The Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) has issued a policy statement that includes guidelines for the routine use of the newly approved tetravalent meningococcal conjugate vaccine (MCV4) and updated guidelines for the use of the standard tetravalent meningococcal polysaccharide vaccine (MPSV4). The full policy statement was published in the August 2005 issue of Pediatrics and is available online at http://www.pediatrics.org/cgi/content/full/116/2/496.
The U.S. Food and Drug Administration approved MCV4 in 2005 for use in persons 11 to 55 years of age. The new vaccine has several advantages over the older MPSV4, including a booster response after the second dose, longer duration of immunity, and effectiveness against most strains that commonly infect persons 11 years and older.
The AAP committee has made the following recommendations about meningococcal immunization:
• MCV4 or MPSV4 should be used in patients 11 years and older to prevent meningococcal disease outbreaks, although MPSV4 should be used in patients two to 10 years of age.
• Physicians should discuss immunization with patients during a routine office visit at 11 to 12 years of age.
• Two age groups should receive routine immunization with MCV4: (1) children 11 to 12 years of age during their routine office visit, and (2) adolescents when they turn 15 years of age or when they start high school, whichever comes first.
• College freshmen should receive MCV4 if they plan to live in dormitories.
• Patients who are at high risk of meningococcal disease (i.e., those with terminal complement deficiency, those with anatomic or functional asplenia, and those who travel to or reside in high-risk countries) should receive MCV4 if they are 11 years or older.
• Patients with human immunodeficiency virus infection may choose to receive MCV4 if they are 11 years or older.
• Patients who wish to decrease their risk of developing meningococcal disease may choose to receive MCV4 if they are 11 years or older.
• It may be appropriate to revaccinate adolescents with MCV4 three to five years after initial immunization with MPSV4.