Summary
-Menactra recently gained approval for children 2-10 years old -Unless the ACIP changes its recommended age for routine use (currently 11), this will have little impact -Most children will only need this in this expanded age range for travel to some parts of the world.
Analysis
Menactra, currently recommended for routine use in children 11-12 years old and older, recently gained approval for use in children 2-10 years old. This is good, because if someone truly needs it in this age range then one can do the right thing. However, the potential uses of Menactra in this age range are few. Given this fact, the ACIP has little reason to recommend its routine use in a younger age. As I have written before, the holy grail for a vaccine is to be recommended for routine use, which Menactra already is, at ages 11 and up. The additional clients that will be vaccinated are those travelling to meningococcal disease-endemic parts of the world and those with impaired immune systems, such as children with sickle cell disease. These "additional" clients will actually only be getting the vaccine earlier, not "extra"; that is, giving it to a 2-year old travelling to Ethiopia only means that the child gets it now and NOT in 9 more years, so there's not a lot of net upside to this as a single dose vaccine.
