Using the tetravalent meningococcal polysaccharide-protein conjugate vaccine in the prevention of meningococcal disease

Figures & data

Table 1 Chemoprophylactic agents for meningococcal disease

Drug	Age group	Dosage and route	Duration
Rifampina (Rifadin)	Children <1 month	5 mg/kg orally every 12 h	2 days
	Children >1 month	10 mg/kg orally every 12 h	2 days
	Adults	600 mg orally every 12 h	2 days
Ciprofloxacinb (Cipro^®)	Adults	500 mg orally	Single dose
Ceftriaxone (Rocephin^®)	Children <15 years	125 mg intramuscularly	Single dose
	Persons ≥15 years	250 mg intramuscularly	Single dose
Azithromycinc	Children <15 years	10 mg/kg body weight	Single dose
	Persons ≥15 years	500 mg	Single dose

a Rifampin is not recommended for pregnant women because it is teratogenic in laboratory animals. It may decrease the effectiveness of other medications, including oral contraceptives, and alternative contraceptive methods are recommended during its use.

b Ciprofloxacin is not usually recommended for persons aged <18 years or for pregnant and lactating women because it causes cartilage damage in immature laboratory animals; however, it can be used for chemoprophylaxis of children when no acceptable alternative therapy is available.

c Azithromycin is recommended as an alternative agent for chemoprophylaxis in certain areas of the US (North Dakota and Minnesota) where fluoroquinolone-resistant meningococcal disease has been identified.

Derived from Bilukha and Rosenstein (2005) and MMWR (2008).

Table 2 Recommendations for use of tetravalent (A, C, Y, W-135) meningococcal conjugate vaccine

Population type	Ages (years)
Routine vaccination
All persons aged 11–18 years	11–18
Persons at increased risk for meningococcal disease
College freshmen living in dormitories	19–55
Military recruits	19–55
Microbiologists routinely exposed to isolates of Neisseria meningitidis	19–55
Persons with anatomic or functional asplenia or terminal complement deficiencies	2–55
Travelers to or residents of countries in which N. meningitidis is hyperendemic or epidemic, especially sub-Saharan Africa during the dry season (December–June) or	2–55
Saudi Arabia during the Hajj
Persons infected with HIVa	2–55

a Persons with human immunodeficiency virus (HIV) are likely at increased risk of meningococcal disease, although not to the extent that they are at risk for invasive Streptococcus pneumoniae infection. The efficacy of MCV4 among HIV-infected persons is unknown.

Derived from Bilukha and Rosenstein (2005) with update from MMWR (2007).

BilukhaOORosensteinN2005Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP)MMWR Recomm Rep54RR-712115917737

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MMWR2008Emergence of fluoroquinolone-resistant Neisseria meningitidis – Minnesota and North Dakota, 2007–2008MMWR Morb Mortal Wkly Rep57173518288075

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MMWR2007Notice to readers: recommendation from the advisory committee on immunization practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MCV4) in children aged 2–10 years at increased risk for invasive meningococcal diseaseMMWR Morb Mortal Wkly Rep5612656

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