What is the recommended Menactra (meningococcal conjugate vaccine) schedule for routine immunization and for individuals at increased risk?

Menactra Vaccination Schedule

For routine immunization, administer Menactra as a single dose at age 11-12 years, followed by a booster dose at age 16 years. 1

Routine Immunization Schedule

Adolescents (11-18 years)

• Primary vaccination: Single 0.5 mL intramuscular dose at age 11-12 years 1, 2
• Booster dose: Single dose at age 16 years if the first dose was administered before the 16th birthday 1
• Catch-up vaccination: May be administered to persons aged 19-21 years who have not received a dose after their 16th birthday 1

College Freshmen

• College freshmen living in residence halls should receive at least 1 dose of MenACWY within 5 years before college entry, with preferred timing on or after their 16th birthday 1
• If only 1 dose was administered before the 16th birthday, a booster dose should be administered before enrollment 1
• Adolescents who received a first dose after their 16th birthday do not need another dose before college entry unless it has been more than 5 years since the dose 1

High-Risk Populations Schedule

Infants and Young Children (9-23 months)

• Primary series: Two 0.5 mL doses administered 3 months apart 2
• First dose at 9 months, second dose at 12 months 2

Children and Adults with High-Risk Conditions (≥2 years)

For persons with persistent complement deficiencies, complement inhibitor use, anatomic or functional asplenia, or HIV infection: 1

Ages 2-9 years:

• Primary vaccination: Two doses administered ≥8 weeks apart 1
• Booster doses (if person remains at increased risk):
  • If aged <7 years: Single dose at 3 years after primary vaccination, then every 5 years thereafter 1
  • If aged ≥7 years: Single dose at 5 years after primary vaccination, then every 5 years thereafter 1

Ages ≥10 years:

• Primary vaccination: Two doses administered ≥8 weeks apart 1
• Booster doses (if person remains at increased risk): Single dose at 5 years after primary vaccination, then every 5 years thereafter 1

Adults (24-55 years)

• Not routinely recommended except for persons at increased risk for meningococcal disease 1
• Booster vaccination: A single booster dose may be given to individuals 15-55 years of age at continued risk if at least 4 years have elapsed since the prior dose 2

Administration Details

• Route: Intramuscular injection only 2
• Dose volume: 0.5 mL 2
• Do not administer intravenously or subcutaneously 2
• Interchangeability: MenACWY vaccines (Menactra, Menveo, MenQuadfi) are interchangeable 1

Important Clinical Considerations

Contraindications

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose of a meningococcal capsular polysaccharide-, diphtheria toxoid-, or CRM197-containing vaccine 2
• Severe allergic reaction to any component of Menactra 2

Special Precautions

• Guillain-Barré syndrome (GBS): Persons previously diagnosed with GBS may be at increased risk following Menactra receipt; weigh benefits versus risks 2
• Immunocompromised individuals: May have reduced immune responses to Menactra 2
• Complement deficiency: Persons with complement deficiencies or receiving complement inhibitors remain at increased risk for invasive meningococcal disease even after vaccination 2

Common Pitfalls to Avoid

• Do not confuse the routine adolescent schedule (single dose at 11-12 years) with the high-risk schedule (two-dose primary series) 1
• Remember that Menactra does not protect against serogroup B meningococcal disease 2
• For children 9-23 months, ensure the two doses are spaced 3 months apart, not closer 2
• Booster doses for high-risk individuals require repeated dosing every 5 years (or 3 years if <7 years old), not just a single booster 1