A report in MMWR on 7-7-17, High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine, suggests that patients receiving eculizumab (Soliris®) are at high risk for meningococcal disease despite vaccination. Please share this information with partners. 

Healthcare providers:

  • Could consider antimicrobial prophylaxis for the duration of eculizumab therapy to potentially reduce the risk of meningococcal disease
  • Should continue immunizing patients with meningococcal vaccines who receive eculizumab
  • Should maintain a high index of suspicion for meningococcal disease in patients taking eculizumab who present with any symptoms consistent with either meningitis or meningococcemia, even if the patient’s symptoms initially appear mild, and irrespective of the patient’s meningococcal vaccine or antimicrobial prophylaxis status

Eculizumab, a terminal complement inhibitor, is most commonly prescribed for treatment of two rare blood disorders: atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH). It is associated with a 1000 to 2000 fold increased incidence of meningococcal disease. Sixteen cases of meningococcal disease in eculizumab recipients were identified in the United States from 2008 through 2016; eleven (69%) were caused by nongroupable Neisseria meningitidis. Nongroupable N. meningitidis typically does not cause invasive meningococcal disease.  

Meningococcal conjugate vaccine targets serogroups A, C, W, and Y, and provides no protection against nongroupable N. meningitidis. Serogroup B meningococcal vaccines are licensed specifically for protection against serogroup B meningococcal disease. Researchers have not assessed the extent of any potential cross protection for nongroupable N. meningitidis strains.

For More Information:

For Clinicians: Managing the Risk of Meningococcal Disease among Patients Who Receive Eculizumab Therapy

For Patients: Taking Eculizumab (Soliris®) Increases Your Risk for Meningococcal Disease

CDC Health Advisory: Patients Receiving Eculizumab (Soliris®) at High Risk for Invasive Meningococcal Disease Despite Vaccination

Signs and Symptoms of Meningococcal Disease

Soliris® (Eculizumab) Product Label

Atypical Hemolytic Uremic Syndrome (aHUS)

 Paroxysmal Nocturnal Hemoglobinuria (PNH)

 Child and Adolescent Indications Schedule: Vaccines That Might Be Indicated for Persons Aged 0 through 18 Years Based On Medical Indications 

Adult Immunization Schedule by Medical and Other Indications: Recommended Immunization Schedule for Adults Aged 19 Years or Older by Medical Conditions and Other Indications, United States, 2017

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