The U.S. Advisory Committee on Immunization Practices has recommended administration of the quadrivalent conjugated polysaccharide meningococcal vaccine (Menactra – Sanofi Pasteur) to all persons 11 to 18 years old, particularly those entering high school and college freshmen living in dormitories.1,2 The peak incidence of meningococcal disease, after early childhood, occurs in the 15-19 year-old age group. The conjugate vaccine is more immunogenic than the meningococcal capsular polysaccharide vaccine (Menommune – Sanofi Pasteur).

ADVERSE EFFECTS — The most common adverse reactions with the conjugate vaccine have been headache, fatigue and malaise, in addition to pain, redness and induration at the injection site. Guillain-Barré syndrome has occurred rarely.3

CONCLUSION — Previously unvaccinated children starting high school or going away to college this fall should receive a single dose of meningococcal conjugate vaccine (Menactra).

1. Centers for Disease Control and Prevention (CDC). Advisory Committee on Immunization Practices. Revised recommendations of the Advisory Committee on Immunization Practices to vaccinate all persons aged 11-18 years with meningococcal conjugate vaccine. MMWR Morb Mortal Wkly Rep 2007; 56:794.
2. Menactra: a meningococcal conjugate vaccine. Med Lett Drugs Ther 2005; 47:29.
3. Centers for Disease Control and Prevention (CDC). Update: Guillain-Barre syndrome among recipients of Menactra meningococcal conjugate vaccine — United States, October 2005-February 2006. MMWR Morb Mortal Wkly Rep 2006; 55:364.

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Annual immunization against influenza A and B is the most effective method of preventing infection and has been shown to reduce associated complications. A future issue of The Medical Letter will review drug prophylaxis and treatment of influenza.