People with persistent complement component deficiency due to an immune system disorder or use of a complement inhibitor are at increased risk for meningococcal disease even if fully vaccinated. Because patients treated with complement inhibitors can develop invasive meningococcal disease despite vaccination, clinicians using Soliris or Ultomiris also may consider antimicrobial prophylaxis for the duration of complement inhibitor therapy.
We have a year-old getting renal dialysis. The nephrologist will be starting her on ravulizumab Ultomiris , which interferes with C5 complement. A 10 year-old with persistent complement component deficiency also should receive a 2- or 3-dose series depending on brand of meningococcal B vaccine.
As long as the child remains at high risk of meningococcal disease due to complement inhibitor use, booster doses of both MenACWY and MenB are recommended. Are people who are HIV-positive at increased risk for meningococcal disease?
People age 2 years and older with HIV infection who have not been previously vaccinated should receive a 2-dose primary series of MenACWY doses separated by at least 8 weeks. People with HIV infection who have previously received one dose of MenACWY should receive a second dose at the earliest opportunity at least 8 weeks after the previous dose and then receive booster doses at the appropriate intervals see Booster Doses below.
Should he receive one or two doses now? Will he need booster doses later? This dose represents a delayed second dose in the primary series a 2-dose primary series recommended for people with HIV infection. The patient will subsequently need booster doses every 5 years. However, this child received DTaP vaccine yesterday at another clinic. This is because data suggest a reduced response to the Menactra if given within a month after DTaP. Menactra may be used earlier than 6 months after DTaP if it is the only available option and vaccination is necessary due to travel to an area with epidemic or hyperendemic meningococcal disease.
Do I need to repeat the dose of Menactra? A child with a complement component deficiency should still receive a second dose of MenACWY vaccine at least 8 weeks after the first dose. In this case, if the 2nd dose also will be Menactra, it should wait until the child is 29 months old 6 months after the dose of DTaP. A year-old patient with ulcerative colitis is taking high-dose immunosuppressive medications 6-mercaptopurine.
There is no specific indication for meningococcal vaccine in this patient. Although second-hand smoke and other environmental conditions have been identified as risk factors for meningococcal disease, ACIP does not include them as indications for MenACWY vaccination. Providers may always use their clinical judgment in situations not addressed by ACIP.
Adolescents who receive the first dose at age 13 through 15 years should receive a one-time booster dose, preferably at age 16 through 18 years, just before the peak in incidence of meningococcal disease among adolescents occurs.
Teens who receive their first dose of MenACWY at or after age 16 years do not need a booster dose, as long as they have no additional risk factors.
The peak age for meningococcal disease is 16 through 21 years. Subsequent studies indicated that the protection provided by MenACWY wanes within 5 years following vaccination.
A booster dose should be given to first-year college students, regardless of age, who are or will be living in a residence hall if the previous dose was given before the age of 16 years or if their most recent dose given after the 16th birthday was not given within the past 5 years.
A dose of MenACWY administered at age 10 may count as the first adolescent dose normally given at 11 or Which people with risk factors should receive booster doses beyond the routinely recommended adolescent doses of MenACWY? This group includes people 1 with persistent complement component deficiency an immune system disorder or who take a complement inhibitor eculizumab [Soliris] or ravulizumab [Ultomiris] , 2 with anatomic or functional asplenia, 3 with HIV infection, 4 who have higher risk of exposure including microbiologists who handle Neisseria meningitidis isolates and travelers to or residents of areas with epidemic or hyperendemic meningococcal disease [such as the meningitis belt of sub-Saharan Africa].
Children at continued high risk who received the last dose of the primary series of MenACWY before age 7 years should receive the next dose 3 years after the most recent dose, then every 5 years as long as risk remains. People at continued high risk who received the last dose of the primary series at age 7 years or older should receive the next dose 5 years after the most recent dose then every 5 years as long as risk remains.
Should people with continued high risk of meningococcal disease receive additional doses of meningococcal vaccine beyond the 3- or 5-year booster? Yes, people should receive additional booster doses every 5 years if they continue to be at highest risk for meningococcal infection. If a child with a high-risk condition receives MenACWY at age 9 years and a second primary dose 8 weeks later , should they receive a booster dose at age 14 years 5 years after the primary series , or should they receive a dose at age 16 years as recommended in the routine schedule?
The MenACWY booster dose should be given at 14 years 5 years after the primary series and every 5 years thereafter. The every 5-year booster dose schedule for people with high-risk conditions takes precedence over the routine adolescent schedule.
Should we vaccinate them? If the person cannot provide written documentation of the previous vaccination you should assume they are unvaccinated and vaccinate accordingly. Administering Vaccine Back to top By what route should meningococcal vaccines be administered? All meningococcal conjugate vaccines should be administered by the intramuscular route. Meningococcal serogroup B vaccine is given by the intramuscular route. Since vaccine antigen is present in the diluent as well as in the powder, what should we do now?
