A recent spike in orders for the meningococcal tetravalent conjugate vaccine, or MCV4, has led the vaccine's manufacturer to institute order limits among public- and private-sector vaccine providers.
The high volume of MCV4 orders coincides with the typical summertime demand for meningococcal vaccination of college freshmen who will be living in dormitories, as well as with publication of meningococcal vaccination recommendations by the CDC's Advisory Committee on Immunization Practices.
Sanofi pasteur, which manufactures and distributes the vaccine in the United States under the trade name Menactra, reports that production is on schedule to deliver the projected 5 million total doses needed by the end of March 2006.
Menactra was approved by the FDA last January for vaccination of 11- to 55-year-olds. As reported in an earlier AAFP News Now story, the ACIP in late May recommended routine vaccination with MCV4 for young adolescents (11- and 12-year-olds) at the preadolescent health care visit.
In addition to 11- and 12-year-olds, adolescents entering high school (about age 15) who have not yet received MCV4 are also a priority vaccination group. Routine vaccination against meningococcal infection is also recommended for certain persons at increased risk from meningococcal disease, including:
- research and laboratory personnel who are routinely exposed to Neisseria meningitidis,
- military recruits,
- travelers to areas in which N. meningitidis is epidemic or hyperendemic, and
- patients with anatomic or functional asplenia.
Although MCV4 is the preferred vaccine for use among patients ages 11 to 55, meningococcal tetravalent polysaccharide vaccine, or MPSV4, may be substituted if MCV4 is not available. MPSV4 is the recommended vaccine for use in patients ages 2 through 10 and for those older than 55.
MCV4 allocations to both public and private health professionals will be based on estimated monthly needs balanced with available supply. For vaccine purchased through the CDC contract, grantees will be allocated doses based on a month-by-month breakdown of their annual cap, taking into account what has already been shipped. Vaccine providers wishing to order outside the CDC contract should work directly with sanofi pasteur.
Sanofi pasteur officials are collaborating with the CDC to monitor supply and demand for the vaccine and to distribute the vaccine equitably. Sanofi pasteur will provide updates on the allocation process as indicated.
