The Australian Immunisation Handbook 10th Edition 2013

• Children (aged ≥9 months) and adults with high-risk medical conditions,
such as functional or anatomical asplenia43,44 or complement component
disorders (C5-C9, properdin, factor D or factor H), persons receiving
treatment with eculizumab (a monoclonal antibody directed against
complement component C5), 45 or those post HSCT. In persons with these
risk factors, a 2-dose primary schedule of 4vMenCV is recommended, with
doses given approximately 8 weeks apart. 48 Give 4vMenCV at least 8 weeks
after any previous MenCCV doses. In young children who have received 1 or
more doses of MenCCV prior to 12 months of age, the 1st dose of 4vMenCV
is recommended at 12 months of age. The 2nd 4vMenCV dose should be
provided by 18 months of age. (See also 3.3 Groups with special vaccination
requirements and Table 3.3.5 Recommendations for vaccination in persons with
functional or anatomical asplenia.) For persons who have previously received a
dose of 4vMenPV, a booster dose of 4vMenCV, 3 years after the last dose of
4vMenPV, is recommended (see ‘Booster doses or revaccination’ below).
Where 4vMenCV is contraindicated, a single dose of 4vMenPV can be given to
persons aged ≥2 years, unless otherwise indicated.
Booster doses or revaccination
Although the duration of protection following 4vMenCV remains unknown,
persons with medical conditions that place them at high risk of meningococcal
disease (as described above) who have completed a 2-dose primary schedule
of 4vMenCV, should receive 4vMenCV at 5-yearly intervals thereafter, until
further data becomes available. 36,49,50 This includes high-risk infants who have
received MenCCV in infancy, followed by 2 doses of 4vMenCV in the 2nd year
of life. (See also 3.3 Groups with special vaccination requirements and Table 3.3.5
Recommendations for vaccination in persons with functional or anatomical asplenia.)
Persons aged ≥9 months with a medical condition that places them at high risk
of meningococcal disease, and who have previously received 4vMenPV, should
receive a booster dose of 4vMenCV, 3 years after their last dose of 4vMenPV.
Thereafter, administer 4vMenCV every 5 years.
In persons with other risks for meningococcal disease, such as laboratory
personnel or those travelling to endemic or hyperendemic regions, a dose of
4vMenCV should be administered every 5 years if the risk of meningococcal
exposure is ongoing.
For those aged ≥2 years with underlying risk factors, but in whom 4vMenCV is
contraindicated, ongoing boosting with 4vMenPV is recommended at 5-yearly
intervals unless otherwise indicated.
4.10.8 Pregnancy and breastfeeding
Meningococcal vaccines are not routinely recommended for pregnant or
breastfeeding women, 1,51,52 but can be given where clinically indicated (see 4.10.7
Recommendations above).
PART 4 VACCINE-PREVENTABLE DISEASES 291
4.10 MENINGOCOCCAL DISEASE