Decision to fund a new brand of meningococcal ACWY vaccine (MenQuadfi)

Medicines Decision

What we’re doing

We're pleased to announce a decision to fund a new brand of meningococcal ACWY vaccine (MenQuadfi) from 1 December 2022, for immunisation against meningococcal disease caused by groups A, C, W and Y. This vaccine will replace the Menactra brand of meningococcal ACWY vaccine when it is discontinued in early 2023. MenQuadfi will be funded with the same eligibility criteria as Menactra. 

Why we’re funding this new brand

The supplier of the currently funded Menactra brand of meningococcal ACWY vaccine (Sanofi) advised us in 2020 that it planned to discontinue Menactra globally in the future and supply the MenQuadfi brand in its place. 

In May 2022 [PDF, 245 KB] our expert clinical advisors considered an application to list MenQuadfi in the Pharmaceutical Schedule and told us that it would be a suitable replacement for the currenlty listed Menactra, with the same eligibility criteria. Our clinical advisors also told us that there is high quality, strong evidence that MenQuadfi is non-inferior and has a similar safety profile to the currently funded, Menactra. MenQuadfi was approved by Medsafe in June 2022. 

Who we think will be most interested

  • Parents and whānau of tamariki and rangatahi
  • Vaccinators and other healthcare professionals involved in childhood immunisations
  • Te Whatu Ora hospitals
  • Vaccine manufacturers, suppliers, wholesalers, and distributors
  • People who already live or plan to live in institutional close-living situations
  • Organisations providing boarding school hostels, tertiary education halls of residence, military barracks, and prisons/correctional facilities
  • Organisations with an interest in immunisation 

Detail about this decision

The MenQuadfi brand of meningococcal ACWY vaccine will be listed in Section I and Part II of Section H of the Pharmaceutical Schedule from 1 December 2022 as follows, subject to the same eligibility criteria as the currently listed Menactra brand of meningococcal ACWY vaccine. 

Pharmaceutical Brand Name Formulation Pack Size Price and subsidy
Meningococcal [Groups A, C, Y and W-135] Conjugate Vaccine MenQuadfi Inj 10 mcg of each meningococcal polysaccharide conjugated to a total of approximately 55 mcg of tetanus toxoid carrier per 0.5 ml vial 1 $0.00*

*Vaccine prices are listed with zero cost in the Pharmaceutical Schedule as Pharmac distributes them free of charge to vaccinators. A confidential purchase price will apply to MenQuadfi. 

MenQuadfi will be listed with “Xpharm” restriction. An Xpharm listing means that community pharmacies cannot claim subsidy because Pharmac has made alternate distribution arrangements. 

We expect that stock of the Menactra brand at ProPharma will be exhausted by February or March 2023 and the MenQuadfi brand will be distributed to providers from that time. 

We have made a minor administrative change to the eligibility criteria for meningococcal ACWY vaccine to delete reference to the catch-up programme for people currently living in specified close living situations, as the catch-up programme finished on 30 November 2021. People aged from 13 to 25 years who are entering, or are already in, their first year of living in specified close living situations are still eligible to receive a single dose of meningococcal ACWY vaccine. We will be seeking clinical advice about widened access options for close living situations and any inadvertent non-coverage of previous catch-up programmes for people who remain living in specified close living situations, across both meningococcal ACWY and meningococcal B vaccines. 

MenQuadfi is approved by Medsafe for use in people from 12 months of age, whereas the currently listed Menactra is approved for use in people from 9 months of age. Our clinical advisors have told us that the small number of children who might need their first dose of meningococcal vaccine between 9 and 12 months of age could receive meningococcal C vaccine (Neisvac-C) for their first dose, and MenQuadfi for any subsequent doses to complete their course of meningococcal ACWY vaccination. Children under 9 months of age currently receive Neisvac-C for their first dose. Neisvac-C is approved for use in people from 8 weeks of age. We have amended the eligibility criteria for Neisvac-C as outlined below. 

