The college dormitory population is well-recognized for its risk for fatal meningococcal sepsis and as a target for inoculation, but other populations are also susceptible. Persons born with deficiencies in the complement pathway are at 10,000-times greater risk than the general population for a meningococcal infection. A newer medication that targets the terminal complement pathway—eculizumab (binds to C5), used to treat paroxysmal nocturnal hemoglobinuria—renders the recipient even more susceptible to meningococcal infections. People who have had the spleen removed, those with sickle cell disease, professionals (eg, microbiologists) who work with Neisseria meningitides and individuals inadvertently exposed to the bacterium are also at serious risk and should receive vaccine coverage.1,2
Six of 12 meningococcal serotypes (A, B, C, W, X, and Y) are responsible for the majority of infections. The 2 major vaccine types target serotypes A, C, W, Y (quadrivalent [MenACWY]) and serotype B (MenB).2
Current US meningococcal vaccination recommendations are: A quadrivalent vaccine should be given at age 11-12 years with revaccination at age 16 years. Because of the “college dormitory” risk, if a first-year student has not received a quadrivalent dose at age 16 or after, it should be given before they begin school.1,2
Since serogroup B is responsible for 40% of US cases, its use may be considered (not required) in the usual at-risk groups including college students living in close quarters.
A few questions will let you apply what you know about the vaccine and the N. meningitides infection.
1. CDC Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule United States - 2016 Adult Schedule. http://www.cdc.gov/vaccines/schedules/hcp/adult.html
Recommended Adult Immunization Schedule United States – 2016 PDF
2. Crum-Cianflone N, Sullivan E. Meningococcal vaccinations. Infect. Dis. Ther. 2016; 5:89-112. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929086/
3. Viens L J, Henley SJ, Watson M, et al. Human papilloma-associated cancers—United States, 2008-2012. Morbidity and Mortality Weekly Report (MMWR) 2016;65;661–666. http://www.cdc.gov/mmwr/volumes/65/wr/mm6526a1.htm
4. CDC Vaccine Safety. Specific Vaccines Human Papillomavirus (HPV) Vaccine Safety Frequently Asked Questions about HPV Vaccine Safety. http://www.cdc.gov/vaccinesafety/vaccines/hpv/hpv-safety-faqs.html
5. Petrosky E, Bocchini JA, Hariri S. Use of 9-valent human papillomavirus (HPV) vaccine: Updated HPV vaccination recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report (MMWR) 2015; 64: 300-304. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm
6. CDC. Vaccine information for adults. HIV Infection and Adult Vaccination. http://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/hiv.html
7. CDC. VIS Home. HPV (Human Papillomavirus) Cervarix® VIS. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-cervarix.html