Selective Vaccines

Meningococcal

While rates of meningococcal disease have been declining in the US, there were approximately 550 reported cases in 2013.5 Disease rates are highest in children and young adults ages 16 to 23. Think about vaccination if your patients are military recruits, college students, travelers, have had exposure to outbreaks, have asplenia or complement deficiencies, or are microbiologists.

In 2014 two serogroup B meningococcal vaccines were approved for use in adults ages 10 to 25. It is now recommended for those at increased risk for serogroup B meningococcal disease. No revaccination is needed. 

What to know in clinic:

There are 3 vaccines for adults: Quadrivalent vaccine (MenACWY), Polysaccharide vaccine (MPSV4), Serogroup B vaccine (MenB)

MenACWY is given more often. 

Use MPSV4 for unvaccinated adults over age 56 requiring 1 dose of the vaccine. Otherwise use MenACWY

MenB is used for those over age 10 at increased risk for serogroup B meningococcal disease

 

Refer to specific indications on the following page. 

Specific indications:

Military recruits: Give 1 dose of MenACWY vaccine 

1st year college students living in dorms (who didn’t receive a vaccine after age 16): Give 1 dose of MenACWY

Persons traveling to countries where disease is common: Give 1 dose of MenACWY and revaccinate every 5 years while still at risk 

Persons at risk because of an outbreak: Give 1 dose of MenACWY/MPSV4 unless the outbreak is attributed to serogroup B then give a series of MenB

Adults with anatomical or functional asplenia or complement deficiencies: Give 2 doses of MenACWY (2 months apart) and revaccinate every 5 years. They should also receive MenB. 

Microbiologist exposed to Neisseria meningitidis: Give 1 dose MenACWY and revaccinate every 5 years. They should also receive MenB.

License

Meningococcal Copyright © by Stacy C. Kramer, MD. All Rights Reserved.

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