The Advisory Committee on Immunization Practices voted unanimously today to expand the current recommendations for ACWY conjugate vaccination eligibility to include persons with HIV aged 2 months or older.
In addition, those aged 2 years or older with HIV and not previously vaccinated are recommended to receive a two-dose primary series of meningitis ACWY conjugate vaccine (MenACWY). Those previously vaccinated with only one dose are to receive a second dose at the earliest possibility and then to continue to receive boosters when appropriate.
“The ACIP does not currently include HIV-infected persons in the recommendations for routine vaccination of persons at increased risk of meningococcal disease; however, if an HIV-infected person is vaccinated, the recommendations state that they should receive a two-dose primary series,” Jessica MacNeil, MPH, epidemiologist with the National Center for Immunization and Respiratory Diseases at the CDC, said during the meeting.
“There are now five studies which have evaluated the risk for meningococcal disease among HIV-infected persons. Taken together, these studies consistently show an increased risk from meningococcal disease.”
ACIP based its recommendation on these studies — which estimated a fivefold to 24-fold increase in RR of infection for those with HIV — as well as national surveillance, cost modeling, safety and efficacy data. According to these, incidence of coinfection during the past 2 decades was low, but expanding vaccination would result in clear health benefits for the HIV-infected population.
Due to limited data, ACIP made no recommendations regarding meningococcal group B vaccination for persons with HIV.
Following the FDA’s recent changes to the package insert of Trumenba (meningococcal B vaccine, Pfizer), ACIP also received an update on the work group’s discussions concerning current meningococcal B vaccine recommendations. New data and potential changes to the ACIP’s recommendations for the menB vaccine will be addressed at the October meeting when the committee will decide whether to advocate the three-dose schedule exclusively, or with a two-dose option. – by Dave Muoio
Disclosure: MacNeil reports no relevant financial disclosures.