Drug information of Meningococcal conjugate vaccine

Meningococcal conjugate vaccine

Drug group:

Meningococcal conjugate vaccine is used to prevent infection caused by meningococcal bacteria. The vaccine works by exposing you to a small dose of the bacteria or a protein from the bacteria, which causes your body to develop immunity to the disease. Meningococcal conjugate vaccine contains four of the most common types of meningococcal bacteria (serogroups A, C, Y, and W-135).

Mechanism of effect

Presence of bacteriocidal anti-capsular meningococcal antibodies associated with protection from invasive meningococcal disease

Meningococcal serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein carrier

Induces production of bactericidal antibodies directed against the capsular polysaccharides of serogroups A, C, Y and W-135

Drug indications

-Meningococcal Vaccination

-Immunization for High-Risk Conditions

Dosage

Meningococcal Vaccination

Indicated active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135 in high risk adults

0.5 mL/dose IM

Immunization for High-Risk Conditions (ACIP Guidelines)

MenACWY is preferred for adults with any of the following indications who are aged ≤55 yr as well as for adults aged ≥56 years who a) were vaccinated previously with MenACWY and are recommended for revaccination, or b) for whom multiple doses are anticipated

Meningococcal polysaccharide vaccine (MPSV4 [Menomune]) is preferred for adults aged ≥56 years who have not received MenACWY previously and who require a single dose only (eg, travelers)

Asplenia or complement deficiencies

  • Indicated in adults of all ages with functional asplenia or persistent complement component deficiencies
  • Menactra or Menveo: Administer 2 doses at least 2 months apart to adults of all ages with functional asplenia or persistent complement component deficiencies
  • Booster dose: Every 5 years

HIV Infection

  • ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
  • Menactra or Menveo
    • Not previously vaccinated: Give 2-dose primary series
    • Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life

Microbiologists

  • Administer a single dose of meningococcal vaccine to microbiologists routinely exposed to isolates of Neisseria meningitidis
  • Booster dose: Every 5 years

Military recruits

  • Administer a single dose

First-year college students

  • Administer a single dose for first-year college students (up through age 21 years) who are living in residence halls should be vaccinated if they have not received a dose on or after their 16th birthday

Community outbreak

  • Administer a single dose for persons at risk during an outbreak attributable to a vaccine serogroup

Travel/reside in hyperendemic/epidemic countries

  • Administer a single dose for adults who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
  • International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously

PEDIATRIC

Primary Immunization (Adolescent)

Routine primary vaccination of adolescents recommended at age 11 or 12 years unless high risk or outbreak requires earlier vaccination at younger age

11-12 years: 0.5 mL IM once; CDC recommends booster dose at age 16 yr

11-12 years (HIV infection): 2-dose primary series of 0.5 mL IM with at least 8 wk between doses (CDC guidelines)

Catch-up schedule (Adolescent)

  • Administer vaccine at age 13 through 18 years if not previously vaccinated
  • If first dose is administered at age 13 through 15 years, a booster dose should be given at age 16 through 18 years; minimum interval between doses is 8 weeks
  • If first dose administered at age 16 or older, a booster dose is not needed

First-year college students

  • First-year college students (up to age 21 yr) living in residence halls should receive at least 1 dose of MenACWY before college entry; the preferred timing of the most recent dose is on or after their 16th birthday
  • If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment

Immunization for High-Risk Conditions (ACIP Guidelines)

Asplenia

  • Indicated for children with anatomic or functional asplenia (including sickle cell disease)
  • Menveo for children aged <19 months: 4-dose infant series given at 2, 4, 6, and 12 through 15 months
  • For children aged 19 through 23 months who have not completed a series of MenHibrix or Menveo, administer 2 primary doses of Menveo at least 3 months apart
  • For children aged ≥24 months who have not received a complete series of MenHibrix or Menveo or Menactra, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
  • Booster dose: Every 5 years

