Menomune

1. See Also
   1. Neisseria Meningitidis
   2. Bacterial Meningitis
2. Indications
   1. See Menactra (MCV4) which is preferred due to higher immunogenicity
3. Mechanism
   1. Quadrivalent Meningococcal Polysaccharide Vaccine
   2. Covers strains A, C, W-135, and Y (does not contain B serotype)
      1. Covers same strains as Menactra
      2. See Menactra for further explanation
   3. Cost: $100 (similar to Menactra)
   4. Storage: 35 to 46 F (2 to 8 C), Same as Menactra
4. Dose: Menomune
   1. Adult: 0.5 ml SC every 3 years
   2. Intramuscular may be preferred over subcutaneous route
      1. Intramuscular Injection reduces adverse effects
         1. Local erythema (11% for IM, 32% for SC)
         2. Headache (3% for IM and 12% for SC)
      2. Intramuscular has same efficacy as subcutaneous route
5. Efficacy
   1. Like Menactra, Menomune has a high seroconversion rate (98%-100%)
   2. However Menomune duration is much shorter
      1. Menomune duration lasts 3 years in school age children and less in infants
6. Precautions: Safety
   1. Contains Thimerosal
   2. Approved for all ages
   3. Safe in Human Immunodeficiency Virus (HIV)
      1. See Immunization in HIV
7. Adverse effects
   1. Serious adverse events are uncommon (<1.3%)
   2. Headache
   3. Fever (in up to 3% of children)
   4. Local reactions (more common with Menactra)
8. References
   1. Bilukha (2005) MMWR Recomm Rep 54(RR-7):1-21
   2. Peter (2001) Pediatr Infect Dis J 20:311-2
   3. Ruben (2001) Clin Infect Dis 32:170-2