers must learn the symptoms of meningococcal disease. It is vital to get medical help right away if any symptoms appear. This is true even if you are fully vaccinated. The vaccine makes the risk much lower, but it does not remove the risk completely. Doctors must always be watching for signs of this disease in people with MG.1,2

Checking and managing your vaccine status is a key part of your overall MG care. The best plan includes:

  • Getting vaccinated early, right at diagnosis
  • Following the schedule for all vaccine shots and boosters
  • Watching closely for any symptoms

This plan helps lower the dangers for people with MG. Vaccinating early is the best way to be ready for future treatments without a

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Myasthenia-Gravis.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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