At 12 years old, if a child has missed one dose of Pneumococcal Conjugate Vaccine (PCV), should it be given and can Meningococcal Conjugate Vaccine (MenACWY) be administered at the same time?

Pneumococcal Vaccination for a 12-Year-Old Missing One Dose with Concurrent MenACWY Administration

Yes, a 12-year-old child who is missing one dose of pneumococcal conjugate vaccine (PCV) should receive the missing dose, and MenACWY can be safely administered at the same time. 1, 2

PCV Catch-up Vaccination at Age 12

For a 12-year-old with an incomplete PCV vaccination history:

• The Advisory Committee on Immunization Practices (ACIP) recommends that children aged 6-18 years with certain high-risk conditions who have not received PCV13 previously should receive a single dose of PCV13 1
• For healthy children aged ≥5 years, routine PCV13 is not recommended 1
• However, if the child has any of these high-risk conditions, the missing PCV dose should be administered:
  • Anatomic or functional asplenia (including sickle cell disease)
  • Immunocompromising conditions (such as HIV infection)
  • Cochlear implant
  • Cerebrospinal fluid leaks 1

Concurrent Administration with MenACWY

The missing PCV dose can be administered at the same time as MenACWY:

• The CDC and ACIP explicitly state that meningococcal vaccines can be safely administered on the same day as other vaccines, including PCV, as long as they are given at different injection sites 2
• The FDA label for MenACWY states that in clinical trials, MenACWY was given concomitantly with other vaccines including pneumococcal conjugate vaccine with no immune interference observed 3
• Simultaneous administration of both vaccines increases the probability that a person will be fully immunized as recommended 2

Administration Guidelines

When administering both vaccines at the same visit:

• Use different injection sites to minimize local reactions 2
• Do not mix MenACWY or any of its components with PCV or any other vaccine in the same syringe or vial 3
• Document each vaccine in the patient's immunization record

Common Pitfalls to Avoid

1. Missing the opportunity for catch-up vaccination: At age 12, this may be one of the last routine healthcare visits where catch-up vaccination can be easily administered.

2. Unnecessarily separating vaccines: Separating vaccines into multiple visits can lead to missed opportunities for vaccination if the patient doesn't return.

3. Overlooking risk factors: Be sure to assess whether the child has any high-risk conditions that would make the PCV dose particularly important.

4. Incorrect documentation: Ensure proper documentation of both vaccines to prevent unnecessary future doses or missed doses.

By following these recommendations, you can ensure that the 12-year-old patient receives appropriate protection against both pneumococcal and meningococcal diseases while maximizing the efficiency of the healthcare visit.