A vaccination called Hib-MenCY (Menhibrix) is intended to give active protection against meningococcal serogroups C and Y and Haemophilus influenzae   type b.

Hib-MenCY Uses:

• Meningococcal and Haemophilus influenzae type b disease prevention:

• in order to offer active protection against invasive illness brought on by meningococcal serogroups C and Y and type b Haemophilus influenzae. Only infants 2 to 18 months old who have a higher risk of contracting meningococcal disease are advised to receive vaccinations, according to the Advisory Committee on Immunization Practices (ACIP) (CDC/ACIP), including:

  • • infants with ongoing complement pathway deficits
    • infants with functional asplenia or splenectomy, including those with sickle cell disease
    • infants residing in areas where outbreaks of meningococcal (serogroups C and Y) illness occur
  • The ACIP does not recommend routine vaccination for infants who are not at high risk for meningococcal disease.
  • However, the vaccine is recommended for infants who are traveling to specific areas (for example, meningitis belt of subSaharan Africa).These infants require a meningococcal vaccine with serogroups A and W; vaccination with Hib-MenCY-TT will not be sufficient.

Hib-MenCY (Menhibrix) Dose in Adults

Not indicated.

Hib-MenCY (Menhibrix) Dose in Childrens

Note:

• Menhibrix has been discontinued in the US for more than 1 year.
• For more information, including detailed recommendations for catch-up scenarios and/or the management of high-risk patients, consult the CDC/ACIP yearly immunisation schedules.
• Although local or state regulations may go beyond this time limit, the ACIP considers dosages that are administered 4 days before the minimum interval or age to be valid.

Primary immunization:

• Infants and Children of age 6 weeks to 18 months:

  • Intramuscular: Total 4 doses (0.5 mL per dose) administered as follows: 02, 04, 06, and 12 to 15 months of age;
  • The first dose can be given as early as six weeks after conception, and the final dose in the series as late as eighteen months.

Note:

• Hib-MenCY-TT can be used to catch up utilising the current Hib schedule in cases where a newborn at increased risk has not yet received all doses of the Hib vaccination.
• If Hib-MenCY-TT is administered for the first time before 12 months, there should be a break of 8 weeks between each dose.
• If infants have/will receive a different Hib vaccine,it is recommended to give a 2-dose series of a quadrivalent meningococcal vaccine  (Menactra for ages 9 to 23 months; Menactra or Menveo for ages >23 months).

Pregnancy Risk Factor C

• No studies on animal reproduction have been conducted to establish safety in pregnancy.

Dose in Kidney Disease:

Manufacturer’s labeling provides no dosage adjustment in kidney disease.

Dose in Liver disease:

Manufacturer’s labeling provides no dosage adjustment in liver disease.

Less Common Side Effects of Hib-MenCY (Menhibrix):

• Central Nervous System:

  • Irritability
  • Drowsiness

• Gastrointestinal:

  • Decreased Appetite

• Local:

  • Pain At Injection Site
  • Erythema At Injection Site
  • Swelling At Injection Site

• Miscellaneous:

  • Fever ≥100.4°F/38°C

Contraindications to Hib-MenCY (Menhibrix):

If you have experienced a severe allergic reaction to the meningococcal or H. influenzae type b vaccines, you should not take the Hib-MenCY vaccine.

Warnings and precautions

• Anaphylactoid reactions and hypersensitivity reactions

  • In the event of anaphylactic reactions or hypersensitivity, immediate treatment should be provided (including epinephrine 1, mg/mL).

• Syncope

  • After injectable vaccine administration, syncope has been reported.
  • This can lead to serious secondary injuries, such as skull fracture or cerebral hemorhage.
  • It is more common in adolescents and young adults, and occurs within 15 minutes of vaccination.
  • It is important to take all precautions to avoid falling and any injuries that may result, as well as to restore cerebral perfusion in the event of syncope.

• Acute illness:

  • If immunizations should be given or delayed depends on the type and severity of the febrile illness.
  • People with severe or moderate acute illnesses (with or without fever) should have their vaccinations delayed, whereas patients with light acute illnesses shouldn't have their vaccinations delayed (with fever)

• Bleeding disorders:

  • Patients who have had bleeding/hematoma in the past (including thrombocytopenia) should be cautious about intramuscular vaccine administration.
  • Patients who have received anti-hemophilia treatment or equivalent therapies should obtain an intramuscular immunisation.

• Guillain-Barre syndrome (GBS):

  • The patient should not be administered the vaccine if they have had Guillain Barre syndrome in the 6 weeks prior to receiving a tetanus-containing vaccine.

Monitoring parameters:

• The patient should be observed and monitored for 15 minutes following administration for any syncope.
• If seizure-like activity associated with syncope occurs, maintaining cerebral perfusion should be the foremost objective,for which keep patient in supine or Trendelenburg position.

How to administer Hib-MenCY (Menhibrix)?

INTRAMUSCULAR:

• Administer immediately after reconstitution;
  • Give preferably to the anterolateral side of the thigh in babies.
  • In children ≥12 months to ≤18 months, administer to the deltoid muscle of the arm.
• Do not administer intravenously or subcutaneously. Do not coadminister with other Hib-containing vaccines.

US law requires that the following details must be entered in the Patients medical record

• The administering person's name
• Date of administration
• The administering person's address.
• The lot number of vaccine
• The vaccine manufacturer
• If a patient is at risk for bleeding after receiving an intramuscular injection, a doctor who is familiar with that patient's bleeding risk should be consulted to assure reasonable safety before the vaccine can be administered intramuscularly.
• The intramuscular immunisation might be scheduled soon after the patient takes antihemophilic or any similar therapy.
• For the immunisation, a fine needle (23 gauge or smaller) may be used, and for at least two minutes, the location may be subjected to firm pressure (without rubbing).
• The patient should get adequate education of the possibility of hematoma from the injection
• Patients who are taking anticoagulants should be considered to have the same bleeding risks and treated as those with clotting factor disorders.

Mechanism of action of Hib-MenCY (Menhibrix):

• It gives active immunity to meningococcal diseases by the formation of bactericidal antibody against the polysaccharide capsule components of Neisseria Meningitidis serogroups Y and C.
• It stimulates the production anti-capsular antibodies against N.meningitidis type b and Haemophilus influenzae types c

At the beginning:

• • After the third dose, >95% of children experience an antibody reaction to vaccine components. In >98% of cases, it occurs after the fourth dose.

International Brand Names of Hib-MenCY:

• Menhibrix

Hib-MenCY Brand Names in Pakistan:

No Brands Available in Pakistan.