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CDC recommends booster dose of MenC vaccines whenever possible
CDC. MMWR. 2011;60(30):1018-1019.
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Several changes in recommendations for meningococcal immunization were made earlier this year by the Advisory Committee on Immunization Practices. The CDC recently published the data that resulted in these changes, besides findings related to the interchangeability of the two meningococcal conjugate vaccines licensed in the United States.
In January, the FDA lowered the approval age range for a quadrivalent meningococcal conjugate vaccine (MenACWY-CRM; Menveo, Novartis) to include patients aged 2 to 55 years. Another quadrivalent meningococcal conjugate vaccine (MenACWY-D; Menactra, Sanofi-Pasteur) is licensed in the United States for prevention of meningococcal disease caused by serogroups A, C, Y, and W-135 among patients aged 2 to 55 years. This vaccine is also licensed as a two-dose series for children aged 9 to 23 months.
Either meningococcal conjugate vaccine can be used in children aged 2 to 10 years, and both are preferred over quadrivalent meningococcal polysaccharide vaccine, according to the updated ACIP recommendations. This recommendation supersedes the previous recommendation that children aged 2 to 10 years should receive only MenACWY-D when meningococcal vaccination is indicated. For patients aged 2 to 55 years at increased risk for meningococcal disease, a booster dose is recommended if they remain at increased risk.
Children aged 2 to 10 years without risk factors for meningococcal disease are not recommended to receive meningococcal vaccine.
The previous ACIP recommendation included patients aged 2 to 55 years who were at increased risk for meningococcal disease and that all adolescents aged 11 to 18 years are immunized with meningococcal conjugate vaccine. In January, the ACIP expanded that recommendation and now advises that all adolescents receive a booster dose of quadrivalent meningococcal conjugate vaccine at age 16 years, according to a recent Morbidity and Mortality Weekly Report.
The extended age indication for MenACWY-CRM is based on results of a multicenter, randomized controlled trial that evaluated the safety and immunogenicity of MenACWY-CRM in children aged 2 to 10 years. The results indicate that after a single MenACWY-CRM dose, seroresponses to group C, Y, and W-135 in children aged 2 to 5 years and 6 to 10 years were noninferior to responses after a single MenACWY-D dose.
Post-licensure study data show that human complement serum bactericidal activity (hSBA) titers of at least 8 at 3 years after a single dose of MenACWY-CRM or MenACWY-D for patients aged 11 to 18 years were similar for all serogroups. After revaccination with MenACWY-CRM, at least 99% of patients previously immunized with MenACWY-CRM or MenACWY-D had hSBA titers of at least 8.
“At this time, no data exist on the use of MenACWY-D following primary vaccination with MenACWY-CRM. Health care providers should use every opportunity to provide the booster dose when indicated, regardless of the vaccine brand used for the previous dose or doses,” the researchers of the report concluded.
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