Meningococcal group A Diphtheria Conjugate Vaccine
Indications
Meningococcal group A Diphtheria Conjugate Vaccine is used for:
Meningococcal infection
Adult 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 as a single dose.
Immunization for High-Risk Conditions (ACIP Guidelines)
Asplenia or complement deficiencies
Indicated in adults of all ages with functional asplenia or persistent complement component deficiencies
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
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
Child 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
Immunization for High-Risk Conditions (ACIP Guidelines)
Asplenia
Indicated for children with anatomic or functional asplenia (including sickle cell disease)
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, administer 2 primary doses at least 3 months apart
For children aged >24 months who have not received a complete series, administer 2 primary doses 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 (minimum age 2 months) for protection against serogroups A and W meningococcal disease
Dosing Considerations
Indicated for routine prophylaxis initiated during adolescence
Schedule for initiating vaccine at a particular age
(age 2 months): FDA approved for 4-dose series given at 2, 4, 6, and 12 months of age
(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
(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
(adolescents and adults aged 11 through 55 years): FDA approved as a single dose
Renal Dose
Administration
Administer IM only; do not administer IV, SC, or ID
Give IM injection, preferably into the anterolateral aspect of the thigh in infants or into the deltoid muscle in toddlers, adolescents, and adults
Contra Indications
Severe allergic reaction (e.g., anaphylaxis) after a previous dose , any component of this vaccine, or any other CRM197, diphtheria toxoid or meningococcal-containing vaccine is a contraindication to administration
Precautions
Guillain-Barre syndrome. Preventing & managing allergic vaccine reactions. Thrombocytopenia or bleeding disorders. Immunocompromised person. Pregnancy & lactation.
Pregnancy-Lactation
Pregnancy category: C
Lactation: Unknown whether distributed in breast milk; use caution
Interactions
Live vaccines. Reduced immunological response w/ immunosuppresants.
Adverse Effects
Side effects of Meningococcal group A Diphtheria Conjugate Vaccine :
Common solicited adverse reactions (> 10%) among children initiating vaccination at 2 months of age and receiving the four-dose series were tenderness (24-41%) and erythema at injection site (11-15%), irritability (42-57%), sleepiness (29-50%), persistent crying (21-41%), change in eating habits (17-23%), vomiting (5-11%) and diarrhea (8-16%).
Common solicited adverse reactions (>10%) among children initiating vaccination at 7 months through 23 months of age and receiving the two-dose series were tenderness (10-16%) and erythema at injection site (12-15%), irritability (27-40%), sleepiness (17-29%), persistent crying (12-21%), change in eating habits (12-20%) and diarrhea (10-16%).
Common solicited adverse reactions (> 10%) among children 2 years through 10 years of age who received injection site pain (31%), erythema (23%), irritability (18%), induration (16%), sleepiness (14%), malaise (12%), and headache (11%).
Common solicited adverse reactions (> 10%) among adolescents and adults who received were pain at the injection site (41%), headache (30%), myalgia (18%), malaise (16%) and nausea (10%).
Mechanism of Action
Presence of bacteriocidal anti-capsular meningococcal antibodies associated with protection from invasive meningococcal disease.
Meningococcal serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein carrier.
Induces production of bactericidal antibodies directed against the capsular polysaccharides of serogroups A, C, Y and W-135.