This is a vaccine to prevent 4 different strains of meningogoccal disease: A, C, Y, and W-135. There are 2 different vaccines on the market: the older meningococcal polysaccharide vaccine MPSV4 (Menomune®) and the newer meningococcal conjugate vaccine MCV4 (Menactra®). Both protect against these same strains of bacteria. It is felt that the newer Menactra® may confer more enduring protection and it has been approved for people between the ages of 2 and 55 years. Menomune® is recommended for adults over age 55.

This vaccine prevents infection with any of these 4 bacterial strains which can cause a potentially fatal infection in the blood and nervous system. Note that this vaccine does not protect against type B which is often the culprit in infant meningococcus.

This vaccine is given as a shot, usually in the arm. Menactra®, approved for ages 2-55 is given as an intramuscular shot, usually in the deltoid muscle. Menomune® is given subcutaneously.

Redness or pain at the injection site and/or fever may occur. These reactions should not last more than 1 to 2 days. Severe allergic reactions can occur but are exceedingly rare.

Regarding Menomune®, this vaccine can contain thimerosol (thimerosol is the preservative in the multidose vial; you can get a single dose vial and reconstitute without thimerosol) and natural rubber latex in the stopper. If you have immune system problems, you may not be able to get good immunity from this vaccine. It is recommended that you not get this vaccine at the same time as whole-cell pertussis or whole-cell typhoid vaccines because of endotoxin content. The vaccine is not recommended for pregnant women unless absolutely necessary. If you are nursing, check with your doctor.

Regarding Menactra® specifically, there have been a few case reports of people who have gotten Guillain-Barré syndrome after the newer Menactra® vaccine, but it is not clear yet if this was caused by the vaccine. Pregnant women who need the vaccine will likely be advised to get the older, Menomune® vaccine as there is more data available. If you are nursing, check with your doctor. Menactra® does not contain thimerosol. The rubber stopper does contain latex. Menactra® is made with diphtheria toxoid, so it is not recommended for anyone with sensitivity to this toxoid.

If you are getting the vaccine for travel purposes, you should get it at least one week before departure.

Individuals with prior severe reactions to this vaccine may not be able to receive another dose. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness.

In addition to the basic pediatric recommendation, the following individuals should also be immunized:

• First year college students living in dormitories, if they have not been immunized
• People exposed to cases of meningococcal disease (close contacts also need antibiotics)
• People who have had their spleen removed, whose spleen is damaged or who have certain complement deficiencies should receive 2 doses at least 8 weeks apart and then every 5 years if they remain at risk
• Microbiologists working with the bacterium Neisseria meningitidis
• Military recruits
• Travelers going to endemic areas like sub-Saharan Africa Dec-June
• People traveling to Mecca during the Hajj
• Revaccination after 5 years might is recommended for those previously vaccinated who remain at high risk for infection (e.g., persons residing in areas in which disease is epidemic). Revaccination is not recommend if the only risk factor is on-campus housing.
• Persons with HIV should receive 2 doses at least 8 weeks apart
• Children >/= 2 years old with certain high risk conditions, like having no spleen or having certain complement deficiencies, should have 2 doses at least 8 weeks apart. Revaccination is recommended for children if they are still at risk. Revaccination dose should be after 3 years if the first dose was given between ages 2 and 6, and every 5 years if the first dose was given after the age of 7.

• Teenagers and young adults
• People who work with the meningococcal bacteria (e.g. microbiologists)
• Travel to Sub-Saharan Africa, to Mecca during Hajj, or to other high-risk area
• Military recruits
• First year college dormitory residents
• Not having a spleen, or having a damaged spleen
• Being born with certain complement deficiencies

• Menomune®
• Menactra®