Dosing & Uses
Dosage Forms & Strengths
IM solution
- 0.5mL/dose
Meningococcal Vaccination
Indicated active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135 in high risk adults
0.5 mL/dose IM
Immunization for High-Risk Conditions (ACIP Guidelines)
MenACWY is preferred for adults with any of the following indications who are aged ≤55 yr as well as for adults aged ≥56 years who a) were vaccinated previously with MenACWY and are recommended for revaccination, or b) for whom multiple doses are anticipated
Meningococcal polysaccharide vaccine (MPSV4 [Menomune]) is preferred for adults aged ≥56 years who have not received MenACWY previously and who require a single dose only (eg, travelers)
Asplenia or complement deficiencies
- Indicated in adults of all ages with functional asplenia or persistent complement component deficiencies
- Menactra or Menveo: Administer 2 doses at least 2 months apart to adults of all ages with functional asplenia or persistent complement component deficiencies
- Booster dose: Every 5 years
HIV Infection
- ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
Menactra or Menveo
- Not previously vaccinated: Give 2-dose primary series
- Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life
Microbiologists
- Administer a single dose of meningococcal vaccine to microbiologists routinely exposed to isolates of Neisseria meningitidis
- Booster dose: Every 5 years
Military recruits
- Administer a single dose
First-year college students
- Administer a single dose for first-year college students (up through age 21 years) who are living in residence halls should be vaccinated if they have not received a dose on or after their 16th birthday
Community outbreak
- Administer a single dose for persons at risk during an outbreak attributable to a vaccine serogroup
Travel/reside in hyperendemic/epidemic countries
- Administer a single dose for adults who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
- International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously
- Vaccination in the 3 years before the date of travel is required by the government of Saudi Arabia for all travelers to Mecca during the annual Hajj
Dosage Forms & Strengths
IM solution
- 0.5mL/dose
Primary Immunization (Adolescent)
Routine primary vaccination of adolescents recommended at age 11 or 12 years unless high risk or outbreak requires earlier vaccination at younger age
11-12 years: 0.5 mL IM once; CDC recommends booster dose at age 16 yr
11-12 years (HIV infection): 2-dose primary series of 0.5 mL IM with at least 8 wk between doses (CDC guidelines)
Catch-up schedule (Adolescent)
- Administer vaccine at age 13 through 18 years if not previously vaccinated
- If first dose is administered at age 13 through 15 years, a booster dose should be given at age 16 through 18 years; minimum interval between doses is 8 weeks
- If first dose administered at age 16 or older, a booster dose is not needed
First-year college students
- First-year college students (up to age 21 yr) living in residence halls should receive at least 1 dose of MenACWY before college entry; the preferred timing of the most recent dose is on or after their 16th birthday
- If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment
Immunization for High-Risk Conditions (ACIP Guidelines)
Asplenia
- Indicated for children with anatomic or functional asplenia (including sickle cell disease)
- Menveo for children aged <19 months: 4-dose infant series given at 2, 4, 6, and 12 through 15 months
- For children aged 19 through 23 months who have not completed a series of MenHibrix or Menveo, administer 2 primary doses of Menveo at least 3 months apart
- For children aged ≥24 months who have not received a complete series of MenHibrix or Menveo or Menactra, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
- Booster dose: Every 5 years
HIV Infection
- ACIP recommends routine immunization for persons aged ≥2 months with HIV infection
Menactra or Menveo
- Not previously vaccinated: Give 2-dose primary series
- Previously vaccinated with 1 dose of conjugate vaccine: Give a booster dose at the earliest opportunity, provided at least 8 wk have elapsed since the previous dose, and then continue to receive boosters at the appropriate interval throughout life
Complement Deficiency
- For children with persistent complement component deficiency
- For children younger than 19 months of age, administer a 4-dose infant series of Menveo at 2, 4, 6, and 12 through 15 months of age
- For children 7 through 23 months who have not initiated vaccination, 2 options exist depending on age and vaccine brand:
- -a. For children who initiate vaccination with Menveo at 7 months through 23 months of age, a 2-dose series should be administered with the 2nd dose after 12 months of age and at least 3 months after the first dos
- -b. For children who initiate vaccination with Menactra at 9 months through 23 months of age, a 2-dose series of Menactra should be administered at least 3 months apart
- For children ≥24 months who have not received a complete series of any meningococcal vaccine, administer 2 primary doses of either Menactra or Menveo at least 2 months apart
- Booster dose: Every 5 years
