Recommendations Address Meningococcal Vaccine Supply, Demand 'Mismatch'

Even as high-school seniors are making their plans for the summer, the AAFP, CDC and other organizations are planning for those students' exodus to college next fall. Last week, the organizations issued new immunization recommendations intended to align a growing need for meningococcal vaccine -- increasingly mandated by colleges for students to begin classes -- with a static supply of the vaccine.

Sanofi pasteur, which manufactures the tetravalent meningococcal polysaccharide-protein conjugate vaccine, or MCV4, currently anticipates that demand for the vaccine, marketed as Menactra, will outpace supply at least through summer 2006. The CDC, in consultation with its Advisory Committee on Immunization Practices, the AAFP, American Academy of Pediatrics, American College Health Association and Society for Adolescent Medicine, has sent a Notice to Readers advising clinicians about changes pertaining to MCV4, which currently is licensed for use in persons ages 11 to 55 years.

The AAFP Board of Directors adopted updated recommendations for immunizing persons against meningococcal disease on May 18. Until further notice, clinicians should defer MCV4 immunization of patients ages 11 to 12 years, although the AAFP recommends that clinicians continue to vaccinate adolescents who have not previously received MCV4 as they enter high school. College freshmen who will be living in dormitories also should be vaccinated.

"If possible," the recommendation notes, "providers should track 11 - 12 year-olds in whom MCV4 has been deferred and recall them for vaccination when supply improves." The AAFP document also states that persons at high risk for meningococcal disease (i.e., military recruits, travelers to areas in which the disease is hyperendemic or epidemic, microbiologists who are routinely exposed to Neisseria meningitidis, persons with anatomic or functional asplenia, and others) should be vaccinated.

Although MCV4 is preferable to tetravalent meningococcal polysaccharide vaccine, or MPSV4, in most cases, MPSV4 can present an acceptable alternative, particularly in persons who have brief elevations in their risk for meningococcal disease (e.g., travelers to areas in which meningococcal disease is hyperendemic or epidemic). However, availability of MPSV4 also is limited.

Visit the National Immunization Program Web site for updates on these and other vaccine shortages.