Men-C Vaccine Deferral Recommendations in Canada
If the meningococcal C conjugate vaccine (Men-C) is deferred at 2 months, it should be administered at 12 months of age according to Canadian and British Columbia Guidelines, with a subsequent booster dose during adolescence.
Routine Vaccination Schedule for Men-C in Canada
The standard Men-C vaccination schedule in Canada includes:
- Primary dose: All Canadian children should receive a conjugate meningococcal C vaccine (MCV-C) at 12 months of age 1
- Booster dose: Either a booster dose of MCV-C or quadrivalent meningococcal vaccine (MCV-4) during adolescence 1, 2
Recommendations for Deferred Vaccination
When the initial 2-month Men-C vaccination is deferred:
- The vaccine should be administered at 12 months of age as this is the standard age for routine Men-C vaccination in most Canadian provinces 1
- This approach is supported by evidence showing that a single dose at 12 months provides adequate protection 3
Evidence Supporting 12-Month Administration
Research demonstrates that the 12-month dose provides effective protection:
- A Canadian study showed that all subjects achieved protective antibody titers after receiving the Men-C dose at 12 months, regardless of prior vaccination history 3
- While infants who had received prior doses maintained higher antibody levels before the 12-month dose, all groups achieved protection after the 12-month vaccination 3
Adolescent Booster Requirements
Following the 12-month primary dose, an adolescent booster is still required:
- Canadian guidelines recommend a booster dose of either MCV-C or quadrivalent meningococcal vaccine during adolescence (typically around age 12) 1, 2, 4
- This booster is necessary because immunity may wane over time 5
Special Considerations
- High-risk infants: Children at high risk for invasive meningococcal disease should start MCV-C at 2 months of age and should not defer vaccination 1, 2
- Catch-up vaccination: For children who missed their 12-month dose, catch-up vaccination should be administered as soon as possible 6
Potential Pitfalls and Caveats
- Deferring the 2-month dose is generally acceptable for healthy infants but not for high-risk infants
- Parents should be counseled that deferring to 12 months leaves the infant without specific protection during the first year of life
- Ensure that the deferred vaccination is not forgotten and is properly documented in the child's immunization record
- The same vaccine product should be used for all doses in a series when possible 7
By following these recommendations, healthcare providers can ensure appropriate protection against meningococcal disease while accommodating parents' requests to defer the 2-month vaccination.