Menactra is recommended and funded from 9 months of age for:

• Individuals who have previously had meningococcal disease of any group
• Close contacts of a meningococcal disease case of any group
• Adolescents and young adults aged 13–25 years inclusively who are entering within the next 3 months, or in their first year of living in a boarding school hostel, tertiary education halls of residence, military barrack, or prison
• Individuals pre- or post-splenectomy or with functional asplenia
• HIV-positive individuals
• Individuals with a complement deficiency
• Pre/post-solid organ transplantation
• Following stem cell/bone marrow transplantation
• Pre- and post-immunosuppression longer than 28 days

Conjugated meningococcal vaccine (Menactra, MenQuadfi or Nimenrix) is recommended but not funded for individuals:

• Infants and young children aged under 5 years, adolescents and young adults who do not meet the eligibility criteria listed above
• Who are laboratory workers regularly handling meningococcal cultures
• Who are travelling to high-risk countries or before the Hajj

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Storage and preparation

Store as per cold chain between 2°C to 8°C. Protect from light.

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Administration

Menactra can be administered at the same visit as other vaccines including vaccines on the national immunisation schedule except PCV13 (Prevenar 13). Where both Prevenar 13 and Menactra are to be given, administration of Menactra must be at least 4 weeks before or after a dose of Prevenar 13.

For:

Healthy infants and children aged 9–23 months

• Two doses three months apart
• If still at risk 3 years later - offer a booster dose

Healthy children aged 2 years to under 7 years

• One dose
• If still at risk 3 years later – offer a booster dose

Healthy children aged 7 years or over and adults

• One dose
• If still at risk 5 years later – offer a booster dose

Children aged 2 years to under 7 years with a medical condition that increases their risk of meningococcal disease

• Two doses eight weeks apart
• If still at risk 3 years later – offer a booster dose

Children aged 7 years or over and adults with a medical condition that increases their risk of meningococcal disease:

• Two doses eight weeks apart
• If still at risk 5 years later - offer a booster dose

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

Menactra should not be given to:

• Anyone with severe allergy (anaphylaxis) to a previous dose of this vaccine or other meningococcal vaccine, or a component of the vaccine
• Administration of Menactra 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. It may, in this situation only, be given subcutaneously
• Those with a history of Guillain-Barré Syndrome

Protection against meningococcal disease is dependent on an individual having adequate existing circulating protection provided by antibodies because the bacteria cause disease more quickly than the immune system can generate new protection. Immunisation generates circulating antibodies. Over time the antibody levels decrease. The number and quality of antibodies and how long they last depend on what type of vaccine is used, the meningococcal group(s) covered by the vaccine, and the age of the person receiving the vaccine.

As there are generally low numbers of meningococcal disease cases in countries such as Australia, England, Germany, New Zealand and the United States it is not possible to determine exactly how many cases of disease are prevented by vaccination and how long protection after vaccination lasts. Instead, the immune system response and antibody levels are used as an alternative measure of how well and how long meningococcal vaccines can protect from disease.

A case-control study in the US found that the overall vaccine effectiveness in adolescents was 69% up to 6 years after one dose of vaccine. Less than one year after vaccination, vaccine effectiveness was around 82% and at 3–6 years post vaccination, the vaccine was 59% effective in adolescents. Around 71-95% of adolescents, who received one dose Menactra between ages 11–18 years, had protective antibody levels three years later.

After two doses of Menactra, 96–100% of infants aged 9–12 months have protective antibodies against meningococcal groups A, C and Y and 86% have antibodies against group W-135.

Older children, adolescents and adults are expected to have at least five years protection after immunisation. Children aged 9–23 months at the time of their last Menactra immunisation are likely to have fewer years of protection but the exact period of time is not known.

A booster vaccination should be considered for individuals who remain at increased risk of meningococcal disease:

• For children aged 9–23 months when they received their second Menactra dose consider a booster vaccination after three years
• For children aged 2 years to under 7 years consider a booster vaccination after three years
• For children aged 7 years or older and adults consider a booster vaccination after five years

• Cohn AC, et al. Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMRW 2013; 62(RR02); 1-22 22 March [accessed October 2016] Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm
• Institute of Environmental Science and Research Ltd. Meningococcal disease quarterly report Jan - Dec 2019. Porirua: Institute of Environmental Science and Research Ltd (ESR); 2020.
• Lopez L, Sherwood J. The epidemiology of meningococcal disease in New Zealand 2013. Wellington: Institute of Environmental Science and Research Ltd (ESR); 2014. Report No.: FW14023.
• MacNeil et al. Use of MenACWY-CRM Vaccine in Children Aged 2 Through 23 Months at Increased Risk for Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2013. MMRW 2014 63:27 p527-530.
• Medsafe. New Zealand data sheet: Menactra [Internet]. Wellington: New Zealand Medicines and Medical Devices Safety Authority; 2012 [updated 2018 July 5; cited 2021 August 13]. Available from: https://www.medsafe.govt.nz/profs/Datasheet/m/menactrainj.pdf
• Ministry of Health. Immunisation handbook [Internet]. Wellington: Ministry of Health; 2020 [updated 2021 June 23; cited 2021 August 13]. Available from: https://www.health.govt.nz/publication/immunisation-handbook-2020
• PHARMAC. Community Pharmaceutical Schedule [Internet]. Wellington:PHARMAC. 2021 [cited 13 August 2021]. Available from: https://pharmac.govt.nz/pharmaceutical-schedule/community-section-b/