The liquid vaccine component the diluent of Menveo contains the C, W, and Y serogroups, and the lyophilized vaccine component the freeze-dried powder contains serogroup A. Because the patient received only the diluent, he or she is not protected against invasive meningococcal disease caused by N. Invasive disease with N. If the recipient of the C-Y "diluent" only is certain not to travel outside the United States then the dose does not need to be repeated.
However, if the recipient plans to travel outside the United States the dose should be repeated with either correctly reconstituted Menveo, or with a dose of another brand of MenACWY. There is no minimum interval between the incorrect dose and the repeat dose. In all three brands of MenACWY, the most common adverse event were injection site pain, swelling or redness.
Other reported symptoms included malaise and headache. The National Vaccine Injury Compensation Program includes payment for injuries determined to have occurred following vaccination with a vaccine routinely recommended for children in the United States. The recipient can be of any age, but the vaccine must be routinely recommended for children and teens through age 18 years.
MenACWY is routinely recommended for children so it is included in the program. More information about the program and the covered vaccines is at www. As with all vaccines, a severe allergic reaction for example, anaphylaxis to a vaccine component or to a prior dose is a contraindication to further doses of that vaccine. A moderate or severe acute illness is a precaution; vaccination should be deferred until the person's condition has improved.
Because MenACWY is an inactivated vaccine, it can be administered to people who are immunosuppressed as a result of disease or medications; however, response to the vaccine might be less than optimal. No safety concerns associated with vaccination have been identified in mothers vaccinated during pregnancy or their infants. Please tell me more about this. Findings from two studies that examined more than 2 million doses of Menactra given since showed no evidence of an increased risk of GBS.
This precaution did not apply to other meningococcal vaccines. The vaccine must not be frozen. Vaccine that has been frozen or exposed to freezing temperature should not be used.
Do not use after the expiration date. Back to top This page was updated on April 15, This page was reviewed on October 14, Immunization Action Coalition. Sign up for email newsletter. ACIP Recommendations. Package Inserts. Additional Immunization Resources. Adult Vaccination. Screening Checklists. Ask the Experts. Shop IAC. CDC Schedules. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. CDC recommends routine MenACWY vaccination for: All preteens and teens at 11 to 12 years old with a booster dose at 16 years old Children and adults at increased risk for meningococcal disease CDC recommends routine MenB vaccination for: People 10 years or older at increased risk for meningococcal disease.
Information for Healthcare Professionals. It is especially dangerous to infants and young children. Keep reading to learn more about scheduling for different meningitis vaccines, the benefits of these vaccines, the risks of meningitis, and why vaccination is important. There are different types of meningitis vaccine that doctors will administer at different ages. Vaccines protect against bacterial meningitis and some forms of viral meningitis.
Before a vaccine became available for it, Haemophilus influenzae type b Hib was the leading cause of bacterial meningitis. Hib is much less common today due to vaccinations. Doctors usually administer the Hib vaccine at 2, 4, and 6 months of age.
They will administer it again between the ages of 12 and 15 months. Pneumococcus bacteria can cause meningitis and other serious infections, such as pneumonia. Initial vaccination occurs at 2, 4, and 6 months of age, and an infant will receive another dose between the ages of 12 and 15 months. This vaccine series usually starts at the age of 11 years.
However, children with certain conditions may receive it earlier. The recommendation is that teenagers and young adults aged 16—23 years also receive the serogroup B meningococcal vaccine, especially if they fit into a high risk category. This vaccine protects against measles , mumps , and rubella.
Before this vaccine was available, mumps was a common cause of viral meningitis. Measles is also a cause of meningitis. Doctors typically administer this vaccine when an infant is 12—15 months of age and again when they are 4—6 years of age.
Meningitis rates are at an all-time low in the U. Experts believe that MenACWY and MenB vaccines provide protection to people who have been vaccinated but do not protect the larger, unvaccinated community through herd immunity. As a result of epidemics of meningococcal disease being linked to the Hajj in the past, vaccination with MenACWY is now an entry requirement to Saudi Arabia for pilgrims on Hajj or Umrah.
Vaccines against other bacterial meningitis types. Pneumococcal vaccine and its use in the UK Pneumococcal vaccines are routinely given in childhood in many countries across the world. Hib Haemophilus Influenzae Type b vaccine and its use in the UK and Ireland The vast majority of countries across the globe routinely provide Hib vaccine in childhood.
Vaccines against viral meningitis types. Vaccine schedule in the UK and Ireland. Vaccine factsheets to download. Should vaccination be mandatory? MRF Evidence and Policy Manager Prevention , Claire Wright, discusses the pros and cons of making vaccination compulsory in the fight against meningitis and septicaemia. Read the blog. Vaccine hesitancy is one of the biggest threats to global health. But why does it happen? Causes of meningitis and septicaemia. What are meningitis and septicaemia?
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