Vaccines:

Indications for: MENACTRA

Meningitis immunization.

Clinical Trials:

Children 9 through 12 Months of Age

  • The approval was based on data from a randomized, multicenter US-trial which included children who received two doses of Menactra at 9 months and 12 months of age. The first Menactra dose was administered alone, followed by a second Menactra dose given alone, or with MMRV, or with PCV7. Sera was obtained approximately 30 days after the last vaccination for all participants. 

  • Findings showed that Menactra given 3 months apart elicited a robust immune response against the serogroups included in the vaccine. The studies also showed that the measles-mumps-rubella-varicella vaccine (MMRV) and pneumococcal conjugate vaccine (PCV7) can be administered concomitantly with Menactra in children.

  • Menactra was also evaluated when given to children at 12 months and 15 months of age. Prior to the first dose,  33.3% [n=16/48] of participants had a serum bactericidal assay with an exogenous human complement (SBA-H) titer ≥1:8 to Serogroup A, and 0-2% [n=0-1 of 50-51] to Serogroups C, Y and W-135. After the second dose, percentages of participants with an SBA-H titer ≥1:8 were: 85.2%, Serogroup A [n=46/54]; 100.0%, Serogroup C [n=54/54]; 96.3%, Serogroup Y [n=52/54]; 96.2%, Serogroup W-135 [n=50/52].

Individuals 2 through 55 Years of Age 

  • Approval was based on three comparative, randomized, US, multicenter, active-controlled clinical trials that included children (2 through 10 years of age), adolescents (11 through 18 years of age), and adults (18 through 55 years of age).  Participants received a single dose of Menactra (N=2526) or Menomune – A/C/Y/W-135 (N=2317). For all age groups studied, sera were obtained before and approximately 28 days after vaccination.

Immunogenicity in Children 2 through 10 Years of Age 

  • Of 1408 enrolled children 2 through 10 years of age, Menactra elicited comparable immune responses to Menomune A/C/Y/W-135 for all 4 serogroups.

  • In a subset of children 2 through 3 years of age with undetectable pre-vaccination titers, seroconversion rates were similar between Menactra and Menomune A/C/Y/W-135.

  • In a subset of children 4 through 10 years of age with undetectable pre-vaccination titers, seroconversion rates were similar between Menactra and Menomune A/C/Y/W-135.

Immunogenicity in Adolescents 11 through 18 Years of Age 

  • In a comparative clinical trial, 881 adolescents 11 through 18 years of age showed similar immune responses for all 4 serogroups between Menactra and Menomune A/C/Y/W-135.

  • In participants with undetectable pre-vaccination titers, seroconversion rates were similar between Menactra and Menomune A/C/Y/W-135.

Immunogenicity in Adults 18 through 55 Years of Age

  • In a comparative clinical trial, 2552 adults 18 through 55 years of age showed similar immune responses for all 4 serogroups between Menactra and Menomune A/C/Y/W-135.

  • In participants with undetectable pre-vaccination titers, seroconversion rates were similar between Menactra and Menomune A/C/Y/W-135.

Immunogenicity in Adolescents and Adults Following Booster Vaccination

  • Prior to revaccination, the percentage of participants (n=781) with an SBA-H titer ≥1:8 were 64.5%, 44.2%, 38.7%, and 68.5% for Serogroups A, C, Y and W-135, respectively. Among the subset of trial participants (n=112) for whom SBA-H responses at Day 6 were assessed, 86.6%, 91.1%, 94.6%, and 92.0% achieved a ≥4-fold rise in SBA-H titer for Serogroups A, C, Y and W-135, respectively. The proportions of participants (n=781) who achieved a ≥4-fold rise in SBA-H titer by Day 28 were 95.0%, 95.3%, 97.1%, and 96% for Serogroups A, C, Y and W-135, respectively. The proportions of participants who achieved an SBA-H titer ≥1:8 by Day 28 were >99% for each serogroup.

Adults and Children:

<9mos: not recommended. Give by IM inj only in deltoid region. Primary vaccination: 9–23mos: 0.5mL given as 2-dose series three months apart; 2–55yrs: 0.5mL once. Booster vaccination: 15–55yrs: may give a single (0.5mL) dose for those at continued risk, if at least 4yrs have elapsed since the prior dose.

MENACTRA Contraindications:

Severe allergic reaction to any previous meningococcal capsular polysaccharide-, diphtheria toxoid- or CRM197-containing vaccine.

MENACTRA Warnings/Precautions:

Have epinephrine inj (1:1000) available. History of Guillain-Barre syndrome. Immunosuppressed. Risk of syncope. Adults >55yrs old. Pregnancy. Nursing mothers.

MENACTRA Interactions:

Immunosuppressants (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, high-dose steroids) may get suboptimal response. Concomitant vaccines: see full labeling.

Adverse Reactions:

Inj site reactions, headache, fatigue, malaise, arthralgia, vomiting, diarrhea, anorexia, chills, fever, rash, irritability, drowsiness; children: also, abnormal crying.

Note:

To register pregnant patients or to report adverse events call (800) 822-2463. Refer to www.cdc.gov for ACIP guidelines on vaccinating acutely ill patients.

How Supplied:

Single-dose vials—5