At what age should a child receive the Men C (Meningococcal Conjugate) vaccine if parents opt out at 2 months?

Meningococcal C Vaccine Timing for Children After Opting Out at 2 Months

If parents opt out of the Men C vaccine at 2 months, the child should receive this vaccine at 12 months of age according to Canadian and British Columbia guidelines. 1

Routine Meningococcal Vaccination Schedule

• Routine vaccination against meningococcal disease is not recommended for healthy children 2 months to 10 years of age unless they are at increased or persistent risk for meningococcal disease 1
• The standard recommendation is for children to receive the meningococcal C conjugate vaccine at 12 months of age in Canada, with some jurisdictions providing additional earlier doses 2
• Adolescents routinely receive a booster dose of serogroup C vaccine or a quadrivalent (serogroups A, C, W and Y) vaccine 2

Considerations for Children Who Missed the 2-Month Dose

• For healthy children who missed the 2-month dose, the appropriate time to receive the Men C vaccine is at 12 months of age 1
• This approach aligns with the Advisory Committee on Immunization Practices (ACIP) recommendations that do not routinely recommend meningococcal vaccines for healthy children 2 months to 10 years of age 1
• Research has shown that a single dose at 12 months produces robust immune responses, with all children achieving protective antibody levels after vaccination at this age 3, 4

Special Circumstances Requiring Earlier Vaccination

• Children at increased risk for meningococcal disease should start immunization for serogroup C as soon as possible after 2 months of age, rather than waiting until 12 months 2
• High-risk groups include children with:
  • Persistent complement component deficiencies 1
  • Anatomic or functional asplenia 1
  • Travel to regions where meningococcal disease is hyperendemic or epidemic 1
  • Exposure during a community outbreak 1

Vaccine Efficacy Considerations

• A single dose of meningococcal C conjugate vaccine at 12 months provides better long-term protection than early infant doses without boosting 5, 3
• Studies show that antibody persistence is limited when vaccination occurs only in early infancy, with 63% of children having insufficient protective antibodies approximately 2 years after a single early dose 5
• The 12-month dose induces stronger immunologic memory compared to earlier vaccination, which is important for long-term protection 6, 3

Booster Dose Requirements

• For healthy children who receive their Men C vaccine at 12 months, no additional booster doses are required until adolescence 1
• Adolescents should receive a booster dose at 11-12 years of age 1
• Children who remain at high risk for meningococcal disease after receiving their vaccine at 12 months may require additional booster doses according to their risk factors 1

Practical Considerations

• If parents initially opt out but later decide to vaccinate before 12 months, the vaccine can be administered at any point, with the understanding that the 12-month dose may still be recommended depending on the age at vaccination 1
• When administering a delayed Men C vaccine, ensure it doesn't interfere with other routine vaccinations scheduled at 12 months 1
• Different meningococcal conjugate vaccine products can be used interchangeably if the same product used previously is not available 1