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#Update: Increase in #Human #Infections with #Avian #Influenza #H7N9 Viruses During the 5th #Epidemic — #China, Oct. ‘16–Aug. 7 ‘17 (@CDCgov, edited)

Title : #Update: Increase in #Human #Infections with #Avian #Influenza #H7N9 Viruses During the 5th #Epidemic — #China, Oct. ‘16–Aug. 7 ‘17....

3 Nov 2016

#Recommendations for Use of #Meningococcal Conjugate #Vaccines in #HIV-Infected #Persons — #ACIP, 2016 (@CDCgov, MMWR)

 

Title: #Recommendations for Use of #Meningococcal Conjugate #Vaccines in #HIV-Infected #Persons — #ACIP, 2016.

Subject: HIV/AIDS, meningococcal vaccination recommendations.

Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract.

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Recommendations for Use of Meningococcal Conjugate Vaccines in HIV-Infected Persons — Advisory Committee on Immunization Practices, 2016

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Weekly / November 4, 2016 / 65(43);1189–1194

Format: [ PDF [99 KB] ]

Jessica R. MacNeil, MPH1; Lorry G. Rubin, MD2; Monica Patton, MD1; Ismael R. Ortega-Sanchez, PhD3; Stacey W. Martin, MS1

 

Summary

  • What is currently recommended?
    • The Advisory Committee on Immunization Practices (ACIP) currently recommends routine vaccination with meningococcal conjugate vaccine for all adolescents and for certain groups of persons at increased risk for meningococcal disease:
      • persons who have persistent complement component deficiencies;
      • persons who have anatomic or functional asplenia;
      • microbiologists who routinely are exposed to isolates of Neisseria meningitidis;
      • persons identified to be at increased risk because of a meningococcal disease outbreak attributable to serogroup A, C, W, or Y;
      • military recruits;
      • first-year college students living in residence halls; and
      • persons who travel to or reside in areas in which meningococcal disease is hyperendemic or epidemic.
    • In addition, ACIP recommends routine vaccination with serogroup B meningococcal (MenB) vaccine for:
      • persons who have persistent complement component deficiencies;
      • persons who have anatomic or functional asplenia;
      • microbiologists who routinely are exposed to isolates of N. meningitidis; and
      • persons identified to be at increased risk because of a serogroup B meningococcal disease outbreak.
  • Why are the recommendations being modified now?
    • A growing body of evidence supports an increased risk for meningococcal disease in human immunodeficiency virus (HIV)–infected persons.
    • The evidence supporting the use of meningococcal conjugate vaccines in HIV-infected persons was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework.
  • What are the new recommendations?
    • All HIV-infected persons aged ≥2 months should routinely receive meningococcal conjugate vaccine;
    • children aged <2 years should be vaccinated using a multidose schedule.
    • Persons aged ≥2 years with HIV who have not been previously vaccinated should receive a 2-dose primary series of meningococcal conjugate vaccine.
    • Persons with HIV who have been previously vaccinated with meningococcal conjugate vaccine should receive a booster dose at the earliest opportunity (at least 8 weeks after the previous dose) and then continue to receive boosters at the appropriate intervals.
    • If the most recent dose was received before age 7 years, a booster dose should be administered 3 years later.
    • If the most recent dose was received at age ≥7 years, a booster should be administered 5 years later and every 5 years thereafter throughout life.

 

Abstract

At its June 2016 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of meningococcal conjugate vaccine (serogroups A, C, W, and Y; including MenACWY-D [Menactra, Sanofi Pasteur] or MenACWY-CRM [Menveo, GlaxoSmithKline]) for persons aged ≥2 months with human immunodeficiency virus (HIV) infection. ACIP has previously recommended routine vaccination of persons aged ≥2 months who have certain medical conditions that increase risk for meningococcal disease (1), including persons who have persistent (e.g., genetic) deficiencies in the complement pathway (e.g., C3, properdin, Factor D, Factor H, or C5–C9); persons receiving eculizumab (Soliris, Alexion Pharmaceuticals) for treatment of atypical hemolytic uremic syndrome or paroxysmal nocturnal hemoglobinuria (because the drug binds C5 and inhibits the terminal complement pathway); and persons with functional or anatomic asplenia (including persons with sickle cell disease). Routine vaccination with meningococcal conjugate vaccine is also recommended for all healthy adolescents in the United States (1). This report summarizes the evidence considered by ACIP in recommending vaccination for HIV-infected persons, and provides recommendations and guidance for use of meningococcal conjugate vaccines (serogroups A, C, W, and Y) among HIV-infected persons aged ≥2 months; the majority of meningococcal disease among HIV-infected persons is caused by these four serogroups.

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Keywords: US CDC; USA; Updates; HIV/AIDS; Meningococcal Disease; Vaccines.

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