The American Academy of Pediatrics’ guidelines on the use of quadrivalent meningococcal conjugate vaccines are now in line with those recommended by the CDC’s Advisory Committee on Immunization Practices, after a policy statement published online this week.
The recommendations emphasize a booster dose for those aged 16 to 18 months, when immunity may wane, according to the AAP’s Committee on Infectious Diseases.
The ACIP updated its recommendations in January, after a review of data that included the vaccine-effectiveness and cost-effectiveness of different vaccination strategies for adolescents. At that time, the ACIP recommended routine vaccination of adolescents aged 11 or 12 years, with a booster dose at 16 years; and a two-dose primary series given 2 months apart for adolescents with HIV and patients aged 2 to 54 years with persistent complement component deficiency and functional or anatomic asplenia.
Meningococcal conjugate vaccines (Menactra, Sanofi-Aventis; Menveo, Novartis) were licensed in 2005. Since then, further data on bacterial antibody persistence, US trends in meningococcal disease epidemiology and vaccine-effectiveness have indicated that many vaccinated adolescents were only protected for 5 years. This meant a dose given at age 11 or 12 years may only provide immunity until age 16 years, when risk for the disease begins to peak.
The AAP’s Red Book Committee said the same brand of vaccine should be used for all doses, but in cases in which the physician is unsure, any vaccine can be used to complete the series.