Meningococcal A C Y and W-135 diphtheria conjugate vaccine

Dosage Forms & Strengths

IM solution

• 0.5mL/dose

Meningococcal Vaccination

Indicated active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135 in high risk adults

0.5 mL/dose IM

Immunization for High-Risk Conditions (ACIP Guidelines)

MenACWY is preferred for adults with any of the following indications who are aged ≤55 yr as well as for adults aged ≥56 years who a) were vaccinated previously with MenACWY and are recommended for revaccination, or b) for whom multiple doses are anticipated

Meningococcal polysaccharide vaccine (MPSV4 [Menomune]) is preferred for adults aged ≥56 years who have not received MenACWY previously and who require a single dose only (eg, travelers)

Asplenia or complement deficiencies

• Indicated in adults of all ages with functional asplenia or persistent complement component deficiencies
• Menactra or Menveo: Administer 2 doses at least 2 months apart to adults of all ages with functional asplenia or persistent complement component deficiencies
• Booster dose: Every 5 years

HIV Infection

• ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
• Menactra or Menveo
  • Not previously vaccinated: Give 2-dose primary series
  • Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life

Microbiologists

• Administer a single dose of meningococcal vaccine to microbiologists routinely exposed to isolates of Neisseria meningitidis
• Booster dose: Every 5 years

Military recruits

• Administer a single dose

First-year college students

• Administer a single dose for first-year college students (up through age 21 years) who are living in residence halls should be vaccinated if they have not received a dose on or after their 16th birthday

Community outbreak

• Administer a single dose for persons at risk during an outbreak attributable to a vaccine serogroup

Travel/reside in hyperendemic/epidemic countries

• Administer a single dose for adults who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
• International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously
• Vaccination in the 3 years before the date of travel is required by the government of Saudi Arabia for all travelers to Mecca during the annual Hajj

Dosage Forms & Strengths

IM solution

• 0.5mL/dose

Primary Immunization (Adolescent)

Routine primary vaccination of adolescents recommended at age 11 or 12 years unless high risk or outbreak requires earlier vaccination at younger age

11-12 years: 0.5 mL IM once; CDC recommends booster dose at age 16 yr

11-12 years (HIV infection): 2-dose primary series of 0.5 mL IM with at least 8 wk between doses (CDC guidelines)

Catch-up schedule (Adolescent)

• Administer vaccine at age 13 through 18 years if not previously vaccinated
• If first dose is administered at age 13 through 15 years, a booster dose should be given at age 16 through 18 years; minimum interval between doses is 8 weeks
• If first dose administered at age 16 or older, a booster dose is not needed

First-year college students

• First-year college students (up to age 21 yr) living in residence halls should receive at least 1 dose of MenACWY before college entry; the preferred timing of the most recent dose is on or after their 16th birthday
• If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment

Immunization for High-Risk Conditions (ACIP Guidelines)

Asplenia

• Indicated for children with anatomic or functional asplenia (including sickle cell disease)
• Menveo for children aged <19 months: 4-dose infant series given at 2, 4, 6, and 12 through 15 months
• For children aged 19 through 23 months who have not completed a series of MenHibrix or Menveo, administer 2 primary doses of Menveo at least 3 months apart
• For children aged ≥24 months who have not received a complete series of MenHibrix or Menveo or Menactra, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
• Booster dose: Every 5 years

HIV Infection

• ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
• Menactra or Menveo
  • Not previously vaccinated: Give 2-dose primary series
  • Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life

Complement Deficiency

• For children with persistent complement component deficiency
• For children younger than 19 months of age, administer a 4-dose infant series of Menveo at 2, 4, 6, and 12 through 15 months of age
• For children 7 through 23 months who have not initiated vaccination, 2 options exist depending on age and vaccine brand:
• -a. For children who initiate vaccination with Menveo at 7 months through 23 months of age, a 2-dose series should be administered with the 2nd dose after 12 months of age and at least 3 months after the first dos
• -b. For children who initiate vaccination with Menactra at 9 months through 23 months of age, a 2-dose series of Menactra should be administered at least 3 months apart
• For children ≥24 months who have not received a complete series of any meningococcal vaccine, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
• Booster dose: Every 5 years

Travel/reside in hyperendemic/epidemic countries

• For children who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
• Administer an age-appropriate formulation and series of Menactra (minimum age 9 months) or Menveo (minimum age 2 months) for protection against serogroups A and W meningococcal disease
• Note: Prior receipt of MenHibrix is not sufficient for children traveling to the meningitis belt or the Hajj because it does not contain serogroups A or W
• International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously
• Vaccination in the 3 years before the date of travel is required by the government of Saudi Arabia for all travelers to Mecca during the annual Hajj

Community outbreak

• For children at risk during a community outbreak attributable to a vaccine serogroup, administer or complete an age- and formulation-appropriate series of MenHibrix, Menactra, or Menveo

Dosing Considerations

Indicated for routine prophylaxis initiated during adolescence

CDC guidelines provide guidance for high risk infants/children (eg, sickle cell, asplenia, persistent complement deficiencies, traveling to endemic areas, outbreaks)

Schedule for initiating vaccine at a particular age (product specific)

• Menveo (age 2 months): FDA approved for 4-dose series given at 2, 4, 6, and 12 months of age
• Meveo (age 7-23 months): FDA approved for 2-dose series with 2nd dose being given in 2nd year of life at least 3 months after the first dose
• Menveo (age 2-10 years): Single dose; for children aged 2 yr through 5 yr at continued high risk of meningococcal disease, a 2nd dose may be administered 2 months after the 1st dose
• Menveo (adolescents and adults aged 11 through 55 years): FDA approved as a single dose
• Menactra: (age 9-23 months): FDA approved for 2-dose series given 3 months apart
• Menactra: (age 2-55 years): FDA approved as single dose with a booster dose (if at least 4 yr have elapsed) in high risk individuals aged 15 yr through 55 yr

Safety and efficacy of Menactra and Menveo not established in adults aged >55 yr (Menomune A/C/Y/W-135 recommended for 1 time doses in travelers)

>10%

Tenderness at injection site

Erythema

Swelling

Irritability

Abnormal crying

Drowsiness

Appetite loss

Induration

Vomiting

Fever

Malaise

Headache

Postmarketing Reports

Data available from persons aged 11-55 years

Ear: Impaired hearing, ear pain, vertigo, vestibular disorder

Eye: Eyelid ptosis

General: Injection site pruritus, pain, erythema, inflammation and swelling, fatigue, malaise, pyrexia

Immune system: Hypersensitivity/anaphylaxis

Infections and infestations: Vaccination site cellulitis

Investigation: Alanine aminotransferase increased, body temperature increased

Musculoskeletal and connective tissue: Arthralgia, bone pain, myalgia

Nervous system: Guillain-Barre syndrome, paresthesia, dizziness, syncope, tonic convulsion, headache, facial paresis, balance disorder

Respiratory: Oropharyngeal pain

Skin: Skin exfoliation