Travel/reside in hyperendemic/epidemic countries
- For children who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic, including countries in the African meningitis belt or the Hajj
- Administer an age-appropriate formulation and series of Menactra (minimum age 9 months) or Menveo (minimum age 2 months) for protection against serogroups A and W meningococcal disease
- Note: Prior receipt of MenHibrix is not sufficient for children traveling to the meningitis belt or the Hajj because it does not contain serogroups A or W
- International travelers should receive a booster dose of MenACWY if the last dose was administered >4 years previously
- Vaccination in the 3 years before the date of travel is required by the government of Saudi Arabia for all travelers to Mecca during the annual Hajj
Community outbreak
- For children at risk during a community outbreak attributable to a vaccine serogroup, administer or complete an age- and formulation-appropriate series of MenHibrix, Menactra, or Menveo
Dosing Considerations
Indicated for routine prophylaxis initiated during adolescence
CDC guidelines provide guidance for high risk infants/children (eg, sickle cell, asplenia, persistent complement deficiencies, traveling to endemic areas, outbreaks)
Schedule for initiating vaccine at a particular age (product specific)
- Menveo (age 2 months): FDA approved for 4-dose series given at 2, 4, 6, and 12 months of age
- Meveo (age 7-23 months): FDA approved for 2-dose series with 2nd dose being given in 2nd year of life at least 3 months after the first dose
- Menveo (age 2-10 years): Single dose; for children aged 2 yr through 5 yr at continued high risk of meningococcal disease, a 2nd dose may be administered 2 months after the 1st dose
- Menveo (adolescents and adults aged 11 through 55 years): FDA approved as a single dose
- Menactra: (age 9-23 months): FDA approved for 2-dose series given 3 months apart
- Menactra: (age 2-55 years): FDA approved as single dose with a booster dose (if at least 4 yr have elapsed) in high risk individuals aged 15 yr through 55 yr
Safety and efficacy of Menactra and Menveo not established in adults aged >55 yr (Menomune A/C/Y/W-135 recommended for 1 time doses in travelers)
Adverse Effects
>10%
Tenderness at injection site
Erythema
Swelling
Irritability
Abnormal crying
Drowsiness
Appetite loss
Induration
Vomiting
Fever
Malaise
Headache
Postmarketing Reports
Data available from persons aged 11-55 years
Ear: Impaired hearing, ear pain, vertigo, vestibular disorder
Eye: Eyelid ptosis
General: Injection site pruritus, pain, erythema, inflammation and swelling, fatigue, malaise, pyrexia
Immune system: Hypersensitivity/anaphylaxis
Infections and infestations: Vaccination site cellulitis
Investigation: Alanine aminotransferase increased, body temperature increased
Musculoskeletal and connective tissue: Arthralgia, bone pain, myalgia
Nervous system: Guillain-Barre syndrome, paresthesia, dizziness, syncope, tonic convulsion, headache, facial paresis, balance disorder
Respiratory: Oropharyngeal pain
Skin: Skin exfoliation
Warnings
Contraindications
Severe allergic reaction (eg, anaphylaxis)
Hypersensitivity to any component
Cautions
Not indicated for N. meningitidis serogroup B
Persons previously diagnosed with Guillain-Barré syndrome (GBS) may be at increased risk of GBS following therapy; decision to give drug should take into account potential benefits and risks; GBS has been reported in temporal relationship following administration of therapy
Prior to administration, healthcare provider should review immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions to allow an assessment of benefits and risks; epinephrine and other appropriate agents used for control of immediate allergic reactions must be immediately available should an acute anaphylactic reaction occur
Some individuals with altered immunocompetence, including some individuals receiving immunosuppressant therapy, may have reduced immune responses to drug
Persons with certain complement deficiencies and persons receiving treatment that inhibits 18 terminal complement activation (for example, eculizumab) are at increased risk for invasive disease caused by N meningitidis, including invasive disease caused by serogroups A, C, Y and 20 W-135, even if they develop antibodies following vaccination
Drug may not protect all recipients
Syncope (fainting) has been reported following vaccination; procedures should be in place to prevent falling injury and manage syncopal reactions
Pregnancy & Lactation
Pregnancy category: C
Lactation: Unknown whether distributed in breast milk; use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Presence of bacteriocidal anti-capsular meningococcal antibodies associated with protection from invasive meningococcal disease
Meningococcal serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein carrier
Induces production of bactericidal antibodies directed against the capsular polysaccharides of serogroups A, C, Y and W-135
Administration
IM Preparation
Menactra
- Clear to slightly turbid solution
- Withdraw the 0.5 mL dose of vaccine from the single-dose vial using a sterile needle and syringe
