DTP & Meningitis ACWY

Combined Tetanus, Diphtheria and Polio

The teenage booster, also known as the 3-in-1 or the Td/IPV vaccine, is given as a single injection into the upper arm to boost your child’s protection against three separate diseases: tetanus, diphtheria and polio. It tops up the effect of the earlier baby and pre-school vaccinations against these diseases. The brand name of the 3-in-1 teenage booster given in the UK is REVAXIS.

Who is the 3-in-1 vaccine suitable for and how safe is it?
The tetanus, diphtheria and polio vaccine is suitable for practically all children, it is a very safe vaccine but, as with all vaccines, some children may have minor side effects, such as swelling, redness or tenderness at the site of the injection.
Sometimes, a small painless lump develops, but it usually disappears in a few weeks.

Who should not have the 3-in-1 booster?
There are very few teenagers who aren’t able to have this vaccine, but it should be avoided by anyone who has had an anaphylactic reaction (a serious allergic reaction) to a previous dose of the vaccine, or a reaction to any part of the vaccine that may be present in tiny amounts, such as neomycin, streptomycin or polymixin B.

It’s safe for teenagers with a minor illness, such as a cough or cold, to have the vaccination. However, anyone with a fever should delay their vaccination until they have recovered. This is to avoid wrongly associating any progression of the illness with the effects of the vaccine.

In total, you need five doses of the tetanus, diphtheria and polio vaccines through your life to build up and maintain your immunity.
The first three doses are received as a baby as the 5-in-1 vaccine, the fourth dose is given around the age of three as a pre-school booster known as the 4-in-1 vaccine, and the fifth and final dose is the teenage 3-in-1 booster given between the ages of 13 and 18.
If you think you may have missed any of your doses, talk to your doctor, practice nurse or school nurse.

More DTP Booster FAQs –

Find NHS information on the teenage booster here: https://www.nhs.uk/conditions/vaccinations/3-in-1-booster-questions-answers/

Meningitis ACWY

From September 2015, young people will be offered MenACWY vaccine in place of the current routine MenC vaccine given in school years 9 or 10.
In addition, there will be a one-off catch-up exercise to vaccinate school year 11 pupils from January 2016.

This schools programme is part of a wider MenACWY programme to vaccinate all young people aged 13-18 years of age (schools years 9-13), and to offer vaccination to older first time university entrants (‘freshers’).

This programme is being introduced to respond to a rapid and accelerating increase in cases of invasive meningococcal group W (MenW) disease. The vaccination of this age group will not just protect these young people but also help to protect children and adults across the population. It is based on advice from an independent expert committee, the Joint Committee on Vaccination and Immunisation, which advises the Government on vaccination.

The reason that the programme is mostly being offered in schools is because experience shows that this form of delivery is very effective at reaching the target population, ensuring good vaccine uptake. Year 13 students in the 2014/15 academic year will be offered vaccination through their GP practice starting in August. Arrangements to cover those pupils who will be in school years 12 and 13 in the 2015/16 academic year will be confirmed before the end of 2015.

The Men ACWY vaccine protects against four different causes of meningitis and septicaemia – meningococcal (Men) A, C, W and Y diseases.

Why do teenagers and students need Men W vaccination?

Cases of meningitis and septicaemia (blood poisoning) caused by Men W bacteria are rising, due to a particularly deadly strain.

Older teenagers and university students are at high risk of infection because they tend to live in close contact in shared accommodation, such as university halls of residence.

Men ACWY vaccine is given by a single injection into the upper arm. There are two Men ACWY vaccines that will be used in the vaccination programme, called Nimenrix and Menveo. They are very similar and both work equally well.

Men W disease

Cases of meningitis and septicaemia due to Men W have been increasing in England, from 22 cases in 2009 to 117 in 2014. The increase seems to be speeding up in 2015, caused by an aggressive strain of the bug.

With early diagnosis and antibiotic treatment, most people with meningococcal disease make a full recovery. But it’s fatal in about 1 in 10 cases and can lead to long-term health problems, such as amputation, deafness, epilepsy and learning difficulties.

Men W infections are particularly severe and usually need to be treated in intensive care. They have a higher death rate than the more common Men C and Men B strains.

The Men ACWY vaccine has previously been recommended only for people at increased risk of meningococcal disease, including people with no spleen or a spleen that doesn’t work properly, for Hajj pilgrims, and for travellers to countries with high rates of meningococcal disease, including parts of Africa and Latin America.

More about Men ACWY as a travel vaccine.

The Men ACWY vaccine

The Men ACWY vaccine provides good protection against serious infections caused by four different meningococcal groups (A, C, W and Y) including meningitis and septicaemia.

The vaccine only contains the sugar coating on the surface of the four groups of meningococcal bacteria and works by triggering the body’s immune system to develop antibodies against the sugar coating without causing disease.

Read more about vaccine ingredients.

Who should not have the Men ACWY vaccine?

You should not have the Men ACWY vaccine if you are allergic to the vaccine or any of its ingredients. You can find out the vaccine ingredients in the patient information leaflets for Nimenrix and Menveo.

You should also check with the doctor or nurse before having the Men ACWY vaccine if you:

  • have a bleeding problem, such as haemophilia, or bruise easily
  • have a high temperature
  • are pregnant or breastfeeding

How is meningitis W spread?

Meningococcal disease is caused by a bacterium called Neisseria meningitidis (also called the meningococcus). These bacteria can be divided into 13 different groups, of which five (A, B, C, W and Y) are responsible for nearly all serious meningococcal infections.

The meningococcal bacteria live in the back of the nose and throat in about 1 in 10 of the population without causing any illness. The bacteria is spread from person to person by close prolonged contact with a person carrying the bacteria, such as coughing, kissing and sneezing.

Very occasionally, the meningococcal bacteria can cause serious illness, including meningitis and septicaemia.

Meningococcal infections can strike at any age, but babies, young children and teenagers are especially vulnerable.

Read more about how meningitis bugs are spread.

Men W cases on the increase

In England, most meningococcal infections are caused by group B (Men B). Men C, Men W and Men Y are usually responsible for only 10-20% of cases.

Although the total number of meningococcal cases in England has been falling since the early 2000s, Men W infections have increased from only 22 cases in 2009 to 117 in 2014. Currently, Men W alone accounts for almost a quarter of all meningococcal infections in England.

From 2009 to 2012, an average of four people died of meningitis W each year. Most of the people who died were elderly. But during 2013 and 2014, there were 24 deaths from Men W disease including, for the first time in over a decade, babies and toddlers.

Read more about meningitis and septicaemia.

More Men ACWY FAQs –

Find NHS information on the Meningitis ACWY vaccine here: https://www.nhs.uk/conditions/vaccinations/men-acwy-vaccine/

Find information from UK charity Meningitis Now here:


Further information about MenW disease and the vaccine is available here:


Teenage immunisations for ages 14 to 18 (English and translations) – 


Protect yourself against Meningitis and Septicaemia information leaflet – https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/438674/PHE_9268_MenW_leaflet_2015_8pages_09_web_cr.pdf