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Immunizations - travel vaccinations - Management
What schedule is used for travellers who require meningitis (ACWY®) vaccination?
- For adults and children aged 1 year and older — vaccinate with quadrivalent meningococcal vaccine 2–3 weeks before travel.
- For children under 1 year of age — vaccinate with quadrivalent meningococcal vaccine 2 months before travel (two doses needed).
- Menveo® (conjugate vaccine) is preferred to ACWY Vax® (polysaccharide vaccine) for all age groups (off-label use in children under 11 years of age) because of better and longer lasting protection.
- Menveo®
- Primary immunization:
- For adults and children aged 1 year and older, give a single dose of vaccine.
- For children under 1 year of age, give two doses of vaccine, one month apart.
- Booster doses:
- Children who received their primary immunization as infants should be given an additional dose of Menveo® (with an interval of at least 12 months between completion of the primary course and the booster dose) if they remain at high risk.
- The need for booster doses in other age groups has yet to be determined, however it is likely to provide longer protection than ACWY Vax®.
- ACWY Vax®
- Primary immunization:
- For adults and children over 5 years old, give a single dose of vaccine.
- ACWY Vax® is no longer recommended for children under the age of 5 years.
- Booster doses:
- For adults and children over 5 years old, give a booster dose every 5 years to those at continued risk.
- Children who were under 5 years when first vaccinated should be given a booster dose (preferably with Menveo®) after 2–3 years if they remain at high risk.
Basis for recommendation
These recommendations are based on expert opinion from the medical literature [DH, 2010; NaTHNaC, 2010a].
- One dose of quadrivalent vaccine (ACWY Vax®) will elicit a protective response in over 90% of older children and adults within 2–3 weeks. In children below the age of 2 years, protection rates against serogroups C, W135, and Y are lower than against serogroup A, and antibodies decline more rapidly than in older children and adults. Immunity typically lasts for 5 years in adults before requiring a reinforcing dose. In children and infants (especially those under 2 years) immunity lasts for a shorter period, particularly against the group C strain.
- Although not yet licensed for use in children, the available data show a better antibody response to all serogroups after two doses of conjugate vaccine (Menveo®). Based on this, and experience with other conjugate vaccines, the Joint Committee on Vaccination and Immunization expect immunity to be higher, longer-lasting, and confer less risk of immunological tolerance than with the polysaccharide vaccine. For this reason, conjugate vaccine is recommended in preference to polysaccharide vaccine in all age groups, and particularly in children under 5 years of age.
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