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Meningococcal Conjugate Vaccine: Proceed, but with Caution

The CDC reports five cases of Guillain-Barré syndrome (GBS) in adolescents whose symptoms began 2 to 5 weeks after receiving the conjugate meningococcal vaccine.

A conjugate meningococcal vaccine (Menactra) was licensed in the U.S. in January 2005 and is recommended for all 11- and 12-year-olds, students entering high school, and college freshmen dormitory residents (JW Pediatr Adolesc Med Mar 14 2005). As of October 4, 2005, the Vaccine Adverse Event Reporting System (VAERS) had received five reports of Guillain-Barré syndrome (GBS) in adolescents (age, 17–18) whose symptoms began 2 to 5 weeks after receiving the vaccine.

The five patients received vaccines from four different vaccine lots and lived in four different states (PA, OH, NY, NJ). One patient had intercurrent pharyngitis, and one had had two previous episodes of GBS following other immunizations. The mother of one patient had had GBS 5 years earlier. All patients are reportedly recovering after treatment with plasmapheresis, IV immunoglobulin, or both.

Comment: Because the precise incidence of GBS is not known, these cases might represent the expected rate of GBS that occurs by chance alone. The CDC and FDA are investigating the possibility of an association because of the timing of symptom onset and the severity of GBS. Until further information is available, we should continue to follow the current recommendations for routine meningococcal vaccination of adolescents and inform families of the ongoing investigation. It is equally important for families to understand the serious nature of meningococcal disease. It might be prudent to defer vaccination in adolescents with a history of GBS until the investigation is complete. The CDC requests that all possible cases of GBS following meningococcal vaccination be reported to VAERS at http://www.vaers.hhs.gov or 800-822-7976.

— Peggy Sue Weintrub, MD

Published in Journal Watch Pediatrics and Adolescent Medicine November 4, 2005

Citation(s):

Centers for Disease Control and Prevention (CDC). Guillain-Barré syndrome among recipients of Menactra® meningococcal conjugate vaccine — United States, June-July 2005. MMWR Morb Mortal Wkly Rep 2005 Oct 14; 54:1023-5.

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