On July 7, 2017, CDC sent Health Advisory CDCHAN-00404 through its Health Alert Network. The advisory was about eculizumab (Soliris), a drug that blocks part of the immune system.
People who receive eculizumab have a 1,000 to 2,000 times greater risk of invasive meningococcal disease than the general U.S. population. The drug label carries a boxed warning about this risk. The Advisory Committee on Immunization Practices (ACIP) recommends meningococcal vaccines for all patients who receive the drug.
What CDC found
Some patients on eculizumab got meningococcal disease even after they had the recommended vaccines. CDC found 16 cases of meningococcal disease in eculizumab patients in the U.S. from 2008 through 2016. Of these, 11 (69%) were caused by nongroupable Neisseria meningitidis. This type of the bacteria rarely causes serious disease in healthy people.
What CDC asked of health care providers
- Consider antibiotics to prevent infection for as long as the patient takes eculizumab.
- Continue to give meningococcal vaccines to all patients on eculizumab.
- Give the vaccines at least 2 weeks before the first dose of eculizumab, unless the risk of a delay in treatment is greater than the risk of infection.
- Suspect meningococcal disease in any eculizumab patient with signs of meningitis or a blood infection, even if the signs seem mild and the patient had vaccines or antibiotics.
For other health advisories from 2017, see Health Advisory #137: Legionnaires’ Disease in West Virginia and Health Advisory #141: Dramatic Increase in Lyme Disease Cases.
This guidance is from July 2017. It is kept here as a record and is not current advice. Check current guidance from the CDC or your doctor.