What are the recommendations for administering Menveo (Meningococcal conjugate vaccine) to a 65-year-old male with potential risk factors for meningococcal disease?

Menveo Administration for a 65-Year-Old Male

Menveo is NOT recommended for routine use in a 65-year-old male, as it is FDA-licensed only for ages 11-55 years; however, if this patient has specific high-risk conditions (complement deficiency, asplenia, microbiologist exposure, or travel to endemic areas), the meningococcal polysaccharide vaccine (MPSV4) should be used instead. 1

Age-Based Licensing Restrictions

• Menveo (MenACWY-CRM) received FDA licensure as a single 0.5 mL intramuscular dose specifically for persons aged 11-55 years only 1
• The ACIP explicitly states that persons aged >55 years should receive MPSV4 (meningococcal polysaccharide vaccine), not conjugate vaccines like Menveo 1
• At age 65, this patient falls outside the approved age range by a full decade 1

Risk-Based Vaccination Decision Algorithm

Step 1: Assess if the patient has ANY high-risk indication for meningococcal vaccination:

• Microbiologist with routine exposure to Neisseria meningitidis isolates 1
• Travel to or residence in countries where meningococcal disease is hyperendemic or epidemic 1
• Persistent complement component deficiencies 1
• Anatomic or functional asplenia 1

Step 2: If NO high-risk conditions exist:

• Do not administer any meningococcal vaccine 1
• Meningococcal vaccination is not routinely recommended for healthy adults over age 55 1

Step 3: If high-risk conditions ARE present:

• Administer MPSV4 (quadrivalent meningococcal polysaccharide vaccine), NOT Menveo 1
• MPSV4 is the preferred vaccine for all persons aged >55 years, regardless of risk factors 1

Administration Details (If MPSV4 is Indicated)

• MPSV4 contains the same four serogroups (A, C, Y, W-135) as Menveo but uses polysaccharide technology rather than conjugate technology 1
• Single 0.5 mL dose administered intramuscularly 1
• For ongoing high-risk exposure, revaccination every 5 years may be considered 1

Critical Pitfalls to Avoid

• Do not use Menveo off-label in patients >55 years when MPSV4 is the guideline-recommended vaccine for this age group 1
• The superior immunogenicity of conjugate vaccines in younger populations does not translate to approval or recommendation for older adults 1, 2
• Administering Menveo to a 65-year-old would constitute off-label use without supporting evidence for safety or efficacy in this age group 1
• If the patient received Menveo before age 56 and requires revaccination at age 65, switch to MPSV4 for the booster dose 1

Contraindications

• Severe allergic reaction (anaphylaxis) to any previous dose of Menveo, CRM197, diphtheria toxoid, or any meningococcal-containing vaccine 1
• These contraindications would also apply to MPSV4 if the patient has history of severe reaction to meningococcal polysaccharide components 1