g., during a community or organization outbreak of MenC or MenY disease. Finally, despite not receiving ACIP recommendation for universal use, HibMenCY-TT may still be used in the US (for those who can afford to pay) in any infant for routine vaccination against Hib and at the same time affording some protection against serogroups C and Y meningococcal disease (Table 2) [40, 42]. Table 2 Eligible groups of children (2–18 months old) for meningococcal vaccination Subgroup Primary Protein Tyrosine Kinase inhibitor vaccination (age

of vaccination) Booster dose Complement deficiencies HibMenCY-TTa (four doses at 2, 4, 6, and 12–15 months of age or catch-up schedule) or MenACWY-Db (9–18 months, 2 doses 3 months apart) If first dose received at age 9 months to 6 years and remain at increased risk for meningococcal disease, should receive an additional dose of MCV4 (MenACWY-Db or MenACWY-CRM 197  c ) 3 years after primary vaccination. Boosters should be repeated every 5 years

thereafter Functional or anatomic asplenia HibMenCY-TTa (four doses at 2, 4, 6, and 12–15 months of age or catch-up schedule) or MenACWY-Db (9–18 months, 2 doses 3 months apart) Part of a community or organization outbreak HibMenCY-TTa (four doses at 2, 4, 6, and 12–15 months of age or catch-up schedule) or MenACWY-Db (9–18 months, 2 doses 3 months apart) Traveling to the Hajj or the ‘meningitis belt’ MenACWY-Db (9–18 months, 2 doses 3 months apart) Adapted from the Center for Disease Captisol manufacturer Amisulpride Control and Prevention’s Advisory Committee on Immunization Practices recommendations. Vaccines for children program. Vaccines to prevent meningococcal disease. 2012. Available at: http://​www.​cdc.​gov/​vaccines/​programs/​vfc/​downloads/​resolutions/​1012-2-mening-mcv.​pdf aMenHibrix™, GlaxoSmithKline Biologicals, Rixensart, Belgium bMenactra™, Sanofi Pasteur Inc., Swiftwater, PA, USA cMenveo™, Novartis Vaccines, Cambridge, MA, USA Children recognized in early infancy as being at increased risk for meningococcal disease should receive a four-dose series as outlined above.

The ACIP recommends the following alternative schedules for use in the following circumstances [40]: If an infant at risk of meningococcal disease falls behind in their Hib vaccine doses, HibMenCY-TT may be given as per the recommended Hib catch-up JPH203 datasheet schedule. If, however, the first dose of HibMenCY-TT is given after 12 months of age, two doses should be given at least 8 weeks apart to ensure adequate protection against Nm serogroups C and Y. For infants at risk of meningococcal disease who have received or are going to receive a different Hib vaccine product, they should receive MenACWY-D if they are between 9–23 months of age or MenACWY-CRM or MenACWY-D from 24 months of age. HibMenCY-TT may be given concomitantly with other routine infant vaccines, including 7- or 13-valent pneumococcal conjugate vaccines [33, 35, 37, 40].