Meningococcal B Vaccination
There are five main serotypes of meningococcal disease: A,B, C, Y, and W-135; B,C, and Y cause most of the disease seen in the United States. The standard vaccines cover serotypes A,C, and W-135. None have provided any activity against serotype B, which is one of the main disease causing serotypes.
The FDA has recently approved two vaccines protecting against serotype B for patients aged 10-25 years of age:
1. MenB-4C (Bexsero) given at 0 and 1 – 6 months.
2. MenB-FHbp (Trumenba) given at 0, 2, and 6 months.
The vaccine is also recommended for those at increased risk:
complement deficiencies, asplenia, and those who are exposed.
There is no preferred vaccine between the two, however, you should use the same vaccine to complete the required doses. How long immunity lasts is currently unknown.
Currently the FDA has approved PPSV23 and PCV13 for the protection against pneumococcal disease. New guidelines recommend that both be given for those who are 65 years of age or older. Both should also be given for those 19-64 who are immunocompromised, have asplenia, and those with cochlear implants or cerebral spinal fluid leaks.
Ideally, you want to give PCV13 first. After one year, administer PPSV23.
Those who are immunocompromised will need an additional PPSV23 vaccine 5 years after the first PPSV23 dose. If the PPSV23 was given first for some reason, wait one year before giving the PCV13.
Currently Zostavax is FDA approved and has been shown to reduce the incidence of shingles by 51% and prevents post herpetic neuralgia by 67%. It is believed that it’s effectiveness decreases to 21% after 7 years, however, there is no current recommendation for a booster shot.
There is a new herpes zoster vaccine (HZ/su) currently under investigation, which is showing to be 97% effective. More trials need to be done before the FDA approves this new vaccine. But, it looks promising thus far!