Meningococcal Vaccination

What is the routine childhood vaccine schedule for MMR?

Dose 1: 12-15 months

Dose 2: 4-6 years (before school entry)

What is the catch up vaccination series for MMR?

• No evidence of immunity:

• 2 doses ≥28 days apart

- 2 doses ≈ 97% effective

- No routine booster needed

What is the MMR recommendation for adults?

• 1 dose → most adults

• 2 doses → high-risk:

- Healthcare personnel

- International travelers

- College students

What proves immunity to MMR?

-Documented vaccination

-Lab evidence of immunity or prior infection

-Birth before 1957

There are three different meningococcal immunizations approved for use in patient in the United States. What are they?

-Meningococcal conjugate or MenACWY

-Serogroup B meningococcal or MenB

-Pentavalent or MenABCWY

*All administered IM*

What are the most common serotypes found in the United States?

A, B, C, Y, and W-135

What are the two current meningococcal conjugate vaccinations that have been approved for Serogroup A, C, W, and Y?

• MenQuadfi® (Sanofi Pasteur)

• Menveo® (GlaxoSmithKline) One- or Two-Vial

What is the routine meningococcal (MenACWY) vaccine schedule for adolescents?

A 2 dose series:

- First dose at 11-12 years

- Booster at 16 years

If the first MenACWY dose is given at 13–15 years, when is the booster given?

at age 16-18 years (before the period of increased risk)

If the first MenACWY dose is given at ≥16 years, is a booster needed?

no booster needed

Which children (2 months-10 years) should receive MenACWY vaccine?

those with high-risk conditions

Which medical conditions indicate MenACWY in young children?

-Asplenia

-Complement deficiency

-HIV

Which medications increase meningococcal risk?

-Eculizumab (Soliris)

-Ravulizumab (Ultomiris)

What travel related risk indicates MenACWY?

travel to epidemic regions

Which living/working settings increase risk of meningococcal?

-Microbiologist (lab exposure)

-Residence hall (close living)

What is the vaccination schedule for children (2 months-10 years) who should receive MenACWY vaccine?

2 doses, 8 weeks apart

How often are boosters given in children who receive the MenACWY vaccine?

<7 (every 3 years), >7 (every 5 years)

What are the two meningococcal vaccinations that have been approved for Serogroup B?

-Bexsero

-Trumenba

*Not interchangeable*

What is the preferred age to receive a serogroup B vaccine for meningococcal?

16-18 years of age

True or False: Adolescents and young adults (16 though 23 years old) may also receive a serogroup B meningococcal vaccine.

True

Are MenB vaccines routinely recommended for all adolescents?

no

At what are can MenB vaccines be used?

>/= 10 years old (if indicated)

Which medical conditions indicate MenB vaccination?

-complement component deficiency (e.g., C5-C9, properdin, factor H, factor D)

-Functional or anatomic asplenia (including sickle cell disease)

What specific medications indicate MenB vaccination?

complement inhibitor (e.g., Soliris or Ultomiris)

What are the working conditions that indicate MenB vaccination?

- Microbiologist who is routinely exposed to Neisseria meningitidis (the causal pathogen).

- Being a part of a community experiencing a serogroup B meningococcal disease outbreak.

What is the dosing for Bexsero (MenB-4C)?

Dose: 2 dose series (0, 6 months)

Dose (increased risk): 3 dose series (0, 1-2, 6)

What is the dosing for Trumenba (MenB-FHbp)?

Dose: 2 dose series (0, 6 months)

Dose (increased risk): 3 dose series (0, 1-2, 6 months)

What is the booster schedule for MenB vaccines during an outbreak?

• If 1 year or more has passed since the most recent MenB vaccine.

- Public health authorities may recommend a booster dose after 6 months have passed in certain situations.

What is the meningococcal vaccination that was approved for Serogroup A, C, W, Y + B?

MenABCWY

• Penbraya

- Contains MenACWY + Trumenba® (MenB-FHbp)

• Penmenvy

- Contains MenACWY + Bexsero® (MenB-4C, GSK)

When should you recommend a MenABCWY vaccine?

Only recommend a MenABCWY vaccine as an option when a patient is receiving MenACWY and MenB vaccines at the same visit.

• Patients must get the same vaccine brand for all doses of MenB vaccine.

- Administer Trumenba® or Bexsero® for additional MenB doses (6 months in non-outbreak) for second dose.

What are the cautions and precautions to be aware of when receiving a meningococcal vaccination?

• Any previous anaphylactic or severe reaction to the initial dose of meningococcal vaccine is a contraindication to the use of future meningococcal immunizations.

• Meningococcal vaccines should only be given to pregnant or breastfeeding women if they are at increased risk for infection (e.g. outbreak).

• Patients with a history of severe allergic reaction to any vaccine component, such as latex, should not receive the immunization.