TABLE 5. Recommended vaccination schedule and intervals for persons with anatomic and functional asplenia (including sickle cell disease) — Advisory Committee on Immunization Practices, United States, 2020.
| Age group | Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)* or MenACWY-CRM (Menveo, GlaxoSmithKline)† or MenACWY-TT (MenQuadfi, Sanofi Pasteur)§ | Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline) |
|---|---|---|
| 2–23 mos |
Primary vaccination: MenACWY-CRM: If first dose at age
• 2 mos: 4 doses at 2, 4, 6, and 12 mos
• 3–6 mos: See catch-up schedule¶
• 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday) |
No recommendations for use of MenB vaccines in this population** |
| 2–9 yrs |
Primary vaccination††: MenACWY-D§§,¶¶: 2 doses ≥8 wks apart and ≥4 wks after completion of PCV13 series
or MenACWY-CRM
or MenACWY-TT: 2 doses ≥8 wks apart
Boosters (if person remains at increased risk)***:
• Aged <7 yrs: Single dose at 3 yrs after vaccination and every 5 yrs thereafter
• Aged ≥7 yrs: Single dose at 5 yrs and every 5 yrs thereafter |
No recommendations for use of MenB vaccines in this population** |
| ≥10 yrs | Primary vaccination††: MenACWY-D¶¶: 2 doses ≥8 wks apart and ≥4 wks after completion of PCV13 series or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk)***: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter | Primary vaccination**: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person remains at increased risk)†††: Single dose at 1 yr after completion of primary vaccination and every 2–3 yrs thereafter Note: MenB-FHbp and MenB-4C are not interchangeable |
Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM197 conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine; PCV = pneumococcal conjugate vaccine.
* Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
† Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
§ Licensed in the United States only for persons aged ≥2 years.
¶ If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
** Licensed in the United States only for persons aged 10–25 years. Vaccination of persons aged ≥26 years is considered off-label.
†† Primary vaccination licensed as a single dose in persons aged 2–55 years for MenACWY-D and MenACWY-CRM or ≥2 years for MenACWY-TT. Two-dose primary series is considered off-label.
§§ MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children.
¶¶ Because of the high risk for invasive pneumococcal disease, children with functional or anatomic asplenia or human immunodeficiency virus infection should not be vaccinated with MenACWY-D (Menactra) before age 2 years to avoid interference with the immune response to PCV. If MenACWY-D is used in a person (of any age) with these conditions, it should not be administered until at least 4 weeks after completion of all PCV doses.
*** Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
††† Licensed in the United States only for a primary series. Administration of booster doses is considered off-label.