Infectious Disease Book

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Meningococcal VaccineAka: Menomune, MPSV4, Tetravalent meningococcal polysaccharide vaccine, Menactra, MCV4, Tetravalent Meningococcal Conjugate Vaccine

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  1. See Also
    1. Neisseria Meningitidis
    2. Bacterial Meningitis
  2. Indications
    1. Underlying medical condition
      1. Functional Asplenia
      2. Terminal complement deficiency
      3. Properdin deficiency
      4. Human Immunodeficiency Virus (HIV)
    2. Close living areas
      1. College students in dormitories
      2. Military recruits
    3. Travel to endemic areas
      1. Sub-Saharan Africa
      2. Himalayas
      3. Saudi Arabia (especially Mecca)
    4. Recommended for routine use in teens (Menactra)
      1. All 12 year olds
      2. Catch-up any 15-16 year olds if not immunized
  3. Mechanism
    1. Polysaccharide vaccine
  4. Preparations
    1. General
      1. Covers strains A, C, W-135, Y
      2. Does not cover serotype B
        1. B accounts for 50% of infant cases
        2. B accounts for <20% of teen cases
        3. Reasons for not including serotype B in vaccine
          1. B has poor immunogenicity in vaccine
          2. Risk of cross-reactivity with neural tissue
      3. Both vaccines are similar in cost (~$100)
      4. Both vaccines are stored at 35 to 46 F (2 to 8 C)
    2. Menomune (MPSV-4)
      1. Tetravalent meningococcal polysaccharide vaccine
      2. Approved for all ages
      3. Provides short immunity <5 years
      4. Vaccine contains thimerosal
    3. Menactra (MCV-4)
      1. Tetravalent Meningococcal Conjugate Vaccine
      2. Approved for ages 11 to 55 years
      3. Preferred in most cases over MPSV-4 (see efficacy)
      4. Conjugate vaccine with Diphtheria protein
        1. Boosts T-Cell response
        2. Lengthens duration of immunity significantly
      5. Vaccine has no preservative (single use vial)
        1. Does not contain thimerosal
  5. Dose: Menomune
    1. Adult: 0.5 ml SC every 3 years
    2. Intramuscular may be preferred over subcutaneous route
      1. Intramuscular injection reduces adverse effects
        1. Local erythema (11% for IM, 32% for SC)
        2. Headache (3% for IM and 12% for SC)
      2. Intramuscular has same efficacy as subcutaneous route
  6. Dose: Menactra
    1. Administer 0.5 ml IM
  7. Efficacy
    1. Both vaccines have high seroconversion (98%-100%)
    2. Duration
      1. Menactra >8 years
      2. Menomune 3 years in school age (<3 years in infants)
  8. Precautions
    1. Safe in Human Immunodeficiency Virus (HIV)
      1. See Immunization in HIV
  9. Adverse effects
    1. Serious adverse events are uncommon (<1.3%)
    2. Headache, fever
    3. Local reactions (more common with menactra)
  10. References
    1. Bilukha (2005) MMWR Recomm Rep 54(RR-7):1
    2. Peter (2001) Pediatr Infect Dis J 20:311
    3. Ruben (2001) Clin Infect Dis 32:170

Menomune (C0244512)

ConceptsPharmacologic Substance (T121) , Immunologic Factor (T129)
EnglishMenomune
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Meningococcal vaccine (C0700144)

Definition (MSH)Vaccines or candidate vaccines used to prevent infection with NEISSERIA MENINGITIDIS.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Immunologic Factor (T129)
Englishmeningococcal vaccine, Meningococcal Vaccines, Meningococcus vaccine
Spanishvacuna antimeningocócica, vacuna antimeningococica
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Menactra (C1567129)

ConceptsPharmacologic Substance (T121) , Immunologic Factor (T129)
EnglishMenactra
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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