Why delay meningococcal vaccination with Menactra (MenACWY-D) for infants with HIV or functional or anatomic asplenia until the pneumococcal conjugate vaccine (PCV) series is completed?

In addition to being at increased risk for meningococcal disease, children with HIV infection or functional or anatomic asplenia are at high risk for invasive disease caused by Streptococcus pneumoniae, which is more common than meningococcal disease. Data show that the Menactra may interfere with the immunologic response to PCV if these two vaccines are given too close together. So ACIP recommends that Menactra not be administered to children with these conditions before age 2 years to avoid interference with the response to PCV. If Menactra is used in people of any age with these conditions, do not administer it until at least 4 weeks after completion of the PCV series. Menveo (MenACWY-CRM) and MenQuadfi (MenACWY-TT) do not affect the immune response to PCV and can be given at any time before or after PCV, although MenQuadfi is not licensed for use in children younger than age 2 years.