Abstract
Meningococcal infection is serious, often resulting in fulminant sepsis or meningitis. There are two main types of meningococcal conjugate vaccine currently available in Canada: serotype C meningococcal conjugate, and quadrivalent conjugate for serotypes A, C, Y, and W-135. The immunological characteristics that inform ongoing immunization policies, as well as some of the limits of current knowledge, are presented. All Canadian children should receive a conjugate meningococcal C vaccine (MCV-C) at 12 months of age, and either a booster dose of MCV-C or of quadrivalent meningococcal vaccine (MCV-4) in adolescence. Children at high risk of invasive meningococcal disease should start MCV-C at two months of age, and be given MCV-4 at two years of age.
Keywords: Adolescents, Canada, Children, MCV-4, Meningococcal infection, Meningococcal vaccine
Français en page 486
RECOMMENDATIONS
In view of the safety, immunogenicity and effectiveness of meningococcal vaccines, as well as the severity of some Neisseria meningitidis infections and public concern about the risk of severe meningococcal disease, the Canadian Paediatric Society recommends the following:
Canadian children should be immunized with an MCV-C at 12 months of age. Other infants may begin MCV-C immunizations at an earlier age, depending on provincial or territorial vaccine programs and the most up-to-date recommendations published by the National Advisory Committee on Immunization.
Infants at increased risk for invasive meningococcal infection should begin MCV-C immunization at two months of age.
MCV-4 should be given to children two years of age or older who are at increased risk for meningococcal infection. MCV-4 may also be considered for HIV-positive children two years of age or older.
All adolescents should be offered a booster dose with MCV-4 or MCV-C at approximately 12 years of age. How often boosters will be required later in life is unknown. Both vaccines are generally safe and well tolerated.
To report possible adverse events associated with vaccines, go to www.phac-aspc.gc.ca/im/aefi-form-eng.php.
Acknowledgments
This position statement has been reviewed by the Canadian Paediatric Society’s Community Paediatrics Committee.
Footnotes
INFECTIOUS DISEASES AND IMMUNIZATION COMMITTEE
Members: Jane C Finlay MD; Susanna Martin MD (Board Representative); Jane C McDonald MD; Heather Onyett MD; Joan L Robinson MD (Chair)
Liaisons: Upton D Allen MD, Canadian Pediatrics AIDS Research Group; Janet Dollin MD, The College of Family Physicians of Canada; Charles PS Hui MD, Health Canada, Committee to Advise on Tropical Medicine and Travel; Nicole Le Saux MD, Canadian Immunization Monitoring Program, ACTive; Larry Pickering MD, American Academy of Pediatrics, Committee on Infectious Diseases; Marina I Salvadori MD, National Advisory Committee on Immunization; John S Spika MD, Public Health Agency of Canada
Consultants: Robert Bortolussi MD; Noni E MacDonald MD; Dorothy L Moore MD
Principal authors: Marina I Salvadori MD; Robert Bortolussi MD
The recommendations in this statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. All Canadian Paediatric Society position statements and practice points are reviewed on a regular basis. Please consult the Position Statements section of the CPS website (www.cps.ca) for the full-text, current version.