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Notice to Readers Availability of Meningococcal Vaccine in Single-Dose Vials for Travelers and High-Risk Persons

The Food and Drug Administration has approved a single-dose vial of quadrivalent polysaccharide vaccine against Neisseria meningitidis serogroups A, C, Y, and W135. The single-dose vial replaces the previously available 10-dose vial, which, once reconstituted, has a 5-day shelf life. This limitation is obviated by the single-dose vial and should facilitate administration to persons at high risk.

Immunization is recommended for persons with anatomic or functional asplenia and deficiencies of the terminal components of the complement system. Additionally, travelers to areas with hyperendemic or epidemic meningococcal disease should be immunized (1). Updated travel advisories can be obtained from travelers' clinics, county and state health departments, and CDC.

The vaccine is not recommended for routine use in the United States for three reasons: 1) meningococcal disease is infrequent (approximately 3000 cases per year); 2) no vaccine exists for serogroup B, which accounts for about 50% of cases in the United States; and 3) vaccine is not efficacious against group C disease in children less than 2 years of age (2). This age group accounts for 28% of the group C cases in the United States (CDC, unpublished data).

In adults, the protective efficacy of the vaccine is 85%-95% for disease caused by serogroups A or C (3,4). Efficacy data are not available for serogroups Y and W135, but the vaccine is immunogenic for both of these serogroups (5-7). Side effects of the vaccine are mild and infrequent, consisting primarily of erythema and induration at the site of injection and low-grade fever. Protective immunity is achieved 10-14 days after vaccination.

The new single-dose tetravalent vaccine is available from local distributors or Connaught Laboratories, Inc., A Pasteur Merieux Company (telephone (800) 822-2463). Physicians are encouraged to report all cases of meningococcal disease to their local and state health departments. Reported by: Meningitis and Special Pathogens Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

References

  1. ACIP. Meningococcal vaccines. MMWR 1985;34:255-9.

  2. Taunay A de E, Galvao PA, de Morais JS, Gotschlich EC, Feldman RA. Disease prevention by meningococcal serogroup C polysaccharide vaccine in preschool children: results after eleven months in Sao Paulo, Brazil (Abstract). Pediatr Res 1974;8:429.

  3. Makela PH, Kayhty H, Weckstrom P, Sivonen A, Renkonen OV. Effect of group A meningococcal vaccine in army recruits in Finland. Lancet 1975;2:883-6.

  4. Artenstein MS, Gold R, Zimmerly JG, Wyle FA, Schneider H, Harkins C. Prevention of meningococcal disease by group C polysaccharide vaccine. N Engl J Med 1970;282:417-20.

  5. Hankins WA, Gwaltney JM, Hendley JO, Farquhar JD, Samuelson JS. Clinical and serological evaluation of a meningococcal polysaccharide vaccine groups A, C, Y, W135 (41306). Proc Soc Exp Biol Med 1982;169:54-7.

  6. Armand J, Arminjon F, Mynard MC, Lafaix C. Tetravalent meningococcal polysaccharide vaccine groups A, C, Y, W135: clinical and serological evaluation. J Biol Stand 1982;10:335-9.

  7. Griffiss M, Brandt BL, Altieri PL, Pier GB, Berman S. Safety and immunogenicity of group Y and group W135 meningococcal capsular polysaccharide vaccines in adults. Infect Immun 1981;34:725-32.

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