MCV4 Singapore: MCV4 / Meningococcal Polysaccharide (Serogroups A, C, Y and W-135) Diphtheria Toxoid Conjugate vaccine jab/shot/injection schedule, to vaccinate against the Neisseria meningitidis / meningococcus, to immunise against meningococcal disease / meningitis / meningococcemia clinic, Singapore. Private and confidential service. Definitions, references, and latest news.
Polysaccharide and conjugated meningococcal vaccines
Internationally marketed meningococcal polysaccharide vaccines are bivalent (A and C), trivalent (A, C and W-135) or tetravalent (A, C, Y and W-135). The vaccines are purified, heat-stable, lyophilized capsular polysaccharides from meningococci of the respective serogroups.
Both group A and group C vaccines have documented short-term efficacy levels of 85–100% in older children and adults. However, group C vaccines do not prevent disease in children under 2 years of age, and the efficacy of group A vaccine in children under 1 year of age is unclear. Group Y and W-135 polysaccharides have been shown to be immunogenic only in children over 2 years of age.
A protective antibody response occurs within 10 days of vaccination. In schoolchildren and adults, the bivalent and tetravalent polysaccharide vaccines appear to provide protection for at least 3 years, but in children under 4 years the levels of specific antibodies decline rapidly after 2–3 years.
The currently available bivalent and tetravalent meningococcal vaccines are recommended for immunization of specific risk groups as well as for large-scale immunization, as appropriate, for the control of meningococcal outbreaks caused by vaccine-preventable serogroups (A and C, or A, C, Y, W-135 respectively). Travellers who have access to the tetravalent polysaccharide vaccine (A, C, Y, W-135) should opt for this rather than the bivalent vaccine because of the additional protection against groups Y and W-135.
These vaccines do not provide any protection against other serogroups such as group B and group X meningococci, which are important causes of meningococcal disease in some countries.
Conjugate meningococcal vaccines
A T-cell-dependent immune response is achieved through conjugation of the polysaccharide to a protein carrier. Conjugate vaccines are therefore associated with an increased immunogenicity among infants and prolonged duration of protection.
Monovalent serogroup C conjugate vaccines were first licensed for use in 1999 and are now incorporated in national vaccination programmes in an increasing number of countries. In contrast to group C polysaccharide vaccines, the group C conjugate vaccine elicits adequate antibody responses and immunological memory even in infants who are vaccinated at 2, 3 and 4 months of age. Cross-protection does not occur and travellers already immunized with conjugate vaccine against serogroup C are not protected against other serogroups.
In 2010, a conjugated serogroup A meningococcal vaccine designed particularly for use in the African "meningitis belt" received regulatory approval in India and in a few African countries. This vaccine, which is licensed for single-dose immunization of individuals 1–29 years of age, has proved to be safe and highly immunogenic. The conjugate MenA vaccine has been used in large vaccine campaigns in Burkina Faso, Mali and Niger and is being progressively introduced in countries of the African meningitis belt.
Two tetravalent conjugate vaccines against serogroups A, C, Y and W-135 have been licensed in North America and are gradually becoming available in several other countries. In the United States and Canada these vaccines are licensed for individuals 2–55 years of age. A two-dose series of one of these vaccines is licensed also for children aged 9–23 months. These vaccines are expected to induce protection of similar efficacy to, but of longer duration than, that induced by the polysaccharide tetravalent meningococcal vaccine.
|Dose schedule||Price |
|Varilrix™|| Varicella zoster virus |
|Zostavax™||Herpes zoster Shingles||≥50y||1||$295/=|
|Stamaril®||Yellow fever virus||Yellow fever||9m-59y||1||10 yearly||$250/=|
|Inactivated / Whole / Viral & Bacterial|
|Rabipur®||Rabies virus||Rabies||any||3||d 0, 7, & 21 or 28||$call/=|
|Ixiaro®||Japanese encephalitis virus||Japanese encephalitis||≥17y||2||2nd: 28d after 1st||$386/=|
|1||Booster: 12-24m after 2nd|
|Dukoral®||Vibrio cholerae||Cholera||2-6y||3||1-6w interval||$113/=|
|1||Booster: 6m after 3rd|
|1||Booster: 2y after 2nd|
|Inactivated / Fractional / Protein|
|Intanza™||Influenza virus||Influenza||18-59y||1||1 yearly||$30/=|
|Fluarix™||Influenza virus||Influenza||6-36m||½||1 yearly||$30/=|
|Tetavax||Clostridium tetani||Tetanus||adults||3||1-2m interval |
3rd @ 6-12m
|Bordetella pertussis||Pertussis |
|Inactivated / Fractional / Polysaccharide / Pure|
|Typhim Vi®||Salmonella typhi||Typhoid fever||>5y||1||3 yearly||$48/=|
|Mencevax® ACWY||Neisseria meningitidis |
types A, C, W-135
|Inactivated / Fractional / Polysaccharide / Conjugate|
|Menactra®||Neisseria meningitidis |
types A, C, W-135
| Prevenar 13® (SG) / |
Prevnar 13® (US)
|Streptococcus pneumoniae |
types 1, 3, 4, 5,
6A, 6B, 7F, 9V, 14,
18C, 19A, 19F, 23F
|Pneumococcal infection||6w-6m||4||1m interval |
4th @ 12-15m
If the clinic attendance is just for vaccination alone, no additional consultation fees are charged.
