CDC seeks input on meningococcal vaccine for children younger than 2 years

The Centers for Disease Control and Prevention (CDC) held meetings this summer to discuss adding a new infant vaccine to its list of recommendations, but those gatherings frequently turned into a forum on the overall issue of immunizations, with both supporters and detractors having their say.

In public meetings held in June and July in Concord, New Hampshire; Denver, Colorado; Chicago, Illinois; and Seattle, Washington, the CDC sought input on whether and how to include the views of the public and health care providers when considering recommending the meningococcal conjugate vaccine for infants as young as 9 months.

In general, however, response was positive. For example, in Chicago, 86% of participants voted that meningitis vaccines should be routine, whereas 78% of participants said so in Denver, according to advocates.

Pediatricians are no strangers to the debate about immunizations, encountering a growing number of vaccine-hesitant parents who choose not to have their children vaccinated for diseases that have become rare as a result of high immunization rates and for relatively uncommon diseases, such as meningitis, that have high mortality rates.

MCV4 is currently recommended for all children and adolescents aged 11 to 18 years and for children aged 2 to 10 years with prolonged increased risk for meningococcal disease. The Advisory Committee on Immunization Practices (ACIP) has not recommended adding the vaccine to the immunization schedule for infants or vaccinating high-risk children younger than 2 years.

There are about 1,000 cases of meningococcal disease each year in the United States, with the highest rate occurring among children younger than 2 years. The disease progresses rapidly, causing death in 10% to 15% of those infected and serious complications such as brain damage, amputation, or loss of hearing in another 10% to 20%.

In April, the Food and Drug Administration (FDA) approved the use of the MCV4 vaccine for infants as a 2-dose series starting at 9 months for the prevention of meningococcal disease caused by Neisseria meningitides serogroups A, C, Y and W-135. Since the introduction of the Haemophilus influenza type b (Hib) vaccine in the 1990s, Neisseria meningitidis and Streptococcus pneumoniae have become the most common causes of bacterial meningitis in the United States.

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