Menveo
- Mix lyophilized vaccine powder with diluent provided Invert and mix thoroughly
- Resulting solution should be clear and colorless
IM Administration
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration
Give IM injection, preferably into the anterolateral aspect of the thigh in infants or into the deltoid muscle in toddlers, adolescents, and adults
Storage
Do not freeze
Store refrigerated, away from freezer compartment, at 36-46 degrees Fahrenheit
Protect from light
Do not use after the expiration date
Reconstituted vaccine should be used immediately; may be held at or below 77 degrees Fahrenheit for up to 8 hr
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Menactra (PF) intramuscular - | 4 mcg/0.5 mL vial | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
meningococcal vaccine A,C,Y,W-135 diph conj(PF)intramuscular
MENINGOCOCCAL VACCINE - INJECTION
(MEN-in-go-COC-al)
COMMON BRAND NAME(S): Menactra, Menveo, Trumenba
USES: This vaccine is used to help prevent certain serious, sometimes fatal, bacterial infections (meningitis, meningococcemia). This infection may cause severe problems (hearing loss, brain/nerve problems, paralysis, blindness, seizures, loss of limbs) even with antibiotic treatment. This vaccine works by increasing the body's natural defense (immunity) against the bacteria that cause meningococcal disease.Vaccination is the best way to prevent infection. However, like any vaccine, it may not fully protect everyone who receives it.The brand and dose of vaccine you receive depend on your age. Other vaccines may also be given at the same time, usually in a different site on the body.
HOW TO USE: Read all vaccine information available from your health care professional before receiving the vaccine. If you have any questions, ask your health care professional.This vaccine is given by injection into a muscle by a health care professional. Adults and children usually receive the injection in the upper arm, and infants receive it in the upper thigh. Depending on your age, the vaccine is given one or more times. Ask your health care professional for your recommended vaccine schedule.Since fever may commonly occur after vaccination (especially in infants and children), your health care professional may recommend a fever/pain relief medication (such as acetaminophen) for use if needed. Ask your health care professional for details.
SIDE EFFECTS: Pain/redness/swelling at the injection site, headache, fever, chills, drowsiness, tiredness, joint/muscle pain, nausea, loss of appetite, or diarrhea may occur. If any of these effects last or get worse, tell your health care professional promptly.Rarely, some people have symptoms such as fainting, dizziness, vision changes, or ringing in the ears just after getting a vaccine injection. Tell your health care professional right away if you have any of these symptoms. Sitting or lying down may help, since these symptoms usually don't last long.Remember that this medication has been prescribed because your health care professional has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your health care professional right away if any of these rare but very serious side effects occur: numbness/tingling, muscle weakness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your health care professional.Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018.
PRECAUTIONS: Before receiving this vaccine, tell your health care professional if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as latex found in some brands), which can cause allergic reactions or other problems. Talk to your health care professional for more details.Before receiving this vaccine, tell your health care professional your medical history, especially of: current fever/illness, a certain nerve disease (Guillain-Barre syndrome), immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment).This drug may make you drowsy. Alcohol or marijuana (cannabis) can make you more drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this vaccine should be used only when clearly needed. Discuss the risks and benefits with your health care professional.It is unknown if this vaccine passes into breast milk. Consult your health care professional before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your health care professional. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this vaccine include: drugs that weaken the immune system (including cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone).
OVERDOSE: Not applicable.
NOTES: Keep vaccine records for yourself and your children. After your children are grown, give them a record to share with their health care professionals to help prevent unnecessary re-vaccinations.
MISSED DOSE: It is important that you or your child receive each vaccination as scheduled. Be sure to ask when each dose should be received, and make a note on a calendar to help you remember.
STORAGE: Store in the refrigerator. Do not freeze. Different brands of this medication may have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised March 2022. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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