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Meningococcal ACYW Vaccine

Men-C-ACYW — the Grade 7 vaccine protecting against four strains (A, C, Y, W-135)

Quick Summary

Meningococcal ACYW Vaccine

Protects against four strains of meningococcal bacteria (A, C, Y, and W-135).

Required for school Publicly funded
Disease Protected Against
Meningococcal disease caused by four strains (A, C, Y, W-135) — serious infections including meningitis and bloodstream infection.
Ontario Routine Timing
One dose in Grade 7, offered free through the school-based immunization program.
Number of Doses
One dose meets the school requirement (some at higher risk may need more)
Publicly Funded Status
Yes — free for Grade 7 students (and as catch-up through Grade 12)
Bottom line: The Grade 7 meningococcal ACYW vaccine broadens protection to four strains of the bacteria — the type C vaccine your child got at 12 months covered only one. Meningococcal disease is required for school attendance under Ontario law, and one dose of Men-C-ACYW after age one meets that requirement (unless a valid exemption applies). It's offered free at school alongside HPV and hepatitis B.
The Disease

What it protects against

Meningococcal disease is a serious infection caused by Neisseria meningitidis bacteria. This vaccine protects against four strains: A, C, Y, and W-135.

Form of disease What parents might notice How it spreads Why it can be serious How vaccination helps
Meningitis Fever, irritability, poor feeding, drowsiness, a stiff neck, or sensitivity to light. In babies, signs can be hard to spot and may come on quickly. Through close contact with respiratory or throat secretions — coughing, sneezing, sharing drinks or utensils, or kissing. Infection of the lining of the brain and spinal cord can become life-threatening very quickly and may cause lasting effects such as hearing loss or brain injury. The vaccine helps the immune system recognize the type C bacteria's coating and respond quickly.
Bloodstream infection (septicemia) Fever, a very unwell-seeming child, and sometimes a distinctive rash that doesn't fade when pressed. Same close-contact spread as above. Meningococcal septicemia can progress rapidly and be life-threatening. It's one of the reasons this infection is treated as a medical emergency. Vaccination reduces the chance of this serious invasive infection from the type C strain.
Meningococcal disease is uncommon, but when it occurs it can be extremely serious and progress quickly. This vaccine broadens protection from the single strain (C) covered at 12 months to four strains (A, C, Y, W-135). Adolescents and young adults are a group where meningococcal disease can spread more readily — partly due to closer social contact — which is one reason a broader vaccine is given at this age. Note that none of these vaccines cover the separate "B" strain, which has its own vaccine.
Timing & Schedule

Why it's given at this age

Why Grade 7? Protection from the type C vaccine given at 12 months wanes over time, and adolescents are a group in which meningococcal disease can spread more readily. Offering the broader four-strain vaccine in Grade 7 refreshes and widens protection heading into the teen years. It's offered conveniently through school-based clinics.

Why one dose? For most healthy adolescents, a single dose provides protection, and one dose of Men-C-ACYW after age one meets the school requirement. Young people at higher risk of meningococcal disease (due to certain medical conditions or travel) may need additional doses — a healthcare provider can advise.

What if it's missed at school? The vaccine remains free through your local public health unit, and catch-up is publicly funded through Grade 12. See the Catch-Up & Missing Records page.

Can it be given with other vaccines? Yes. In Grade 7 it's offered alongside the hepatitis B and HPV vaccines through the school program, given at different injection sites.

My child already had a meningococcal vaccine — do they need this one? Yes. The type C vaccine given at 12 months covered only the C strain. This Grade 7 vaccine adds protection against three more strains (A, Y, W-135) your child hasn't been protected against. Under the school requirement, one dose of Men-C-ACYW after age one is what's needed.
Ontario School & Reporting Status

School and reporting status

Meningococcal disease is required for school attendance under Ontario law. Under the Immunization of School Pupils Act (ISPA), Ontario requires immunization against meningococcal disease for school attendance, unless a valid exemption is on file. Specifically, one dose of Men-C-ACYW given after the first birthday meets this requirement.

This is an important distinction at the Grade 7 clinic: of the three vaccines offered there, meningococcal ACYW is the one that's required for school, while hepatitis B and HPV are offered and recommended but not required for attendance. See the School Requirements hub for more on this distinction.

