![]() ![]() ![]() Further, SBA activity among children aged 2-3 years who received MCV4 was lower than in children aged 4-10 years. 6, 7 Although SBA titers at 28 days and 6 months after vaccination were significantly higher in children aged 2-10 years who received MCV4 compared with children who received MPSV4 for all four serogroups (p<0.001), 5 the difference in magnitude of SBA titers between children in the two groups was not substantial. The duration of protection of MPSV4 is considered to be short (3-5 years), especially in young children, based on substantial declines in measurable levels of antibodies against group A and C polysaccharides by 3 years after vaccination. Summary of ACIP Deliberations and RationaleĪCIP evaluated data to determine the anticipated duration of protection from a single dose of MCV4 in children aged 2-10 years. These data, expert opinion of workgroup members, and feedback from partner organizations were presented by the workgroup to the full ACIP at the October 2007 and February 2008 ACIP meetings for its deliberation regarding a potential recommendation to vaccinate only those children at increased risk for meningococcal disease, among children aged 2-10 years. 5 Hence, MCV4 was found to be safe and noninferior to MPSV4 for all serogroups.ĭuring June 2007–February 2008, the ACIP Meningococcal Vaccine Workgroup considered use of MCV4 among children aged 2-10 years by reviewing data on MCV4 immunogenicity and safety in this age group, the epidemiology and burden of meningococcal disease, cost-effectiveness of various vaccination strategies, and programmatic implications. 5 The proportion of children aged 2-10 years who did not have detectable SBA (titer 1:32) by day 28 after MCV4 vaccination was 98.6% for serogroup A, 87.9% for serogroup C, 86.2% for serogroup Y, and 96.0% for serogroup W-135, similar to MPSV4 for all serogroups. Rates of most solicited local and systemic adverse events after MCV4 vaccination were comparable to rates observed after administration of MPSV4. Immunogenicity was measured by serum bactericidal activity (SBA), a correlate of protection. 1 Because clinical efficacy trials were not feasible in the United States, MCV4 licensure was based on clinical trials in which the safety and immunogenicity of MCV4 was compared with MPSV4. MPSV4 was recommended for routine use only among persons at increased risk for meningococcal disease. 4 Before licensure of MCV4, quadrivalent meningococcal polysaccharide vaccine (MPSV4) (Menomune®, Sanofi Pasteur) was the only meningococcal vaccine available in the United States. On October 17, 2007, the Food and Drug Administration added approval for use of quadrivalent meningococcal conjugate vaccine (MCV4) (Menactra®, Sanofi Pasteur, Swiftwater, Pennsylvania) in children aged 2-10 years to existing approval for use in persons aged 11-55 years. ![]() ![]() ACIP continues to recommend routine vaccination against meningococcal disease for all persons aged 11-18 years and those persons aged 2-55 years who are at increased risk for meningococcal disease. This report summarizes the deliberations of ACIP and the rationale for its decision and restates existing recommendations for meningococcal vaccination among children aged 2-10 years at increased risk for meningococcal disease. Shared Decision Making and CommunicationĪt its February 2008 meeting, the Advisory Committee on Immunization Practices (ACIP) decided not to recommend routine vaccination of children aged 2-10 years against meningococcal disease unless the child is at increased risk for the disease.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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