New recommendations on meningococcal vaccines

The American Academy of Pediatrics (AAP) has updated its 2011 policy statement on meningococcal vaccines for children and adolescents to include 2 subsequently licensed conjugate vaccines for use in infants.

Special Report: Meeting the challenge of vaccine costs

The new policy statement adds recommendations for immunizing high-risk infants aged as young as 2 months with the quadrivalent MenACWY-CRM (Menveo) vaccine, licensed in 2013, or the bivalent HibMenCY-TT (MenHibrix) vaccine, licensed in 2012, which is also approved for Haemophilus influenzae type b (Hib). The AAP doesn’t recommend routinely vaccinating healthy children aged 2 months to 10 years who aren’t at high risk of meningococcal disease.

The vaccines are given in a 4-dose primary series to children aged between 2 and 18 months who are at increased risk of invasive meningococcal disease because they have persistent complement deficiency (C3, C5-C9, properdin, factor H, or factor D) or functional or anatomic asplenia, or if they are part of a community outbreak. Infants at risk because of travel to an area with hyperendemic or epidemic meningococcal disease should receive the quadrivalent rather than the bivalent vaccine.

Children aged 2 months to 6 years who are at persistent risk should receive a booster dose 3 years after the primary vaccine series and every 5 years thereafter.

HibMenCY-TT also can be used for routine vaccination against Hib. If it is given to protect against meningococcal disease, it should be used for all 4 doses of Hib vaccine, and other Hib vaccines should be avoided.

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.