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.