Meningococcal Vaccination
Meningococcal disease is an infection caused by the gram-negative bacteria Neisseria meningitidis. There are 12 serogroups of N. meningitidis. Invasive meningococcal disease (e.g., meningitis, sepsis) is usually caused by serogroups A, B, C, W, X, and Y.1 The chart below reviews routine vaccination recommendations for available meningococcal vaccines in the U.S.
All meningococcal vaccine
doses are 0.5 mL and should be given intramuscularly (IM)
Meningococcal serogroup A, C, W,
Y |
|||
Vaccine Type/ |
DOSE FREQUENCY1 |
||
2 months to 10
years |
11 to 23 years |
24 years or
older |
|
MenACWY-CRM
(Menveo [~$135]; MenACWY-D MenACWY-TT* (MenQuadfi
[~$140]; *MenQuadfi contains Neisseria meningitidis antigens
that are individually conjugated to tetanus toxoid protein,
but note MenQuadfi is NOT a substitute for routine tetanus immunizations.1
|
Not routinely recommended. Only recommended for people at risk (see footnote a). Dosing schedule varies based on patient age, reason someone is considered at risk, and the product used. Booster doses are recommended for anyone still at risk (see footnote a). See the latest dosing and booster dose interval recommendations at: https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm.
|
Routine vaccination:e
A booster dose is recommended five years after the last dose if a person becomes at risk AFTER vaccination (see footnote a). Continue booster doses every five years for anyone still at risk. For
patients that become “at risk” prior to routine vaccination, see the latest
dosing and booster dose interval recommendations at: |
Not routinely recommended. Only recommended for people at risk (see footnote a). Number of doses varies based on patient age, reason someone is considered at risk, and the product used. Booster doses are recommended for anyone still at risk (see footnote a). See the latest dosing and booster dose interval recommendations at: https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm. Can be given to at-risk adults older than the
FDA-approved upper age limit.1,4,5
|
|
|||
Meningococcal serogroup B |
|||
Vaccine Type/ |
DOSE FREQUENCY |
||
2 months to 9 years |
10 to 23 years |
24 years or older |
|
MenB-4C OR MenB-FHbp |
Not recommended.1 |
Routine vaccination: previously unvaccinated people at risk (see footnote b):1
|
|
Shared decision makingd for people not at risk: two doses (between 16 and 23 years [ideally 16 to 18 years])
|
Not routinely recommended.1 Can be given to at-risk adults older than the FDA-approved upper age limit.4,5 |
||
|
- People at risk for meningococcal disease caused by serogroups A, C, W, or Y include: people with persistent complement component deficiencies; people receiving a complement inhibitor (e.g., eculizumab, ravulizumab); people with anatomic or functional asplenia (e.g., sickle cell disease); people with human immunodeficiency virus (HIV) infection microbiologists regularly exposed to Neisseria meningitidis isolates; people at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; people who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits.1
- People at risk for meningococcal disease caused by serogroup B include: people with persistent complement component deficiencies; people receiving a complement inhibitor (e.g., eculizumab, ravulizumab); people with anatomic or functional asplenia (e.g., sickle cell disease); microbiologists regularly exposed N. meningitidis isolates; and people at increased risk because of a meningococcal disease outbreak caused by serogroup B.1
- Pricing based on wholesale acquisition cost (WAC). Medication pricing by Elsevier (McKesson for Menactra), accessed November 2020.
- Find information on shared clinical decision making at https://www.cdc.gov/vaccines/acip/acip-scdm-faqs.html.
- Routine vaccination recommended for adolescents between 11 and 18 years. Catch up vaccinations can be done between 19 and 21 years.1
Prepared
by the Editors of Therapeutic Research Center (361208).
References
- CDC. Morbidity and Mortality Weekly Report: Meningococcal vaccination: recommendations of the Advisory Committee on Immunization Practices, United States, 2020. September 25, 2020. https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm. (Accessed November 3, 2020).
- CDC. Immunization schedules. Table 2: Recommended adult immunization schedule by medication condition and other indications, United States, 2020. February 3, 2020. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html. (Accessed November 2, 2020).
- CDC. Immunization schedules. Table 1: Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2020. February 3, 2020. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. (Accessed November 2, 2020).
- Immunization Action Coalition. Ask the experts: meningococcal ACWY. Updated October 22, 2020. https://www.immunize.org/askexperts/experts_meningococcal_acwy.asp. (Accessed November 3, 2020).
- Immunization Action Coalition. Ask the experts: meningococcal B. Updated October 22, 2020. https://www.immunize.org/askexperts/experts_meningococcal_b.asp. (Accessed November 3, 2020).
- Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation, 11th edition. Wolters Kluwer Health, 2017. [VitalSource Bookshelf].
- National Institutes of Health. United States National Library of Medicine. TOXNET Toxicology Data Network. Drugs and Lactation Database (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501922/?report=classic. (Accessed November 3, 2020).
Cite
this document as follows: Clinical Resource,
Meningococcal Vaccination. Pharmacist’s
Letter/Prescriber’s Letter. December
2020.