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Technically Speaking
April 2013
Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
Recommendations for Use of Meningococcal Vaccines in High-Risk Infants and Children
Published April 2013
The recommendations and available products for meningococcal vaccination of high-risk infants and children have evolved since 2007 when ACIP first recommended vaccination of children age 2 to 10 years who are at increased risk for meningococcal disease. Published on March 22, 2013, the current recommendations summarize and compile all previous meningococcal recommendations. The current recommendations are complex; for example, in the recommendations for vaccinating people in certain risk groups, the number of recommended vaccine doses and products varies, and includes some off-label use. This column offers an overview of the meningococcal recommendations for vaccinating high-risk infants and children, and provides links to some valuable resources that will help healthcare professionals make appropriate vaccination decisions.
It is important to understand the differences between vaccines available for meningococcal immunization. The nomenclature for meningococcal vaccines is based on both the number of serotypes included in the vaccine and whether the vaccine is conjugate or polysaccharide. Menomune® (Sanofi Pasteur), the only polysaccharide meningococcal vaccine, is known as MPSV4, with the 4 denoting the number of serotypes in the vaccine. Two different licensed quadrivalent meningococcal conjugate vaccines — Menactra® (MCV4-D, Sanofi Pasteur) and Menveo® (MCV4-CRM, Novartis) — are known as MCV4. All three vaccines (the polysaccharide and both conjugates) include the same 4 serotypes (A, C, W and Y). Licensed in June 2012, MenHibrix® (Hib-MenCY; GSK) is indicated to prevent invasive disease caused by Neisseria meningitidis serogroups C and Y and Haemophilus influenzae type b (Hib). MenHibrix® protects only against meningococcal serogroups C and Y; it does not protect against serogroups A and W. In general, ACIP recommends routine meningococcal vaccination of children age 2 months and older who are at increased risk for meningococcal disease, including:
Children age 2 months and older with certain medical conditions, such as anatomical or functional asplenia or complement component deficiency; and
Children age 9 months and older who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, particularly if contact with the local population will be prolonged.
The recommended product, dosing schedule and interval for booster dose(s) vary based on many factors. For example, a 12-month-old infant traveling to Saudi Arabia should get two doses of MCV4-D, three months apart, but an infant with asplenia should get Hib-MenCY at ages 2, 4, 6, and 12–15 months. Due to these complexities, providers who use these vaccines should consider printing the following resources for reference when needed. These resources also include information about routine meningococcal vaccination of adolescents and recommendations for vaccinating high-risk adults.
Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP).” MMWR 2013; 62[No. RR-2]
Meningococcal Vaccination Recommendations by Age and/or Risk Factor” (a summary table)
2013 ISSUES >> view all
Handouts for Parents, Teens, and Adults Help Providers Explain the Value of Vaccines
At Your Fingertips: Official Vaccine Recommendations and Product Information
Ask the Experts: Providing Answers to Your Timely and Challenging Influenza Vaccination Questions
Vaccinations and Pregnancy
Temperature Monitoring – The "Vital Sign" for Vaccine Storage
JULY 2013
The End of Hepatitis B Transmission Begins At Birth
APRIL 2013
Recommendations for Use of Meningococcal Vaccines in High-Risk Infants and Children
MARCH 2013
What to Do if the Wrong Dose of a Vaccine Is Administered
CDC's 2013 Immunization Schedules and IAC's Easy-To-Use Summaries
Expanded Tdap Recommendations: Administer Tdap to Pregnant Women during Each Pregnancy
This page was reviewed on May 8, 2013
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.