Adult Immunization 2010 Meningococcal Vaccine Segment

1. Adult Immunization 2010 Meningococcal Vaccine Segment This material is in the public domain This information is valid as of May 25, 2010

2. Meningococcal PolysaccharideVaccine (MPSV) - Menomune • Quadrivalent (serogroups A, C, Y, W-135) • Approved for persons 2 years of age and older • Administered by subcutaneous injection

3. MPSV Recommendations • Not recommended for routine vaccination of civilians • Should be used only for persons at increased risk of infection who are 56 years of age or older, or if meningococcal conjugate vaccine is not available

4. Meningococcal ConjugateVaccine (MCV) • Quadrivalent (serogroups A, C, Y, W-135) conjugated to diphtheria toxoid • Menactra approved for persons 2 through 55 years of age • Menveo approved for persons 11 through 55 years of age • Administered by intramuscular injection

5. Meningococcal Vaccine Recommendations • Use of MCV is preferred for persons 2 through 55 years of age for whom meningococcal vaccine is recommended • Meningococcal vaccination is routinely recommended for • adolescents • college freshmen who live in a dormitory • adults at increased risk of infection MMWR 2005;54(RR-7)

6. Meningococcal VaccineRecommendations • Recommended for certain high- risk persons: • persistent complement component deficiency • HIV infection • functional or anatomic asplenia • military recruits • certain research and laboratory personnel • travelers to and U.S. citizens residing in countries in which N. meningitidis is hyperendemic or epidemic MMWR 2005;54(RR-7)

7. Meningococcal VaccineRevaccination • Persons through age 55 years who received a previous dose of meningococcal conjugate or meningococcal polysaccharide vaccine and remain at increased risk should receive an additional dose of meningococcal conjugate five years after the previous dose MMWR 2009;58(37):1042-3

8. Meningococcal VaccineRevaccination • High-risk groups who should be revaccinated • persistent complement component deficiency • persons with anatomic or functional asplenia • microbiologists with prolonged exposure to Neisseria meningitidis • frequent travelers to or persons living in areas with high rates of meningococcal disease MMWR 2009;58(37):1042-3

9. Meningococcal VaccineRevaccination • Revaccination with meningococcal conjugate vaccine is currently not recommended for persons whose only risk factor is living in on-campus housing (i.e., a college student living in a dormitory) MMWR 2009;58(37):1042-3

10. Meningococcal Vaccine Contraindications and Precautions • Severe allergic reaction to a vaccine component or following a prior dose • Moderate or severe acute illness MMWR 2005;54(RR-7)

11. Meningococcal VaccinesAdverse Reactions • Local reactions 3%-29% 11%-59% for 1-2 days • Low grade fever 3% 5% • Systemic reactions 8%-29% 11%-36% (headache, malaise fatigue) MPSV MCV MMWR 2005;54(RR-7)

12. MCV and Guillain-Barre’ Syndrome • GBS is a rare illness and expected background incidence rates are not precisely known • The number of reports is similar to the number of cases expected to occur in this age group • Since 2007, ACIP has considered a history of GBS to be a precaution to the use of meningococcal conjugate vaccine • Meningococcal polysaccharide is an acceptable alternative to MCV • ACIP is reconsidering this issue

13. National Center for Immunization and Respiratory DiseasesContact Information • Telephone (800) CDC-INFO • Email nipinfo@cdc.gov • Website http://www.cdc.gov/vaccines/ • Broadcast Updates and Resources Web Page http://www.cdc.gov/vaccines/ed/webcasts.htm