Class: Vaccine
Dosage Forms. Solution for Intramuscular Injection: Conjugate vaccine (MCV4) 0.5 mL (Menactra, Menveo); Solution for Subcutaneous Injection: Polysaccharide vaccine (MPSV4) 0.5 mL (Menomune)
Common FDA Label Indication, Dosing, and Titration.
1. Prevention of invasive meningococcal disease caused by serotypes A, C, Y, W-135: Adults, single dose of MCV4 or MPSV4 (through age 55 y for MCV4); Children aged 9 mo to 23 mo, two doses of Menactra, Children 2 y and older, a single dose of either Menactra or Menveo
Off-Label Uses.
1. Prevention of invasive meningococcal disease caused by serotypes A, C, Y, W-135: Routine immunization of adolescents aged 11-12 y and a second dose at age 16 y.
2. Prevention of invasive meningococcal disease caused by serotypes A, C, Y, W-135 in individuals at high risk of invasive meningococcal disease or those at ongoing risk of exposure, in individuals with complement deficiencies, asplenia, HIV, individuals who work with Neisseria meningitides in the laboratory: MCV4, two doses 3 mo apart and then every 5 y
3. Prevention of invasive meningococcal disease caused by serotypes A, C, Y, W-135 for military recruits, travelers to or people who live in epidemic areas or endemic countries or first-year college students up to age 21 y who live in dormitory and did not receive a dose at age 16 y: MCV4, single dose
Drug Characteristics: Meningococcal Vaccine
Medication Safety Issues: Meningococcal Vaccine
Drug Interactions: Meningococcal Vaccine
Adverse Reactions: Meningococcal Vaccine
Efficacy Monitoring Parameters. Prevention of invasive meningococcal disease.
Toxicity Monitoring Parameters. Syncope.
Key Patient Counseling Points. Used to prevent meningitis. In addition to recommended primary vaccination, patients at risk for infection (asplenic, immune compromised) should receive boosters every 5 y; first year college students up through age 21 y living in dormitories should be vaccinated if not vaccinated on or after their 16th birthday.
Clinical Pearls. MenACWY-CRM is used to describe Menveo, while MenACWY-D is used to describe Menactra. MenACWY is used to describe all vaccines in this category. Use caution to avoid confusing products. MCV4 should be used to immunize individuals aged 9 mo (Menactra) or 2 y (either conjugate vaccine) up to age 55 y. Use MPSV4 for individuals 56 y of age and older who require immunization. MCV4 is administered IM, while MPSV4 is administered SQ; avoid confusion.