Testing for immunity against the following is available:
|Varicella zoster virus||Varicella Zoster IgG Antibody||$44/=|
|Measles virus||Measles IgG Antibody||$90/=|
|Rubella virus||Rubella IgG Antibody||$24/=|
|Hepatitis A virus||Hepatitis A IgG Antibody||$30/=|
|Hepatitis B virus||Hepatitis B surface Antibody||$10/=|
Other vaccines not stocked
- Haemophilus influenzae type b Vaccine / HIB Vaccine
- Polio Vaccine
- Rotavirus Vaccine
- Tuberculosis Vaccine / TB Vaccine / BCG Vaccine
- Tick-Borne Encephalitis Vaccine / TBE Vaccine
- Live attenuated
- Hajj and Umrah Health Requirements
- Memish ZA. The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Euro Surveill. 2010;15(39)
- Memish Z.A., Goubeaud A., Broker M., Malerczyk C., Shibl A.M. Invasive meningococcal disease and travel. J Infect Public Health. 2010;3(4):143-151.
|Dose schedule||Price |
|Havrix™ 1440 Adult||Hepatitis A virus||Hepatitis A||≥19y||2||m 0 & 6-12||$90/=|
|Twinrix®||Hepatitis A virus |
Hepatitis B virus
|Hepatitis A |
|1-15y||2||m 0, 6-12||$135/=|
|≥16y||3||m 0, 1, 6|
|4||d 0, 7, 21 & m 12|
|Inactivated / Fractional / Protein / Subunit / Recombinant|
|Engerix™-B 20 μg||Hepatitis B virus||Hepatitis B||11-15y||2||m 0, & 6||$50/=|
|≥20y||3||m 0, 1, & 6|
|4||m 0, 1, 2, & 12 or |
d 0, 7, 21 & m 12
types 6, 11, 16, & 18
| Genital warts |
|9-26y||3||m 0, 2, & 6 or |
m 0, 1, & 4
types 16, & 18
(31, 33, & 45)
|10-25y||3||m 0, 1, & 6 |
m 0, 1, & 5
m 0, 2½, 12
types 6, 11, 16, 18,
31, 33, 45,
52, & 58
|3||m 0, 2, & 6 or |
m 0, 1, & 4
For persons aged 0 to <18 years
|Vaccination against||Birth||1 month||3 months||4 months||5 months||6 months||12 months||15 months||18 months||6-7 years^||10-11 years^^|
|Hepatitis B||HepB (D1)||HepB (D2)||HepB (D3)#|
|Diphtheria, Tetanus, Pertussis||DTaP (D1)||DTaP (D2)||DTaP (D3)||DTaP (B1)||Tdap (B2)|
|Poliovirus||OPV (D1)||OPV (D2)||OPV (D3)||OPV (B1)||OPV (B2)||OPV (B3)|
|Measles, Mumps, Rubella||MMR (D1)||MMR (D2)##|
|Pneumococcal Disease||PCV (D1)||PCV (D2)||PCV (B1)|
|Human Papillomavirus||Recommended for females 9 to 26 years; three doses are required at intervals of 0, 2, 6 months|
|Influenza||Recommended annually for all children aged 6 months to <5 years and children aged 6 months to <18 years in high-risk groups|
- National Childhood and Adolescent Immunisation Schedule, Singapore For persons aged 0 to <18 years
- Infectious Diseases (Diphtheria and Measles Vaccination) Regulations