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ACIP recommends HibMenCY for high-risk infants
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Infants at increased risk for meningococcal disease should be vaccinated with four doses of GlaxoSmithKline’s HibMenCY vaccine at 2, 4, 6, and 12 to 15 months, according to a recommendation Wednesday from the Advisory Committee on Immunization Practices.
The recommendation, approved by a 13-1 vote with one abstention, followed data that showed the vaccine could prevent about 50 cases in the United States, but a CDC working group said this figure was not large enough to warrant a general use recommendation. Other sticking points the working group noted were that most infant cases are caused by a type of the bacteria that are not prevented by meningococcal vaccines and occur during the first 6 months of life, before a vaccine could provide protection.
The working group instead recommended that infants with recognized persistent complement pathway deficiencies and those who have anatomic or functional asplenia, including sickle cell disease, receive the vaccine. The panel also noted, and the committee agreed, that HibMenCY can be used in infants aged 2 to 18 months who are in communities with serogroup C and Y meningococcal disease outbreaks.
A spokesperson for GlaxoSmithKline who was in attendance at the meeting urged the committee before the vote to rethink the working group’s recommendations: “Don’t send an unintended message [with your vote] to parents, physicians and third-party payers that meningococcal vaccination in infants and toddlers should not be discussed, because it is an important discussion to have.”
The GlaxoSmithKline spokesperson also raised the issue of a permissive recommendation for the vaccine, but committee members, including committee chair Jonathan Temte, MD, said the committee was trying to “get away” from permissive recommendations because the fact that the vaccine is improved makes it implicitly permissively approved.
Lynn Bozof, president of the National Meningitis Association, echoed comments from GlaxoSmithKline and others, adding: “I can’t help but think of the family members who lose an infant to this illness, and then they learn a vaccine was available that could have helped.”
Meningococcal disease is a serious vaccine-preventable bacterial infection caused by Neisseria meningitidis bacteria. The two most severe common illnesses caused by these bacteria include meningitis and bloodstream infections. Infants with certain medical conditions, such as sickle cell disease or complement component deficiency, are at increased risk for meningococcal disease.