AAP Issues Updated Guidelines for Meningococcal Vaccine

In light of new data, the American Academy of Pediatrics has released updated guidelines for the use of quadrivalent meningococcal vaccines to include a booster dose.

According to the new recommendations, which are consistent with those issued by the CDC’s Advisory Committee on Immunization Practices (ACIP), adolescents should be routinely immunized at age 11 or 12 and receive a booster dose at age 16 to protect them during their high period of vulnerability.

When the guidelines for immunizing adolescents with quadrivalent meningococcal vaccine were first published in 2005, immunity was expected to last 10 years. However, data on the 2 available vaccines—Menactra and Menveo—demonstrated that protective antibody concentrations decreased after 5 years.

ACIP added a booster dose at age 16 following a comprehensive analysis of the data regarding the persistence of immunity, the epidemiology of meningococcal disease, vaccine effectiveness, and the cost-effectiveness of various vaccination strategies.

The new AAP guidelines, which are published in the December issue of Pediatrics, include the following:

• Adolescents should be routinely immunized at 11 through 12 years of age and given a booster dose at 16 years of age;
• Adolescents who received their first dose at age 13 through 15 years should receive a booster at age 16 through 18 years or up to 5 years after their first dose;
• Adolescents who receive their first dose of meningococcal conjugate vaccine at or after 16 years of age do not need a booster dose
• A 2-dose primary series should be administered 2 months apart for those who are at increased risk of invasive meningococcal disease because of persistent complement component deficiency or functional or anatomic asplenia and for adolescents with HIV infection;

For individuals who are at risk of invasive meningococcal disease because of persistent component deficiency or functional or anatomic asplenia, a booster dose should be given 3 years after the primary series if the primary 2-dose series if it was given from 2 through 6 years of age, and 5 years after the primary 2-dose series if it was administered at age 7 or older. Boosters should then be given every 5 years.

To access the recommendations, click here.