The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has recommended two modifications for use of quadrivalent meningococcal vaccines (MCV4, Menactra and Menveo) that will affect the 2011 immunization schedule.

The AAP Committee on Infectious Diseases has approved these recommendations.

MCV4 elicits antibodies protective against Neisseria meningitidis serogroups A, C, Y and W-135.

For children who are at high risk for meningococcal disease due to immunocompromise (complement deficiency, asplenia, HIV infection), a two-dose primary series (at least two months apart) is now recommended. Children at high risk for meningococcal disease due to immunocompromise who have received only one dose in the primary series should receive a second dose at the earliest opportunity (no sooner than eight weeks after the first dose).

The second dose of vaccine is recommended because antibody levels following a single dose may be insufficient to protect those with HIV infection. In...

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