Menitorix: HiB and meningococcal C conjugate vaccine

Menitorix is Haemophilus influenzae B and meningococcal C conjugate vaccine. It is a bivalent vaccine. It is a combination vaccine.

This vaccine is a killed conjugate vaccine. It contains:

Haemophilus type b polysaccharide (polyribosylribitol phosphate)
conjugated to tetanus toxoid as carrier protein

5 mcg

12.5 mcg
Neisseria meningitidis group C (strain C11) polysaccharide 
conjugated to tetanus toxoid as carrier protein
5 mcg

5 mcg
Active components in each dose

As shown in above table each dose of Menitorix vaccine contains active ingredients PRP polysaccharide of Haemophilus influenzae B conjugated to tetanus toxoid and Neisseria meningitis group C polysaccharide conjugated to tetanus toxoid.

Other non reactive ingredients are sucrose and trometamol.

How is the Menitorix vaccine available?

The Menitorix vaccine is supplied as powder in a vial containing active ingredients. 

Another pre-filled syringe contains sodium chloride solution as a diluent.

Each dose is 0.5 ml.

Additionally it also contains 2 needles one for mixing and one for the injection.

It is available in pack of 1 dose and 2 needles or 10 dose and 20 needles.

At what age to get the Menitorix vaccine?

Menitorix is given at 2 months and second dose after at least 4 weeks.

If started at 3 months 2 doses can be given 2 months apart.

In preterm infants 3 doses are needed in the first year of life.

After the first course of vaccinations against Hib and MenC has been completed a booster dose of Hib and MenC should be given, usually at some time in the second year of life.

How to give the Menitorix vaccine?

Menitorix vaccine is for intramuscular injection.

Follow all the safety injection precautions for giving injections.

First take the diluent in a sterile syringe which does not contain preservatives and antiseptics or other drugs.

Then push the diluent in vial with lyophilized powder without forming foam.

Agitate gently and suck back the mixture in the syringe.

Do not apply antiseptics and spirit to vial.

Use the vaccine within 30 minutes of reconstitution or it should be discarded.

The antiseptic or spirit applied to skin before injection should vaporize completely before giving injection.

Inject the dose by intramuscular route.

Give it on an anterolateral aspect of the thigh region.

Do not inject intravenous.

Disposable items used should be discarded as per local biomedical waste management protocols to protect your environment.

How to store Menitorix vaccine?

Store Menitorix vaccine as per recommendations of supplier or manufacturer.

Store this vaccine at temperature 2 degree Celsius to 8 degree Celsius.

Do not freez.

Maintain the temperature range using a strict cold chain.

Maintain the cold chain all all stages from manufacturer to the end user.

If the temperature recommendations were not followed, discard the vaccine.

While discarding local biomedical waste management protocols should be followed to protect environmental damage.

How Does the Menitorix Vaccine work?

Menitorix is a polysaccharide conjugate vaccine.

When it is injected, the conjugate proteins with polysaccharide enter you. 

These polysaccharides resemble actual antigens on bacteria but cannot cause disease.

Your immunity recognizes these antigens and develops an immune mechanism against it.

So when real infection occurs this developed immune system can fight back effectively.

Thus we can prevent meningitis and other diseases caused by HiB.

Safety of vaccine with other vaccines:

Menitorix Vaccine should not be mixed with the same syringe with other vaccines or drugs.

Menitorix can be given at the same time as vaccines intended to protect against one or more of diphtheria, tetanus, whooping cough, polio, hepatitis B, pneumococcal conjugate vaccine and combined vaccines against measles, mumps and rubella (MMR). 

Any other vaccines that are given at the same time as Menitorix will be injected separately at different parts of the body. 

Although Menitorix contains tetanus toxoid (inactivated bacterial toxin), which is used to immunise people against tetanus (lockjaw), it is still necessary that your child should receive the recommended childhood vaccinations against tetanus.

What are the side effects of the Menitorix  vaccine?

With this vaccine following are common side effects. These all side effects though occur generally are mild and can be managed at home and do not usually need admission. They usually occur in the first 5 days after vaccination.

  • Pain, swelling, redness: Injection site pain, swelling and redness can occur within a few hours of giving this vaccine. It can be reduced with cold compression and medicine like paracetamol in adequate doses.
  • Irritability: Irritability can occur after vaccination. It is generally mild to moderate grade and subsides on its own and paracetamol.
  • Sleepiness: Some children may become sleepy after vaccination. This may remain for few hours and usually reduces by its own.
  • Fever: Fever may occur within a few hours of giving this vaccine. It can be managed with or without medicines as needed symptomatically.
  • Muscle pain: Limb pain muscle pain and fatigue are known side effects after vaccination. It usually subsides on its own. The intensity of side effects can be decreased with paracetamol.
  • Diarrhea, loss of appetite, nausea: Some patients may experience side effects like nausea and decreased appetite and diarrhea. They are usually ild and subside by their own.
  • Anaphylaxis: Like all other vaccines and drugs this vaccine may cause anaphylaxis and severe allergic reactions. They are extremely rare to occur.

To whom Menitorix Vaccine should not be given?

In following cases this vaccine should not be given:

  • Do not give this vaccine if the patient is known to be allergic to any of its components.
  • Do not give this vaccine if the patient had got an allergic or anaphylactic reaction at the time of the previous dose.
  • In pregnancy and breastfeeding mothers.

Warnings and caution with Menitorix Vaccine

  • This vaccine prevents meningitis caused by meningococcal C bacterium but prevents meningitis from other strains.
  • This vaccine may not protect all those who have received vaccination.
  • If a child is on a drug that causes immunosuppression this vaccine may fail to induce immunity.
  • If your child has a tendency to increase bleeding you should tell this information to your doctor before any intramuscular injection.
  • You should tell your doctor if your child has any disease that cause immunosuppression like HIV AIDS.

<span class="has-inline-color has-luminous-vivid-orange-color">Dr Yatin Bhole MBBS DCh DNB</span>
Dr Yatin Bhole MBBS DCh DNB

This article was written by Dr Yatin Bhole who is practicing Pediatrician at Bhole Children Clinic, Ravet. This post is for general information and before applying it on yourself, you should meet your doctor or meet us in person.

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