Meningococcal A, C, W135 and Y conjugate vaccine

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Menveo (CSL)
vials containing powder for reconstitution
Approved indication: prevention of meningococcal disease
Australian Medicines Handbook section 20.1

Meningococcal disease is caused by the Gram-negative bacterium Neisseria meningitidis.The most prevalent disease-causing serogroups are A, B, C, W₁₃₅ and Y. Asymptomatic carriage of meningococci in the upper respiratory tract is relatively common, but occasionally the bacteria invade and cause septicaemia and meningitis. Infection can be rapid and fatal and mainly affects children under two years. However, there is also a peak of incidence in adolescents associated with increased carriage rates.

Currently in Australia there are two types of meningococcal vaccine – meningococcal C conjugate vaccines and polysaccharide vaccines. The conjugate vaccines consist of serogroup C polysaccharide conjugated to a carrier protein. These vaccines are immunogenic in babies and are given from two months of age. However, they only protect against serogroup C disease. The polysaccharide vaccines contain serogroups A, C, W₁₃₅ and Y, but because they are not conjugated to protein they may only protect for a short duration, do not induce immunological memory and are relatively ineffective in young children.

This new vaccine is a quadrivalent conjugate vaccine containing oligosaccharides from serogroups A, C, W₁₃₅ and Y individually attached to Corynebacterium diphtheriae CRM₁₉₇ protein. In a clinical trial of people aged 11 and over, one intramuscular dose of the vaccine was immunogenic and seemed to be non-inferior to a similar conjugate vaccine (Menactra).¹In another trial of 11–17 year olds, the vaccine seemed to be comparable to a quadrivalent polysaccharide vaccine (Menomune).²Adverse events were generally mild and included injection-site reactions, headache, nausea and malaise.

Based on immunological data, this vaccine should protect against meningococcal infections caused by serogroups A, C, W₁₃₅ and Y. However, it is important to remember that it will not prevent serogroup B disease. The vaccine is currently only indicated for people aged 11 years or older. The US Food and Drug Administration has requested additional safety data in infants before considering approval in this age group.

manufacturer provided additional useful information

The Transparency Score ( ) is explained in New drugs: transparency', Vol 37 No 1, Aust Prescr 2014;37:27.