Reporting: When given through a school-based clinic run by public health, this vaccine is usually recorded directly by the public health unit. If your child receives it elsewhere, you may need to report it yourself.

Exemptions: If your child cannot receive this vaccine for medical reasons, or you are seeking a non-medical exemption, see the School Requirements hub for the process.

Ingredient Transparency

What's in this vaccine

Several Men-C-ACYW products are authorized in Canada, including Menactra® (Sanofi), Nimenrix® (Pfizer), and Menveo® (GSK). They differ mainly in their carrier protein. The information below covers the category, based on their Health Canada product monographs. None is a live vaccine.

Ingredient / Component Category Why it's there Plain-English explanation
Meningococcal polysaccharides (groups A, C, Y, W-135), linked to a carrier protein Active ingredients Train the immune system to recognize the four strains of meningococcal bacteria. The sugar coatings of the four strains are linked ("conjugated") to a harmless carrier protein so the immune system responds strongly. Depending on the product, the carrier is a diphtheria-related protein (CRM197 or diphtheria toxoid) or tetanus toxoid. None contains live bacteria.
Sodium chloride Tonicity agent Helps match the vaccine's salt concentration to the body's. Ordinary salt, so the injection is gentler on the tissues.
Buffer salts (e.g. sodium phosphate) Buffer Help keep the vaccine at a stable acidity (pH). Small amounts of salts that keep the product stable.
Sucrose or trometamol (in some products) Stabilizer Help keep the vaccine stable, especially if freeze-dried. Stabilizers used in some formulations.
Water for injection Base The liquid base of the vaccine. Sterile water making up most of the injection.
About carrier proteins and allergies: Because the carrier proteins are related to diphtheria or tetanus, mention any history of a serious allergic reaction to a diphtheria- or tetanus-containing vaccine to your provider. These vaccines don't replace routine diphtheria/tetanus immunization. For the precise contents of the specific product used, ask your provider or consult the product monograph.
Side Effects & Safety

Side effects and safety

Expected / common side effects

  • Soreness, redness, or swelling where the needle was given
  • Headache
  • Mild fever
  • Tiredness or feeling generally unwell for a short time
  • Muscle aches

Timing and duration: These reactions usually begin within a day of the vaccine and typically settle within 1–2 days.

Fainting: Fainting can happen after any vaccine in adolescents, related more to the experience of being vaccinated than the vaccine itself. The person giving the vaccine may ask your child to sit and stay nearby for about 15 minutes afterward. Let the clinic know if your child has fainted with needles before.

Home care: A cool compress can ease injection-site soreness. Acetaminophen or ibuprofen may be used for discomfort or fever. People under 19 should not be given ASA (Aspirin) or salicylate-containing products.

Many young people have no side effects at all, and that does not mean the vaccine didn't work.

Rare but important

  • Severe allergic reaction (anaphylaxis) — reported rarely after vaccination in general; exact frequency varies by source.
  • High fever or persistent crying lasting several hours — uncommon, but worth a call to a healthcare provider.

What clinics do to reduce risk: Clinics ask about allergy history before vaccination and are equipped with epinephrine and trained staff in case of a severe allergic reaction.

Observation period: Many clinics recommend staying nearby for about 15 minutes after vaccination, as severe allergic reactions — though rare — typically occur shortly after the injection.

Get urgent help now if your child has:

  • Trouble breathing
  • Swelling of the lips, tongue, throat, or face
  • Widespread hives together with breathing difficulty
  • Severe weakness, limpness, or unresponsiveness
  • A seizure
  • Fainting that doesn't resolve quickly, or a fall causing injury during a faint
  • A high fever, or a fever that persists
  • Any symptom that feels serious or is rapidly getting worse

If any of these occur, go to the nearest emergency department or call 911. Otherwise, contact a healthcare provider and let them know what happened — this information also helps with vaccine safety monitoring.

