28/02/2026
🧠 Meningococcal Disease: Understanding the Real Risk
There has been a lot of discussion recently about meningococcal disease and the timing of vaccination. Let’s look at the facts calmly and objectively.
📊 How common is it?
The overall incidence of invasive meningococcal disease (IMD) in South Africa is low — less than 1.6 per 100 000 population.
However, risk is not equal across age groups.
👶 Who is most at risk?
Data from South Africa shows:
• Infants under 1 year of age have the highest incidence
• A second peak occurs in adolescents and young adults (16–23 years)
• Approximately 52% of infant cases are caused by serogroup B
This means that although adolescents are at risk, infants carry the greatest vulnerability.
⚠️ Why is meningococcal disease taken so seriously?
Even though it is rare, it can be:
• Rapidly progressive (can become critical within 24–48 hours)
• Fatal in approximately 17% of cases despite best medical care
• Associated with lifelong complications in around 20% of survivors
(hearing loss, limb loss, neurological damage, cognitive impairment)
This is why it receives so much attention in paediatrics.
💉 What about vaccination timing?
There has been discussion about delaying MenB vaccination until after 2 years of age to reduce the number of doses required.
The important consideration is this:
The highest risk period is under 1 year of age.
Delaying vaccination reduces doses — but it also leaves infants unprotected during their most vulnerable period.
This is an individual risk-benefit discussion that parents should have with their healthcare provider.
🧾 Is this an outbreak?
No.
Recent reported cases in South Africa are not classified as an outbreak.
However, they serve as a reminder for parents to:
• Review vaccination status
• Understand who is at highest risk
• Make informed decisions based on accurate data
🤍 My aim is not to create fear, nor to minimise risk, but to present balanced, evidence-based information so parents can make informed decisions.
Every recommendation I make is based on age-specific risk and the best interests of my patients.
Dr Willem Smit
Paediatrician