MenACWY vaccine

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MenACWY vaccine
Nimenrix.jpg
Clinical data
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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 small 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. Archived from the original on 2022-02-05. Retrieved 2022-02-04.
  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 2022-01-11. Retrieved 2022-03-06.
  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 2022-02-05. Retrieved 2022-02-04.
  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.