Third Meningococcal Vaccine Recommended for Children at Risk

Lara C. Pullen, PhD

June 24, 2014

The quadrivalent meningococcal conjugate vaccine MenACWY-CRM (Menveo, Novartis) has joined 2 other meningococcal vaccines recommended for use in children. The Advisory Committee on Immunization Practices recommends that only children who are at increased risk for meningococcal disease receive a meningococcal vaccine. Routine vaccination is not recommended for children aged 2 months through 10 years.

Jessica R. MacNeil, MPH, from the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention in Atlanta, Georgia, and colleagues published their report from the Advisory Committee on Immunization Practices recommendations in the June 20 issue of the Morbidity and Mortality Weekly Report. The report summarizes information on MenACWY-CRM and reports the recommendation that the vaccine be given to children aged 2 to 23 months who are at increased risk for meningococcal disease.

MenACWY-CRM includes the capsular polysaccharides from Neisseria meningitides serogroups A, C, W, and Y conjugated to the diphtheria toxin mutant CRM197. Four trials have demonstrated its immunogenicity in infants aged 2 to 23 months.

Three trials included concomitant administration of MenACWY-CRM with the routine childhood vaccination schedule. The investigators note no reduction to pneumococcal serotype 6B or 23F and no interference with the pertussis antigens. The report notes, in particular, that MenACWY-CRM does not interfere with the 13-valent pneumococcal vaccine and therefore can be administered along with it.

Concomitant administration of MedACWY-CRM did not affect serogroup responses with other routine childhood vaccines. Six months of postvaccination surveillance of 5000 participants revealed similar adverse effects as those seen with routine vaccinations.

The vaccine is recommended for infants at increased risk for meningococcal disease, described as:

  • those with persistent complement component deficiencies,

  • those with functional or anatomic asplenia,

  • healthy infants in communities with meningococcal disease outbreaks, and

  • those traveling to or residing in areas where meningococcal disease is hyperendemic or epidemic.

Infants at increased risk may receive MenACWY-CRM, which protects against serogroups A, C, W, and Y. Children at prolonged increased for meningococcal disease should receive booster doses after the primary series.

Additional meningococcal vaccines include MenACWY-D (Menactra, Sanofi Pasteur), which is recommended for use in children aged 9 to 23 months who are at increased risk for meningococcal disease, and Hib-MenCY-TT (MenHibrix, GlaxoSmithKlein), which is recommended for children aged 6 weeks through 18 months who are at increased risk. The same vaccine product should be used for all doses given to a child at increased risk.

The authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2014;63:527-530. Full text


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