Menactra®

05/22/2024
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Product Overview

  • Brand Name: Menactra®
  • Type: Meningococcal (Groups A, C, Y, and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine
  • Form: Solution for injection
  • Dosage Form/Strength: 0.5 mL dose containing 4 µg each of meningococcal A, C, Y, and W-135 polysaccharides conjugated to approximately 48 µg of diphtheria toxoid protein carrier.
  • Manufacturer: Sanofi Pasteur Limited

Indications and Clinical Use

  • Purpose: Active immunization for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135.
  • Target Group: Persons 9 months through 55 years of age.

Contraindications

  • Hypersensitivity: Known systemic hypersensitivity reaction to any component of Menactra® or its container, or a life-threatening reaction after previous administration of a vaccine containing similar components.

Warnings and Precautions

  • General:
    • Inform recipients or their guardians about the benefits and risks of immunization.
    • Review the recipient’s health status, immunization history, and any possible hypersensitivity reactions.
    • Syncope (fainting) has been reported following vaccination.
  • Protection:
    • Menactra® only protects against N. meningitidis serogroups A, C, Y, and W-135, not against other microorganisms.
    • Not indicated for the prevention of invasive meningococcal disease caused by serogroup B or for the treatment of meningococcal infections.
  • Immunocompromised Individuals:
    • May not achieve the expected immune response.
  • Pregnant and Nursing Women:
    • Should be given to pregnant women only if clearly needed.
    • The effect on breast-fed infants is unknown; a risk-benefit assessment is necessary.
  • Neurological Disorders:
    • Guillain-Barré syndrome (GBS) has been reported in temporal relationship following administration.

Adverse Reactions

  • Very Common (>10%):
    • Injection site pain, induration, redness, and swelling.
    • Systemic reactions include headache, fatigue, malaise, and arthralgia.
  • Common (1-10%):
    • Fever, vomiting, diarrhea, anorexia, and rash.
  • Uncommon (<1%):
    • Serious allergic reactions, including anaphylaxis.
    • Seizures and thrombocytopenia.

Dosage and Administration

  • Recommended Dose:
  • Infants/Toddlers (9-23 months): Two doses of 0.5 mL, at least 3 months apart.
  • Persons (2-55 years): A single dose of 0.5 mL.
  • Administration: Intramuscular injection in the anterolateral aspect of the thigh for infants and in the deltoid muscle for older children, adolescents, and adults.

Storage and Stability

  • Storage Temperature: 2°C to 8°C (refrigeration).
  • Protection from Light: Store in the original package.
  • Do Not Freeze: Freezing destroys the vaccine.

Composition

  • Active Ingredients: 4 µg each of meningococcal A, C, Y, and W-135 polysaccharides conjugated to diphtheria toxoid protein.
  • Excipients: Sodium chloride, sodium phosphate (dibasic and monobasic), water for injection.

Clinical Trials and Immunogenicity

  • Immunogenicity Studies:
    • Evaluated in infants, toddlers, children, adolescents, and adults.
    • Induces bactericidal antibodies specific to the capsular polysaccharides of serogroups A, C, Y, and W-135.
    • Achieved high seroprotection rates across various age groups.

Special Populations and Conditions

  • Pediatrics: Safe and effective in pediatric patients.
  • Geriatrics: Not evaluated in adults over 55 years.
  • Immunocompromised Individuals: Limited data; may not achieve expected immune response.

Post-Marketing Experience

  • Additional adverse events have been reported, including lymphadenopathy, hypersensitivity reactions, Guillain-Barré syndrome, and large injection site reactions.
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Written By Paul Kim

Medical Director - APN, NSWOC, RNP

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