HIV Infection

  • ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
  • Menactra or Menveo
    • Not previously vaccinated: Give 2-dose primary series
    • Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life

Complement Deficiency

  • For children with persistent complement component deficiency
  • For children younger than 19 months of age, administer a 4-dose infant series of Menveo at 2, 4, 6, and 12 through 15 months of age
  • For children 7 through 23 months who have not initiated vaccination, 2 options exist depending on age and vaccine brand:
  • -a. For children who initiate vaccination with Menveo at 7 months through 23 months of age, a 2-dose series should be administered with the 2nd dose after 12 months of age and at least 3 months after the first dos
  • -b. For children who initiate vaccination with Menactra at 9 months through 23 months of age, a 2-dose series of Menactra should be administered at least 3 months apart
  • For children ≥24 months who have not received a complete series of any meningococcal vaccine, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
  • Booster dose: Every 5 years

Travel/reside in hyperendemic/epidemic countries

  • For children who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
  • Administer an age-appropriate formulation and series of Menactra (minimum age 9 months) or Menveo (minimum age 2 months) for protection against serogroups A and W meningococcal disease
  • Note: Prior receipt of MenHibrix is not sufficient for children traveling to the meningitis belt or the Hajj because it does not contain serogroups A or W
  • International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously

Community outbreak

  • For children at risk during a community outbreak attributable to a vaccine serogroup, administer or complete an age- and formulation-appropriate series of MenHibrix, Menactra, or Menveo

Drug contraindications

Hypersensitivity , Severe allergic reactions

Severe allergic reaction (eg, anaphylaxis)

Hypersensitivity to any component

Side effects

Headache , vertigo , fever , somnolence , Lipodystrophy , Sore mouth , Ototoxicity , swelling , tiredness , Restlessness , Syncope , "tonic" seizure

Tenderness at injection site,Erythema,Swelling,Irritability,Abnormal crying,Drowsiness-Appetite loss,Induration,Vomiting,Fever,Malaise,Headache,Impaired hearing, ear pain, vertigo, vestibular disorder,Eyelid ptosis,Injection site pruritus, pain, inflammation and swelling, fatigue,pyrexia,Hypersensitivity/anaphylaxis,Vaccination site cellulitis,Alanine aminotransferase increased, body temperature increased,Arthralgia, bone pain, myalgia,Guillain-Barre syndrome, paresthesia, dizziness, syncope, tonic convulsion, headache, facial paresis, balance disorder,Oropharyngeal pain,Skin exfoliation

