Q: What are the new ACIP recommendations for use of MenHibrix, the new combination meningococcal Groups C and Y and Haemophilus influenzae type b vaccine?
A: In October 2012, ACIP voted to recommend that infants at increased risk for meningococcal disease be vaccinated with 4 doses of Hib-MenCY at age 2, 4, 6, and 12 through 15 months. This includes infants with recognized persistent complement pathway deficiencies and infants who have anatomic or functional asplenia, including sickle cell disease. You can find this in footnote #13 of the "Recommended Immunization Schedule for Persons Aged 0 Through 18 Years - United States, 2013". Hib-MenCY can be used in infants age 2 through 18 months who live in communities with serogroup C and Y meningococcal disease outbreaks.

Q: A 7-year-old who needed a tetanus shot for wound management came into our emergency department. My question is, if a child has received the complete 5-dose series of DTaP but has never had Tdap, should the child receive Tdap or Td for wound management?
A: Neither. A child who has completed 5 doses of DTaP has by definition received the fifth dose on or after his/her fourth birthday. In this child???s case, it has been less than four years since receipt of the complete series, so the child does not need either Tdap or Td. The child is fully vaccinated against tetanus according to CDC tetanus wound management guidelines.

Interesting Facts

 

The ACIP recommendations are that pregnant women receive Tdap vaccine during each pregnancy, even if they have received Tdap previously.

Women who have never received Tdap and who do not receive it during pregnancy should receive it immediately postpartum.

Licensed in June 2012, MenHibrix (Hib-MenCY; GSK) is a vaccine indicated for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroups C and Y and Haemophilus influenzae type b. This vaccine does not protect against meningococcal serogroups A, B, and W135.