Children aged 11 to 12 should receive routine MCV4 vaccine again

December 2006

The 11 to 12 years age group should again be included in the recommended routine use of the meningococcal conjugate vaccine.

The recommended delay of MCV4 (Menactra, Sanofi Pasteur) vaccination for 11- and 12-year-olds was made by the CDC in May 2006 based on supply issues. The manufacturer, Sanofi Pasteur, has announced that issues surrounding vaccine supply were resolved.

Since the deferral was lifted, children aged 11 years to 12 years should again receive the routine MCV4 vaccination at the regular preadolescent health care visit, according to recommendations published in the CDC’s Morbidity and Mortality Weekly Report. Providers are also urged to recall patients who were deferred to receive the vaccination.

MCV4 was licensed in January 2005 for use in people aged 11 to 55. The Advisory Committee on Immunization Practices recommends vaccinations for all people aged 11 to 55 and those at increased risk for the disease, including:

• Children aged 11 to 12.
• Adolescents entering high school, approximately 15 years, if they were not previously vaccinated.
• College freshmen living in dormitories.
• Military recruits.
• Travelers to areas where meningococcal disease is endemic.
• Microbiologists who are exposed to Neisseria meningitides.
• People with anatomic or functional asplenia.
• People with terminal complement deficiency.

The ACIP recommendation for routine MCV4 administration was based on the increased opportunity to strengthen the role of the preadolescent health care visit and create a positive effect on vaccine coverage during adolescence, according to the committee. The goal is to have routine MCV4 vaccination for all adolescents, beginning at age 11, by 2008.

Though MCV4 is preferred for people aged 11 to 55, meningococcal polysaccharide vaccine (MPSV4; Menomune, Sanofi Pasteur) can be used if MCV4 is unavailable; MPSV4 is indicated for use in children aged 2 to 10 years and adults older than 55 who are at-risk for meningococcal disease.

Meningococcal disease is the leading cause of bacterial meningitis in children aged 2 to 18 in the United States. More than 2,600 people get this disease each year; one out of 10 die from it. It can cause long-term problems, such as loss of limbs and hearing, nervous system problems, mental retardation, seizures and strokes.

Meningitis is characterized by high fever, headache and stiff neck. Other symptoms may include: nausea, vomiting, confusion and sleepiness. Symptoms develop quickly, anywhere from hours to two days.

For more information:

• CDC. Notice to readers: improved supply of meningococcal conjugate vaccine, recommendation to resume vaccination of children aged 11 to 12 years. MMWR. 2006;55:1177.