Before the Appointment

Who should pause or speak with a healthcare provider first

Speak with a healthcare provider before this vaccine if:

  • Your child has had a serious allergic reaction to a previous dose of meningococcal vaccine, or to any component
  • Your child has had a serious allergic reaction to a diphtheria- or tetanus-containing vaccine (the carrier proteins are related)
  • Your child has a moderate or severe acute illness (it's generally fine to wait until they feel better)
  • Your child has fainted with needles or vaccines before — not a reason to avoid it, but worth telling the clinic so they can take extra care

These usually do NOT require delaying this vaccine:

  • A mild cold or other minor illness without fever
  • Currently breastfeeding
  • A stable, ongoing chronic health condition
  • Currently taking antibiotics for an unrelated condition
Common Questions

Questions parents often ask

No — it's broader. The vaccine at 12 months (Men-C-C) covered only the type C strain. This Grade 7 vaccine covers four strains (A, C, Y, W-135), adding protection your child didn't have before. Under the school requirement, one dose of Men-C-ACYW after age one is what's needed.
No. Meningitis can be caused by several different bacteria and viruses. This vaccine protects against four meningococcal strains (A, C, Y, W-135). The separate meningococcal "B" strain has its own vaccine, which isn't part of the routine Grade 7 program for all students (it may be recommended for those at higher risk). Other vaccines on the schedule protect against other causes of meningitis, like Hib and pneumococcal.
Being behind does not mean starting the series over. The remaining doses can generally be given following minimum spacing guidelines. Visit the Catch-Up & Missing Records page, or speak with a healthcare provider to confirm the right plan for your child.
Generally, no. A mild cold without fever is usually not a reason to delay. If your child has a fever or seems more unwell, it's reasonable to mention this to the clinic — they can advise whether to proceed or reschedule.
A mild fever after a previous dose is common and is not usually a reason to avoid future doses. Let the clinic know about the previous reaction — they can advise on any precautions, such as giving acetaminophen proactively, and will watch for any pattern.
This is common and manageable. Gather whatever records you have, and contact your local public health unit or healthcare provider — they can often help locate or reconstruct records, or advise on next steps if records truly cannot be found. See the Catch-Up & Missing Records page.
This vaccine is typically given by a family doctor or nurse practitioner as part of routine infant well-child visits. Some public health units also offer immunization clinics. See the Resources page for links to find services in your area.
Parents and caregivers are generally responsible for reporting vaccines to their local public health unit — healthcare providers do not always do this automatically. Many areas use Immunization Connect Ontario (ICON) for this. See the Resources page for links.
Mild soreness, redness, tiredness, or a low fever for a day or two are common and expected. Review the "Get urgent help now" list above — if any of those signs occur, seek urgent care. Otherwise, contact a healthcare provider with any concerns.
What the Evidence Shows

What we know about meningococcal vaccination

Fact Meningococcal disease is uncommon, but it can be devastating and progress within hours — which is why prevention is prioritized even though most people will never encounter it.
Concern Some parents wonder why a vaccine is needed for a disease that is rare.
Evidence Even though cases are uncommon, meningococcal disease can be fatal or cause permanent harm such as brain injury, hearing loss, or limb loss, sometimes in previously healthy children. Because it moves so quickly, prevention through vaccination is far more reliable than counting on early treatment. Routine type C vaccination has been associated with reductions in type C disease.
Takeaway Vaccinating against a rare but rapidly dangerous disease is a case where prevention is especially valuable, because the disease can outpace treatment.
Ontario Next Steps

What to do next

Where to get it

Offered free through Grade 7 school clinics run by your local public health unit. Also available free through the public health unit (catch-up through Grade 12).

What to bring

Your child's immunization record (the "yellow card"), health card if available, and a list of any allergies or previous reactions.

If you're behind

Catching up does not mean restarting. Visit the Catch-Up & Missing Records page or ask your provider for a review.

If records are missing

Contact your local public health unit — they may have records on file, or can advise on next steps.

If vaccinated outside Ontario

Bring any available records to a healthcare provider for review — products and schedules elsewhere may differ slightly from Ontario's.

Contact public health

For record reporting, school requirements, or general questions, see the Resources page for your local public health unit's contact details.

Sources

Where this information comes from

This page is based on:

Last reviewed: June 2026  ·  Next review due: December 2026
Schedules, products, and eligibility can change. Always confirm current details with your healthcare provider, your local public health unit, or official Ontario sources.

Please note: This is an independent website. It is not affiliated with, endorsed by, or operated by the Government of Ontario, the Ministry of Health, or any public health unit. The information here is for general education only and is not medical advice — always consult a licensed healthcare provider about your or your child's immunizations.