Mencevax ACWY in Meningococcal Disease Immunization

Disease and Therapy , Knowledge Base / October 6, 2016

Mencevax ACWY is a vaccine indicated for active immunization of adults and children over two years of age against meningococcal meningitis caused by group A, group C, group W135 and group Y meningococci.

Meningococcal meningitis is an infection that results in swelling and inflammation of the membranes covering the brain and spinal cord. It is caused by the bacterium Neisseria meningitides (meningococcus). Most cases occur in children and adolescents. Meningococcus is the most common cause of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults. The infection occurs more often in winter and spring, and risk factors include recent exposure to meningococcal meningitis and a recent upper respiratory tract infection.

Symptoms of meningitis usually come quickly, and may include fever and chills, changes in mental status, nausea and vomiting, purpura (purple, bruise-like areas), rash, petechiae (pinpoint red spots), photophobia, severe headache, meningismus (stiff neck). Other symptoms that may occur include agitation, bulging fontanelles, decreased consciousness, poor feeding or irritability in children, rapid breathing, unusual posture with the head and neck arched backwards (opisthotonos).

Possible complications of meningitis include brain damage, hearing loss, hydrocephalus, myocarditis, seizures, subdural effusion (buildup of fluid between the skull and brain).

The vaccine may be used for:

  • Individuals who are in close contact to patients with disease caused by meningococci of groups A, C, W135 and Y.
  • Travelers to countries where the disease is endemic or highly endemic.
  • Controlling epidemics of infection cause by groups A, C, W135 and Y meningococci in confined communities.
  • Patients with inherited defects of properidin or complement, or functional or anatomical asplenia.

On the other hand, it is not recommended to use the vaccine in infants and children under two years of age as antigenicity of the vaccine is low in this age group and antibodies persist for shorter duration.

The vaccine is intended for subcutaneous (SC) use only, and should under no circumstances be administered intravascularly or intradermally.

As is the case with other vaccines, the administration of Mencevax ACWY should be postponed in patients suffering from acute severe febrile illness. However, the presence of a minor infection, such as a cold, should not result in the deferral of vaccination.

The recommended dose in all age groups is 0.5 ml, administered as a single SC dose.

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