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Nimenrix

Common name:

MCV4-T, quadrivalent meningococcal conjugate vaccine

Protects against meningococcal disease caused by Neisseria meningitidis groups A, C, Y and W (previously W135).

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Overview

Meningococcal disease is caused by the bacteria Neisseria meningitidis. There are several groups of this disease, including groups A, B, C, W, X and Y. The pattern of disease caused by each group varies by time and country or geographical areas.

A specifically designed ‘epidemic’ vaccine, called MenNZB™ was introduced in 2004 during an epidemic of group B meningococcal disease in New Zealand. MeNZB was not meant for long term use and was specific to New Zealand. The vaccine was withdrawn once the rate of disease was significantly reduced.

In recent years, polysaccharide type of meningococcal vaccines have generally been replaced by conjugate meningococcal vaccines. These have the advantage of generating long term memory and can be administered to children under 2 years of age. These conjugated meningococcal vaccines protect against either groups A, C, W and Y or group C disease only. Currently in New Zealand, there is no vaccine available against meningococcal group B, but a new vaccine has recently been introduced in some other countries, including Australia.

Some meningococcal vaccines are funded on the national immunisation schedule for special groups at high risk from this disease.

Nimenrix™ is not funded. It is available for purchase for individuals from 12 months of age for whom meningococcal immunisation is recommended but not funded.

Responses to vaccine

Nimenrix (MCV4-T)

Common Responses

  • Mild pain, redness and swelling around injection site
  • Fever
  • Children:
    • Irritability
    • Drowsiness
    • Decreased appetite
  • Adults:
    • Headache
    • Fatigue
    • Nausea, vomiting and/or diarrhoea

Rare Responses

  • Extensive limb swelling

As with any medicine, very rarely a severe allergic reaction (anaphylaxis) can occur following immunisation.

References

 

In Depth

Other brands:

Meningococcal A, C, Y, W conjugate vaccine:

  • Menactra®

Meningococcal C only conjugate vaccine:

  • NeisVac-C®

Vaccine type: subunit conjugate

Schedule and administration

Nimenrix™ is not funded in New Zealand but is available for purchase.

Conjugated meninigicoccal vaccine is recommended, but not funded, for individuals:

  • who are laboratory workers regularly handling meningococcal cultures
  • who are travelling to high-risk countries or before the Hajj
  • ​who are adolescents and young adults living in communal accommodation (eg, in a hostel or at boarding school, in military accommodation, in correctional facilities or in other long-term institutions).

Special groups

Nimenrix is not funded for any special groups.

Catch-up doses

Not relevant

Storage and preparation

Store the lyophilised vaccine as per cold chain between 2°C to 8°C. Protect from light. The sterile 0.9% saline diluent may be refrigerated or stored at room temperature, but must not be frozen.

Nimenrix must be reconstituted by adding the entire contents of the pre-filled syringe of solvent to the vial containing the powder. After the addition of the solvent to the powder, the mixture should be well shaken until the powder is completely dissolved. The reconstituted vaccine is a clear colourless solution. After reconstitution, the vaccine should be used promptly. Although delay is not recommended, stability has been demonstrated for 8 hours at 30°C after reconstitution. If not used within the 8 hours, do not administer the vaccine.

Administration

Nimenrix can be administered at the same visit as other vaccines including all vaccines on the national immunisation schedule. If not administered on the same day a minimum interval of 4 weeks is required between any tetanus-containing vaccines and Nimenrix. Separate syringes and different injection sites should be used.

The vaccine is for intramuscular injection only, preferably in the deltoid muscle. In children 12 to 23 months of age, the vaccine should be administered in the vastus lateralis. Under no circumstances should Nimenrix be administered intravascularly, intradermally or subcutaneously. Advice regarding administration of booster vaccinations is limited.

  • Protection against meningococcal group A disease wanes quickly over the first year after immunisation with Nimenrix. Where protection against meningococcal A disease is most important a booster dose of Nimenrix could be considered one year after the previous dose
  • Protection against meningococcal groups C, Y, and W135, wanes more slowly than protection against meningococcal group A disease after immunisation with Nimenrix. A booster dose of Nimenrix could be considered for children vaccinated as toddlers, five years after the previous dose if they continue to be at increased risk of meningococcal disease

Vaccine safety

More than 20 years of studies and safety monitoring have shown that both the conjugate and polysaccharide meningococcal vaccines have excellent safely profiles.

Nimenrix should not be given to:

  • Anyone with severe allergy (anaphylaxis) to a previous dose of a meningococcal vaccine or a component of the vaccine
  • Administration of Nimenrix vaccine should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation

Specialist advice should be sought for the following groups:

  • Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions

Vaccine effectiveness

Nimenrix generates long term memory cells and a booster immunisation will rapidly generate more circulating protection years later.

In children, adolescents and adults:

  • Protection against disease caused by meningococcal group A decreases quickly over the first year after immunisation
  • Protection against disease caused by meningococcal groups C, Y, and W135 is expected to last at least five years after immunisation

The following table shows the percentage of individuals with protective levels of circulating antibodies against meningococcal groups A, C, Y and W-135 one month after a single dose of Nimenrix. For children aged 12-23 months the response to meningococcal group C in Nimenrix is compared with the response to a single dose of Meningitec (meningococcal C conjugate vaccine). For individuals aged two years and over the response to Nimenrix is compared with the response to a single dose of Menomune (meningococcal ACYW-135 polysaccharide vaccine)

 

Meningococcal group

Nimenrix

Comparison with Mencevax

Comparison with Meningitec

         

12—23 months

A

98%

--

--

 

C

97%

--

98%

 

Y

97%

--

--

 

W

98%

--

--

2—10 years

A

89%

64%

--

 

C

96%

89%

--

 

Y

92%

68%

--

 

W

97%

82%

--

11—17 years

A

85%

77%

--

 

C

97%

96%

--

 

Y

93%

78%

--

 

W

96%

87%

--

18—55 years

A

80%

69%

--

 

C

91%

92%

--

 

Y

87%

78%

--

 

W

90%

85%

--

 

    Last updated: Jun 2018