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What is Meningococcal Vaccine?


meningococcal vaccine
Image source: CDC PHIL

There are four FDA approved meningococcal vaccines currently available for use in the United States. Two vaccines, Menectra (Sanofi Pasteur) and Menveo (Novartis/GlaxoSmithKline) conjugate vaccines target serogroups A, C, Y and W-135 meningococcal bacteria and two vaccines, BEXSERO (Novartis/GlaxoSmithKline) and TRUMENBA (Wyeth/Pfizer) recombinant vaccines target serogroup B meningococcal bacteria.1

Menactra is a meningococcal (groups A, C, Y and W-135) polysaccharide diphtheria toxoid conjugate vaccine manufactured by Sanofi Pasteur. Menactra is FDA approved for use in individuals 9 months through 55 years of age. In young children between the ages of 9 and 23 months, the vaccine is recommended as a two dose series, administered 3 months apart. In persons between the age of 2 and 55, a single dose is recommended, however a booster dose can be given four years after the first dose in individuals between the ages of 15 and 55 years.2 Menactra vaccine ingredients include strains of A, C, Y and W-135 meningococcal bacteria, muller Hinton agar (beef extract, acid hydrolysate of casein, starch, agar) Watson Scherp media (casamino acid), formaldehyde, ammonium sulfate, modified culture medium, sodium phosphate buffered isotonic sodium chloride solution.3 4

Menveo is meningococcal (groups A, C, Y, and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine manufactured by Novartis Vaccines and Diagnostics (GlaxoSmithKline). Menveo is FDA approved for use in persons 2 months through 55 years of age. Children vaccinated at 2 months of age are recommended to receive 4 doses of the vaccine (2, 4, 6, and 12 months of age). In young children between the ages of 9 and 23 months, the vaccine is recommended as a two dose series, with the second dose administered in the second year of life and at least 3 months following the first dose. One dose of the vaccine is recommended for individuals between the ages of 2 and 55 years of age.5 Menveo vaccine ingredients include strains of serogroup A, C, Y and W-135 meningococcal bacteria, Franz Complete medium, formaldehyde, CY medium, yeast extracts, purified polysaccharides and CRM 197 protein. 6 7

BEXSERO is a meningococcal group B recombinant vaccine manufactured by Novartis Vaccines and Diagnostics (GlaxoSmithKline). BEXSERO is FDA approved for use in individuals aged 10 through 25 years. It is given in a series of two shots at least one month apart. BEXSERO has shown an immune response against three serogroup B strains as measured by serum bactericidal activity. The effectiveness of the vaccine against diverse serogroup B meningococcal disease has not been confirmed.8  BEXSERO vaccine ingredients include strains of the meningococcal B bacteria, factor H binding protein, outer membrane vesicles, aluminum hydroxide, sodium chloride, histidine, sucrose, E. coli, deoxycholate and kanamycin. 9 10

TRUMENBA is a meningococcal group B recombinant vaccine manufactured by Wyeth (Pfizer) Pharmaceuticals. TRUMENBA is FDA approved for use in individuals aged 10 through 25 years and can be administered in both a two or three dose schedule.  As a two-dose schedule, the two doses are given 6 months apart. However, if more than 6 months has elapsed between doses, a third dose should not be administered earlier than 4 months after the second dose.  As a three-dose schedule, the second dose is given 1-2 months after the first dose and the third dose is given 6 months following the first dose.  Both the effectiveness of a 2-dose schedule as well as the vaccine’s ability to offer any protection against the diverse serogroup B meningococcal strains have not been confirmed.11  TRUMENBA vaccine ingredients include strains of meningococcal B bacteria, E. coli, defined fermentation growth media, polysorbate 80, and aluminum phosphate. 12 13

The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that the first dose of meningococcal conjugate vaccine targeting serogroups A, C, Y and W-135 (Menectra or Menveo) be administered at age 11-12 with a second booster dose given at the age of 16. ACIP also recommends that high risk children between 2 months and 10 years and high risk adults be vaccinated with meningococcal conjugate vaccine. Conditions considered to increase a person’s risk for meningococcal disease include HIV infection, complement component deficiencies, functional or anatomical asplenia, travel to meningococcal disease endemic areas, the use of eculizumab (Soliris®) medication and exposure to Neisseria meningitides due to employment as a microbiologist. At times, populations may also be identified as high risk for the disease related to an outbreak of meningococcal serogroup A, C, Y or W-135 disease and as a result be recommended to receive a dose of meningococcal conjugate vaccine.14

The CDC’s Advisory Committee on Immunization Practices (ACIP) states that adolescents may be vaccinated with meningococcal group B vaccine (BEXSERO or TRUMENBA) and that persons considering the vaccine are recommended to receive it between 16 and 18 years of age. Routine vaccination with meningococcal group B vaccine is recommended only for high risk individuals aged 10 and older with conditions that include functional or anatomical asplenia, complement component deficiencies, or for individuals taking eculizumab (Soliris®) medication. In the event of a meningococcal group B outbreak, populations may also be identified as high risk and recommended to receive meningococcal group B vaccines. While the CDC recommends meningococcal serogroup B vaccines for high risk adults, meningococcal group B vaccines have not received FDA approved for use in persons over the age of 25.15 16 17 Additionally, TRUMENBA and BEXSERO vaccines are not interchangeable and the same vaccine brand must be used for all administered doses.18

NVIC “Quick Facts” is not a substitute for becoming fully informed about Meningococcal disease, meningitis and the Meningococcal vaccine. NVIC recommends consumers read the more complete information following the "Quick Facts", as well as the vaccine manufacturer product information inserts, and speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child.

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References

1 FDA Vaccines Licensed for Use in the United States Nov. 16, 2018

2 FDA Menactra Product Insert Apr. 27, 2018

3 CDC Vaccine Excipient & Media Summary Jun. 2018

4 FDA Menactra Product Insert Apr. 27, 2018

5 FDA Menveo Product Insert Oct. 4, 2018

6 CDC Vaccine Excipient & Media Summary Jun. 2018

7 FDA Menveo Product Insert Oct. 4, 2018

8 FDA BEXSERO Product Insert May 31, 2018

9 CDC Vaccine Excipient & Media Summary Jun. 2018

10 FDA BEXSERO Product Insert May 31, 2018

11 FDA TRUMENBA Product Insert Mar. 14, 2018

12 CDC Vaccine Excipient & Media Summary Jun. 2018

13 FDA TRUMENBA Product Insert Mar. 14, 2018

14 CDC Vaccines and Preventable Diseases – Meningococcal Vaccination: What Everyone Should Know May 19, 2017

15 Ibid

16 FDA BEXSERO Product Insert May 31, 2018

17 FDA TRUMENBA Product Insert Mar. 14, 2018

18 CDC Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015 MMWR Oct. 23, 2015; 64(41);1171-6


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