November 1, 2007

ACIP Recommends Meningococcal Vaccine for High-Risk Two-Year-Olds

The Advisory Committee on Immunization Practices (ACIP) has recommended extending meningococcal vaccination to children 2 to 10 years of age at high risk of meningococcal disease, according to IDSA’s ACIP liaison, Samuel Katz, MD, FIDSA. That includes children with asplenia, terminal complement deficiencies, or HIV infection, or those who are encountering a meningococcal disease outbreak. Current recommendations from the Centers for Disease Control and Prevention (CDC) advise vaccinating all persons 11 to 55 years of age.

At its meeting Oct. 24 and 25, Dr. Katz said, ACIP also endorsed the decision by the Food and Drug Administration (FDA) to extend the age limit on FluMist live attenuated nasal influenza vaccine down to 2 years of age. Those with history of asthma or significant wheezing within the past year should be excluded. Both the influenza and meningococcal vaccines were recommended for inclusion in the federal Vaccines for Children program.

ACIP members also emphasized that those receiving vaccine should remain in the physician’s office for 15 minutes following injection, according to Dr. Katz. A significant number of syncopal episodes following vaccination have been reported, a few of them resulting in serious injury. Most have followed vaccination with Merck’s human papillomavirus (HPV) vaccine, Gardasil. 

HPV Vaccine Preference?

Next year FDA is expected to approve another HPV vaccine, GlaxoSmithKline’s Cervarix. Cervarix protects against two HPV strains linked to cervical cancer, while Gardasil, a quadrivalent vaccine, protects against two carcinogenic strains as well as two linked to genital warts. This could justify a preferential recommendation for Guardasil, but Dr. Katz, pointed out, “there is no precedent for such a differentiation in ACIP recommendations because no vaccines for the same infection have been so different in the past.” He said there likely will be considerable debate over this topic in future ACIP meetings. Stay tuned for details.

The next ACIP meeting is Feb. 27-28, 2008.

For more from ACIP, see

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