Can Menactra Be Given to a Patient with Acute DVT?
Yes, Menactra (meningococcal conjugate vaccine) can be safely administered to a patient with acute deep vein thrombosis, as acute DVT is not a contraindication to vaccination with this inactivated vaccine.
Contraindications to Menactra
The only absolute contraindications to Menactra administration are 1:
- Severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine
- Severe allergic reaction to diphtheria toxoid or any meningococcal-containing vaccine
- Severe allergic reaction to CRM197 (the carrier protein)
Why Acute DVT Is Not a Contraindication
Menactra is an inactivated vaccine that does not contain live organisms and therefore poses no increased thrombotic risk 1. The ACIP guidelines explicitly state that inactivated vaccines like meningococcal conjugates can be administered to persons with various medical conditions without restriction 1.
No documented association exists between meningococcal conjugate vaccines and venous thromboembolism in the extensive safety data from clinical trials and post-licensure surveillance 1, 2. The vaccine has been administered to millions of individuals worldwide with an acceptable safety profile 2.
Clinical Management Approach
Proceed with Vaccination If Indicated
Administer Menactra if the patient meets routine indications (age 11-55 years for routine adolescent vaccination, or high-risk groups including college freshmen, military recruits, travelers to endemic areas, or persons with complement deficiencies or asplenia) 1.
Continue therapeutic anticoagulation for the acute DVT without interruption, as vaccination does not interfere with anticoagulant therapy 1.
Precautions During Administration
Observe for syncope for 15 minutes post-vaccination, especially in adolescents, as this is the most common adverse event requiring intervention 1.
Use intramuscular injection in the deltoid region as indicated, which does not increase bleeding risk in anticoagulated patients 1.
Common Pitfalls to Avoid
Do not delay medically indicated vaccination due to concurrent acute DVT, as this represents an unnecessary barrier to protection against invasive meningococcal disease, which carries 10-14% mortality 1.
Do not confuse vaccine-induced immune thrombotic thrombocytopenia (VITT) seen with certain COVID-19 vaccines with standard meningococcal conjugate vaccines—this phenomenon has not been reported with Menactra 3, 4.
Do not withhold vaccination based on anticoagulation status alone, as minor acute illness (including acute DVT being managed) should not defer vaccination unless the patient has moderate-to-severe systemic illness requiring hospitalization 1.