meningococcal polysaccharide diphtheria toxoid conjugate vaccine

meningococcal polysaccharide diphtheria toxoid conjugate vaccine

(me-nin-go-kok-al poli-sak-a-ride vax-seen) ,

Menactra

(trade name),

Menveo

(trade name)

Classification

Therapeutic: vaccines immunizing agents
Pharmacologic: antigens
Pregnancy Category: C

Indications

Active immunization to prevent against invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135.

Action

Induces production of antibodies to several pathologic serogroups of Neisseria meningitidis.

Therapeutic effects

Prevention of invasive meningococcal disease.

Pharmacokinetics

Absorption: Well absorbed from IM sites.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile (antibody presence)

ROUTEONSETPEAKDURATION
IMunknown4 wkunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to meningoccal polysaccharide, diphtheria toxoid or latex; Bleeding disorders (hemophilia, thrombocytopenia, concurrent anticoagulants), unless precautions are taken; Latex allergy (stopper contains latex).
Use Cautiously in: Guillain-Barré syndrome Obstetric: Use only if clearly needed (pregnancy registry participation recommended) use cautiously during lactation; Lactation: Effect on infant unknown; Pediatric: Children <9 mo (safety not established); Geriatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • irritability (Menveo) (most frequent)
  • fatigue
  • headache
  • malaise
  • syncope (Menveo)

Gastrointestinal

  • diarrhea (Menveo) (most frequent)
  • anorexia
  • vomiting (Menveo)

Local

  • pain at injection site (most frequent)
  • induration
  • redness
  • swelling

Musculoskeletal

  • arthralgia

Respiratory

  • apnea in premature infants (Menveo)

Miscellaneous

  • anaphylaxis (menveo) (life-threatening)
  • chills
  • Guillain Barre Syndrome

Interactions

Drug-Drug interaction

Immunosuppressants, antineoplastics, or radiation therapy may ↓ antibody response to and ↑ risk of adverse reactions from vaccines.May ↓ response to pneumococcal vaccine when concurrently administered

Route/Dosage

Menactra

Intramuscular (Adults and Children 2–55 yr) 0.5 mL single dose
Intramuscular (Children 9–23 mo) 0.5 mL initially, then 0.5 mL 3 mo later

Menveo

Intramuscular (Adults and Children 11–55 yr) 0.5 mL single dose
Intramuscular (Children 2–10 yr) 0.5 mL single dose; if patients 2–5 yr are at continued high risk for meningococcal disease, may administer another dose at 2 mo after the first dose
Intramuscular (Children 7–23 mo) 0.5 mL initially, then 0.5 mL in the second yr of life and ≥3 mo after the first dose
Intramuscular (Children 2 mo) 0.5 mL administered at 2, 4, 6, and 12 mo of age

Availability

Solution for IM injection: 0.5 mL/vial

Nursing implications

Nursing assessment

  • Review patient's immunization history for contraindications and history of sensitivity to vaccine, a similar vaccine, or latex. Stopper of Menactra vial contains dry natural latex, which may cause allergic reactions in latex-sensitive patients.
  • Monitor patient receiving Menveo for at least 15 min following injection for syncope or allergic reactions.

Potential Nursing Diagnoses

Risk for infection (Indications)

Implementation

  • Do not confuse Menactra with Menomune (meningococcal polysaccharide vaccine).
  • Record date, lot number, and manufacturer of vaccine as part of immunization record.
  • Intramuscular: Menactra: Administer as a single IM dose, preferrably in deltoid. Do not administer IV, subcutaneously, or intradermally. Inspect solution prior to administration. Do not administer if solution is discolored or contains particulate matter. Do not mix with other vaccines. If administered concurrently with other vaccines, administer a in different sites.
    • Menveo: Combine 2 vials prior to administration. Reconstitute MenA lyophilized conjugate vaccine component with MenCYW-135 liquid conjugate vaccine component by withdrawing entire contents of vial of MenCYW-135 liquid conjugate component and inject into MenA lyophilized conjugate component vial. Invert and shake vial well until the vaccine is dissolved. Withdraw 0.5 mL of reconstituted product; small amount of liquid may remain in vial following withdrawal of dose. Vaccine is clear, colorless, and free from visible foreign particles. Do not administer solutions that are discolored or contain particulate matter. Administer reconstituted vaccine immediately; vaccine is stable at room temperature for up to 8 hours. Inject in anterolateral aspect of thigh in infants or into deltoid muscle in toddlers, adolescents and adults. Do not administer intravenously, subcutaneously or intradermally.

Patient/Family Teaching

  • Inform patient of purpose of vaccine.
  • Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding prior to administration. Patients who are pregnant or become aware they were pregnant the time of the immunization, should contact health care professional or Aventis Pasteur Inc. at 1–800–822–2463.

Evaluation/Desired Outcomes

  • Immunity against invasive meningococcal disease.
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