The following changes will occur in Section I and Part II of Section H of the Pharmaceutical Schedule from 1 December 2022 (additions in bold, deletions in strikethrough):

Section I changes (Menactra and MenQuadfi)

Either:

  1. Any of the following:
    1. Up to three doses and a booster every four years for patients pre- and post-splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre or post solid organ transplant; or
    2. One dose for close contacts of meningococcal cases of any group; or
    3. One dose for person who has previously had meningococcal disease of any group; or
    4. A maximum of two doses for bone marrow transplant patients; or
    5. A maximum of two doses for person pre- and post-immunosuppression*; or 
  2. Both:
    1. Person is aged between 13 and 25 years, inclusive; and
    2. Either:
      i) One dose for individuals who are entering within the next three months, or in their first year of living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons.; or
      ii) One dose for individuals who are currently living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons, from 1 December 2019 to 30 November 2021.

Note: children under seven years of age require two doses 8 weeks apart, a booster dose three years after the primary series and then five yearly.

*Immunosuppression due to steroid or other immunosuppressive therapy must be for a period of greater than 28 days.

Section I changes (Neisvac-C)

Both:

  1. The child is under 9 12 months of age; and
  2. Any of the following:
    1. Up to three doses for patients pre- and post splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre or post solid organ transplant; or
    2. Two doses for close contacts of meningococcal cases of any group; or
    3. Two doses for child who has previously had meningococcal disease of any group; or
    4. A maximum of two doses for bone marrow transplant patients; or
    5. A maximum of two doses for child pre- and post-immunosuppression*.

Notes: children under nine 12 months of age require two doses 8 weeks apart. Refer to the Immunisation Handbook for recommended booster schedules with meningococcal ACWY vaccine.

*Immunosuppression due to steroid or other immunosuppressive therapy must be for a period of greater than 28 days

Section H (Hospital Medicines List) changes (Menactra and MenQuadfi)

Restricted

Initiation

Either:

  1. Any of the following:
    1. Up to three doses and a booster every five years for patients pre- and post splenectomy and for patients with HIV, complement deficiency (acquired or inherited), functional or anatomic asplenia or pre or post solid organ transplant; or
    2. One dose for close contacts of meningococcal cases of any group; or
    3. One dose for person who has previously had meningococcal disease of any group; or
    4. A maximum of two doses for bone marrow transplant patients; or
    5. A maximum of two doses for person pre and post-immunosuppression*; or
  2. Both:
    1. Person is aged between 13 and 25 years, inclusive; and
    2. Either:
      2.2.1       One dose for individuals who are entering within the next three months, or in their first year of living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons.; or
      2.2.2 One dose for individuals who are currently living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons, from 1 December 2019 to 30 November 2021.

Notes: children under seven years of age require two doses 8 weeks apart, a booster dose three years after the primary series and then five yearly.

*Immunosuppression due to steroid or other immunosuppressive therapy must be for a period of greater than 28 days 

Section H (Hospital Medicines List) changes (Neisvac-C)

Restricted

Initiation – Children under 9 12 months of age

Any of the following:

  1. Up to three doses for patients pre- and post splenectomy and for patients with HIV, complement deficiency (acquired or inherited), functional or anatomic asplenia or pre or post solid organ transplant; or
  2. Two doses for close contacts of meningococcal cases of any group; or
  3. Two doses for child who has previously had meningococcal disease of any group; or
  4. A maximum of two doses for bone marrow transplant patients; or
  5. A maximum of two doses for child pre- and post-immunosuppression*.

Notes: children under nine 12 months of age require two doses 8 weeks apart. Refer to the Immunisation Handbook for recommended booster schedules with meningococcal ACWY vaccine.

*Immunosuppression due to steroid or other immunosuppressive therapy must be for a period of greater than 28 days.

The Menactra brand of meningococcal ACWY vaccine will continue to be listed in the Pharmaceutical Schedule so vaccinators can use all existing stock before changing to MenQuadfi.

The National Immunisation Programme at Te Whatu Ora is responsible for supporting the implementation of changes to the National Immunisation Schedule.

The Ministry of Health’s Immunisation Handbook will be updated to reflect the changes to meningococcal vaccines.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.