Every year in the United States, approximately 2,600 people are infected with meningococcus, a potentially fatal bacterial infection transmitted through direct contact with large droplet respiratory secretions from patients or asymptomatic carriers. Research indicates that 10-15% of people infected die from the disease. Of those that survive, 11-19% sustain permanent disabilities. The highest incidence of meningococcal disease occurs in infants less than 1 year of age. In children between 2 and 10 years of age, the incidence is very low, but starting in adolescence, the incidence of disease rises. Although adolescents are less likely to be infected than infants, they are more likely to die when infected.

Mercy Clinics, Inc. endorses the following recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding meningococcal vaccine administration:

1. Meningococcal conjugate vaccine (MCV4*) will be routinely administered to:
   • Young adolescents 11-12 years of age
   • Adolescents at high school entry or 15 years of age (whichever comes first) if they had not previously received the MCV4 vaccination as an effective strategy to reduce meningococcal disease incidence among adolescents and young adults
   • All college freshmen living in dormitories
2. MCV4 is also recommended for other people at increased risk for meningococcal disease including:
   • Military recruits
   • Travelers to areas with high rates of meningococcal disease
   • Patients with anatomic or functional asplenia
   • Patients with terminal complement deficiency
   • Microbiologists routinely exposed to N. meningitdis
3. MCV4 is the preferred vaccine for people ages 11-55 in the above high-risk groups, but MPSV4** (Meningococcal polysaccharide vaccine) can be used if and when MCV4 is not available. 
4. MPSV4 should be used for children 2-10 years old, and adults over 55, who are in the above high-risk groups.
5. Other adolescents, college students, and persons with human immunodeficiency virus who wish to decrease their risk for meningococcal disease may elect to receive the vaccine.

 *=MCV4 brand name Menactra

 **=MPSV4 brand name Menomune

Reference:  CDC. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2005, 54 (RR07): 1-31.

Variation from this guideline is always acceptable if in the opinion of the attending physician individual circumstances require it.

MCI Quality Committee 12-20-05