<P> The World Health Organization recommends that countries with a moderate or high rate of disease or with frequent outbreaks should routinely vaccinate . In countries with a low risk of disease, they recommend that high risk groups should be immunized . In the African meningitis belt efforts to immunize all people between the ages of one and thirty with the meningococcal A conjugate vaccine are ongoing . In Canada and the United States the vaccines effective against all four types of meningococcus are recommended routinely for teenagers and others who are at high risk . Saudi Arabia requires vaccination with the quadrivalent vaccine for international travelers to Mecca for Hajj . </P> <P> Safety is generally good . Some people develop pain and redness at the injection site . Use in pregnancy appears to be safe . Severe allergic reactions occur in less than one in a million doses . </P> <P> The first meningococcal vaccine became available in the 1970s . It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system . The wholesale cost in the developing world is between 3.23 and 10.77 USD per dose as of 2014 . In the United States it costs 100 to 200 USD for a course . </P> <P> Neisseria meningitidis has 13 clinically significant serogroups, classified according to the antigenic structure of their polysaccharide capsule . Six serogroups, A, B, C, Y, W - 135, and X, are responsible for virtually all cases of the disease in humans . </P>

When did the first meningitis vaccine come out