meningococcal polysaccharide diphtheria toxoid conjugate vaccine

General

Pronunciation:
me-nin-go-kok-al poli-sak-a-ride vax-seen


Trade Name(s)

  • Menactra
  • Menveo

Ther. Class.
vaccines/immunizing agents

Pharm. Class.
antigens

Indications

Active immunization to prevent against invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135.

Action

Induces production of antibodies to several pathologic serogroups of Neisseria meningitidis.

Therapeutic Effect(s):

Prevention of invasive meningococcal disease.

Pharmacokinetics

Absorption: Well absorbed from IM sites.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE (antibody presence)

ROUTEONSETPEAKDURATION
IMunknown4 wkunknown

Contraindication/Precautions

Contraindicated in:

  • Hypersensitivity to meningococcal polysaccharide, diphtheria toxoid or latex
  • Bleeding disorders (hemophilia, thrombocytopenia, concurrent anticoagulants), unless precautions are taken
  • Latex allergy (stopper contains latex).

Use Cautiously in:

  • Guillain-Barré syndrome
  • OB:  Use during pregnancy only if clearly needed (pregnancy registry participation recommended)
  • Lactation: Use while breastfeeding only if clearly needed
  • Pedi:  Children <9 mo (safety and effectiveness not established)
  • Geri:  Safety not established.

Adverse Reactions/Side Effects

CNS: irritability (Menveo), fatigue, headache, malaise, syncope (Menveo)

GI: diarrhea (Menveo), anorexia, vomiting (Menveo)

Local: pain at injection site, induration, redness, swelling

MS: arthralgia

Resp: apnea in premature infants (Menveo)

Misc: ANAPHYLAXIS (MENVEO), chills, Guillain Barré Syndrome

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

  • Immunosuppressants, antineoplastics, or  radiation therapy  may ↓ antibody response to and ↑ risk of adverse reactions from vaccines.
  • May ↓ response to  pneumococcal vaccine  when concurrently administered

Route/Dosage

Menactra

IM (Adults and Children 2–55 yr): 0.5 mL single dose.

IM (Children 9–23 mo): 0.5 mL initially, then 0.5 mL 3 mo later.

Menveo

IM (Adults and Children 11–55 yr): 0.5 mL single dose.

IM (Children 2–10 yr): 0.5 mL single dose; if patients 2–5 yr are at continued high risk for meningococcal disease, may administer another dose at 2 mo after the first dose.

IM (Children 7–23 mo): 0.5 mL initially, then 0.5 mL in the second yr of life and ≥3 mo after the first dose.

IM (Children 2 mo): 0.5 mL administered at 2, 4, 6, and 12 mo of age.

Availability

Solution for injection: 0.5 mL/vial

Assessment

  • Review patient's immunization history for contraindications and history of sensitivity to vaccine, a similar vaccine, or latex. Stopper of  Menactra  vial contains dry natural latex, which may cause allergic reactions in latex-sensitive patients.
  • Monitor patient receiving  Menveo  for at least 15 min following injection for syncope or allergic reactions.

Potential Diagnoses

Implementation

  • Record date, lot number, and manufacturer of vaccine as part of immunization record.
  • IM 

     Menactra:  Administer as a single IM dose, preferably in deltoid. Do not administer IV, subcutaneously, or intradermally. Inspect solution prior to administration. Do not administer if solution is discolored or contains particulate matter. Do not mix with other vaccines. If administered concurrently with other vaccines, administer a in different sites.

    •  Menveo:  Combine 2 vials prior to administration. Reconstitute MenA lyophilized conjugate vaccine component with MenCYW-135 liquid conjugate vaccine component by withdrawing entire contents of vial of MenCYW-135 liquid conjugate component and inject into MenA lyophilized conjugate component vial. Invert and shake vial well until the vaccine is dissolved. Withdraw 0.5 mL of reconstituted product; small amount of liquid may remain in vial following withdrawal of dose. Vaccine is clear, colorless, and free from visible foreign particles. Do not administer solutions that are discolored or contain particulate matter. Administer reconstituted vaccine immediately; vaccine is stable at room temperature for up to 8 hours. Inject in anterolateral aspect of thigh in infants or into deltoid muscle in toddlers, adolescents and adults. Do not administer intravenously, subcutaneously or intradermally.

Patient/Family Teaching

  • Inform patient of purpose of vaccine.
  • Rep:  Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding prior to administration. Patients who are pregnant or become aware they were pregnant the time of the  Menactra  immunization, should contact health care professional or Sanofi Pasteur Inc. at 1-800-822-2463 for information about the Pregnancy Exposure Registry.

Evaluation/Desired Outcomes

Immunity against invasive meningococcal disease.

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