Interactions

Azathioprine , Asparaginase , Anti-thymocyte , Epirubicin , Streptozocin , Oxaliplatin , durvalumab , ixabepilone , ixekizumab , Brentuximab , pegaspargase , Avapritinib , secukinumab , atezolizumab , daratumumab , lutetium lu 177 dotatate , Siltuximab , Obinutuzumab , Daclizumab , Venetoclax , Selinexor , talazoparib , belinostat , ozanimod , ozogamicin , iobenguane I 131 , zanubrutinib , Ruxolitinib , Omacetaxine , Belatacept , bosutinib , Dasatinib , Gemtuzumab , Cobimetinib , Temsirolimus , Siponimod , Rucaparib , Blinatumomab , Romidepsin , Brodalumab , Ustekinumab , Rilonacept , corticorelin , cosyntropin , Carmustine , Ofatumumab , Risankizumab , Tildrakizumab , vedolizumab , Muromonab-CD3 , Guselkumab , Floxuridine , midostaurin , Nelarabine , Azacitidine , Alemtuzumab , Ocrelizumab , Baricitinib , Pentostatin , Decitabine , trabectedine , dinutuximab , Duvelisib , Pralatrexate , Palbociclib , olaparib , Anakinra , Ibrutinib , Ixazomib , Alefacept , Aflibercept , Tisagenlecleucel , Abatacept , Axicabtagene ciloleucel , Pazopanib , Ibritumomab tiuxetan , Acalabrutinib , Cabazitaxel , Bendamustine , Canakinumab , Basiliximab , Clofarabine , Ponatinib , Pemetrexed , Bexarotene , Copanlisib , Tositumomab , Golimumab , Mechlorethamine , Idarubicin , Idelalisib , brigatinib , Tocilizumab , Sarilumab , Eribulin , Inotuzumab‎ , Teniposide , Etoposide , thiotepa , Lenalidomide , pomalidomide , Tofacitinib , Osimertinib , Panobinostat , Ribociclib , Corticotropin , Prednisolone , Mycophenolic acid , Antilymphocyte Immunoglobulins , Altretamine , carfilzomib , mercaptopurine , prednisone , cortisone , Aldesleukin , Adalimumab , Certolizumab , Chlorambucil , Influenza vaccine , Fluorouracil , Plicamycin , Dimethyl Fumarate , teriflunomide , Vinblastin , Vincristin , Vinorelbine , Capecitabine , Carboplatin , cladribine , Melphalan , Mitomycin , Mitoxantrone , Natalizumab , Nilotinib , Hydrocortisone , Fingolimod , Levamisole , Lomustine , Mycophenolate mofetil , Methotrexate , Methylprednisolone , Sirolimus , Cisplatin , Cyclosporine , Cyclophosphamide , Fludarabine phosphate , Fludrocortisone , Deflazacort , Dexamethasone , Docetaxel , Doxorubicin , Rituximab , Cytarabine , Topotecan , Thioguanine , Gemcitabine , Daunorubicin , Dacarbazine , Dactinomycin , Paclitaxel , Thalidomide , Tacrolimus , Trastuzumab , Triamcinolone , Temozolomide , Betamethasone , Bleomycin , Budesonide , Bortezomib , Busulfan , Procarbazine , Everolimus , Irinotecan , Ifosfamide , Imatinib , Interferon gamma-1b , Infliximab
escherichia coli-daunorubicin liposomal-denileukin diftitox-diroximel fumarate-doxorubicin liposomal-hydroxyurea-inebilizumab-irinotecan liposomal-isatuximab-lurbinectedin-mogamulizumab-monomethyl fumarate-niraparib-polatuzumab vedotin-triamcinolone ophthalmic-uracil mustard-vincristine liposome-

Alerts

-Syncope may occur

-May potentially increase risk of Guillain-Barre Syndrome; causality unknown

-Not indicated for N. meningitidis serogroup B

-Not immunizing agent for diphtheria

-Patients with bleeding disorder

-Immunosuppressed patients: Patients with certain complement deficiencies and patients receiving treatment that inhibits terminal complement activation (eg, eculizumab, ravulizumab) are at an increased risk for invasive meningococcal infection, including post-vaccination

-Anaphylactoid/hypersensitivity reactions

-Vaccine administration that is too high on the upper arm may cause shoulder injury (eg, shoulder bursitis, tendinitis) resulting in shoulder pain and reduced range of motion following injection.

- Use with caution in patients with a history of bleeding disorders 

-Not to be used to treat meningococcal infections or to provide immunity against N. meningitidis serogroup B or diphtheria

Points of recommendation

- Use proper injection technique for vaccines administered in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration

-The decision to administer or delay vaccination because of current or recent febrile illness depends on the severity of symptoms and the etiology of the disease. Defer administration in patients with moderate or severe acute illness (with or without fever); vaccination should not be delayed for patients with mild acute illness (with or without fever)

-Apnea has been reported following IM vaccine administration in premature infants; consider clinical status implications

Pregnancy level

C

C

Use is recommended only if clearly needed and the benefit outweighs the risk.

Breast feeding warning

Unknown whether distributed in breast milk; use caution

Related drugs

Meningococcal Vaccines

Drug forms

Menactra, Menveo

Ask a Pharmacist


User's questions
    No comments yet.