MenACWY vaccine

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MenACWY vaccine

The MenACWY vaccine, available as Menactra, Nimenrix, Menveo and others, is a meningitis vaccine that protects against Neisseria meningitidis types A, C, W, and Y.[1][2] It is generally used in young children, teenagers and high risk adults, and is safe and effective.[3][4] The first licensed MenACWY vaccine was found to provide 80-85% protection within 3-4 years after vaccination, being more effective when given between one and five years of age.[3] It is given by injection into muscle or just under the skin.[3] Typically one or two doses, depending on brand, are required 4 to 6 weeks apart in small children and a single dose in older teens and adults.[5]

It is recommended for people with no spleen, weakened immune system, unvaccinated freshers, travellers to Mecca, Saudi Arabia, for the the annual Hajj, and some laboratory workers.[3] In the US it is recommended for all 11 to 12 year olds with a booster at 16 years of age.[6] The MenACWY vaccine is produced attached to a protein; diphtheria toxoid (D) such as Sanofi Pasteur's Menactra, tetanus toxoid (TT) such as Pfizer's Nimenrix, or non-toxic mutant diphtheria toxin (CRM197) as in GlaxoSmithkline's Menveo.[1] It is kept cold but frozen.[3]

Side effects include swelling and pain at the site of injection, and drowsiness.[3][5] An association with Guilllain-Barré syndrome (GBS) is unproven, but if there is a history of GBS, the MenACWY may not be given.[3] In people with no spleen, the MenACWY has been found to interfere with the response to the pneumococcal vaccine 13 (PCV13), so is given with a one month interval with the PCV13 given first.[3]

Menactra was licensed in the US in 2005, and in India in 2012, for use in people age 2 to 55 years.[3] In the US it has kept the number of disease cases low.[2] In 2015 in the UK, following the spread of a very invasive clone of type W meningococcus, a programme of vaccinating 13 to 18 year olds with the MenACWY vaccine began.[1][7] It led to almost 70% fewer cases of group W meningococcal disease than anticipated within one year of its introduction.[1] In the UK, both Menveo and Nimenrix cost the NHS £30 per dose.[5] In India, a dose of Menactra costs ₹3,600 and Menveo costs ₹5,000.[3]

Brands

Types
Common name Conjugate Production Comments Cost
Menactra Diphtheria toxoid (D)[2] Sanofi Pasteur[2] First licensed in 2005, for age group 9-months to 55-years.[2] Licensed in US and India.[3] Single dose 0.5ml IM in age 2-55 years.[3] In 2011 ACIP recommended 2 doses in children aged 9 to 23 months, 3 months apart.[3] In India, it is scheduled as 2 doses in children aged 9 to 23 months, 4 to 6 weeks apart.[3] Can have revaccination after 3 to 5 years in high risk groups.[3] India - ₹5,000
Mencevac GlaxoSmithkline 0.5ml SC or IM, in age over 2 years.[3] Can have revaccination after 3 to 5 years in high risk groups.[3] India - ₹1,050
Menomune Sanofi Pasteur Inc >age 2-years: single 0.5 mL subcutaneous injection [8]
MenQuadfi TT Sanofi Pasteur[9] Single dose IM[9]
Menveo CRM197[2] Novartis[2] First licensed in 2010, for age group 2-months to 55-years.[2] Single 0.5ml dose IM in age over 2 years in India and from 2 months to 55 years in the US.[3] India - ₹3,600[3]

UK - £30 [5]

Nimenrix TT Pfizer Usually single dose 0.5ml IM in age over one year[5] UK - £30[5]

References

  1. ↑ 1.0 1.1 1.2 1.3 Pollard, Andrew J.; Snape, Matthew D.; Sadarangani, Manish (2021). "22. Meningoccal vaccines". In Vesikari, Timo; Damme, Pierre Van (eds.). Pediatric Vaccines and Vaccinations: A European Textbook (Second ed.). Switzerland: Springer. pp. 254–255. ISBN 978-3-030-77172-0.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Suryadevara, Manika (2021). "19. Meningococcus". In Domachowske, Joseph; Suryadevara, Manika (eds.). Vaccines: A Clinical Overview and Practical Guide. Switzerland: Springer. pp. 235–246. ISBN 978-3-030-58416-0. Archived from the original on 2023-07-02. Retrieved 2024-04-11.
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 Faridi, MMA; Dewan, Pooja (2020). "40. Meningococcal vaccine". In Vashishtha, Vipin M.; Kalra, Ajay (eds.). IAP Textbook of Vaccines (Second ed.). New Delhi, London: Jaypee Brothers Medical Publishers. pp. 470–474. ISBN 978-93-5270-989-2. Archived from the original on 2024-04-11. Retrieved 2024-04-11.
  4. ↑ "Meningitis". www.who.int. Archived from the original on 22 October 2021. Retrieved 9 March 2022.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 "14. Vaccines". British National Formulary (BNF) (82 ed.). London: BMJ Group and the Pharmaceutical Press. September 2021 – March 2022. pp. 1381–1382. ISBN 978-0-85711-413-6.{{cite book}}: CS1 maint: date format (link)
  6. ↑ "Meningococcal ACWY Vaccination". www.cdc.gov. 22 October 2021. Archived from the original on 20 December 2019. Retrieved 4 February 2022.
  7. ↑ "MenACWY Vaccine (Meningococcal group A, C, W-135 and Y conjugate vaccine) | Vaccine Knowledge". vk.ovg.ox.ac.uk. Archived from the original on 4 February 2022. Retrieved 4 February 2022.
  8. ↑ "Menomune-A/C/Y/W-135". FDA. Center for Biologics Evaluation and Research. 19 November 2019. Archived from the original on 11 April 2022. Retrieved 21 May 2022.
  9. ↑ 9.0 9.1 "MenQuadfi". ema.europa.eu. European Medicines Agency. Archived from the original on 28 January 2022. Retrieved 4 February 2022.
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