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Menomune Prescribing Information

Drug Detail:Meningococcal groups a, c, y, and w-135 vaccine (monograph) (Medically reviewed)

Drug Class:

Contents
Uses Warnings Before Taking Dosage Side effects Interactions

Highlights of Prescribing Information

These highlights do not include all the information needed to use Menomune® – A/C/Y/W-135 vaccine safely and effectively. See full prescribing information for Menomune® – A/C/Y/W-135 vaccine.

Menomune® – A/C/Y/W-135, Meningococcal Polysaccharide Vaccine, Groups A, C, Y and W-135 Combined
Suspension for subcutaneous injection
Initial U.S. Approval: 1981

Recent Major Changes

Contraindications (4)[1/2009]
Warnings and Precautions (5)[1/2009]

Deferral of vaccination during acute illness moved from Contraindications to Warnings and Precautions.

Indications and Usage for Menomune

  • Menomune – A/C/Y/W-135 vaccine is a vaccine indicated for active immunization against invasive meningococcal disease caused by Neisseria meningiditis serogroups A, C, Y, and W-135. Menomune – A/C/Y/W-135 vaccine is approved for use in persons 2 years of age and older. (1)

Menomune Dosage and Administration

  • Single 0.5 mL subcutaneous injection. (2)

Dosage Forms and Strengths

  • Menomune – A/C/Y/W-135 vaccine is supplied as a single dose or multidose (10 dose) vial of lyophilized vaccine, with corresponding single dose or multidose vial of diluent. After reconstitution of the lyophilized vaccine with the diluent, each dose consists of a 0.5 mL suspension for injection. (3)

Contraindications

  • Do not administer to anyone with a history of a severe allergic reaction (eg, anaphylaxis) to Menomune – A/C/Y/W-135 vaccine or any component of the vaccine. (4)

Warnings and Precautions

  • The stoppers to the vials of lyophilized vaccine and diluent contain dry natural latex rubber that may cause allergic reactions. (5.1)

Adverse Reactions/Side Effects

  • Common (>10%) adverse events in children 2 to 10 years of age were injection site pain, drowsiness, irritability, and diarrhea. (6)
  • Common (>10%) adverse events in persons 11 to 55 years of age were pain, redness, and induration at the injection site, headache, fatigue, malaise, arthralgia, and diarrhea. (6)

To report SUSPECTED ADVERSE REACTIONS, contact Sanofi Pasteur Inc. at 1-800-822-2463 (1-800-VACCINE) or VAERS at 1-800-822-7967 or http://vaers.hhs.gov.

Drug Interactions

  • Do not mix Menomune – A/C/Y/W-135 vaccine with other vaccines in the same syringe or vial. (7)
  • Immunosuppressive therapies may reduce the immune response to Menomune – A/C/Y/W-135 vaccine. (7)
  • No safety and immunogenicity data are available on the concomitant administration of Menomune – A/C/Y/W-135 vaccine with other US licensed vaccines. (7)

Use In Specific Populations

  • Pregnancy: No human or animal data. Use only if clearly needed. (8.1)
  • Geriatrics: Not known whether persons aged 65 years and older respond differently from younger persons. (8.4)

See 17 for PATIENT COUNSELING INFORMATION.

Revised: 10/2009

Related/similar drugs

ciprofloxacin, ceftriaxone, Rocephin, rifampin, meningococcal conjugate vaccine

Full Prescribing Information

2. Menomune Dosage and Administration

2.2. Primary Immunization

Primary immunization with Menomune – A/C/Y/W-135 vaccine consists of a single 0.5mL dose administered subcutaneously. The preferred site of administration is the deltoid region.

The ACIP (Advisory Committee on Immunization Practices) has specfic recommendations for use of meningococcal vaccines. (1) (2) (3)

2.3. Revaccination

The ACIP has recommendations for revaccination against meningococcal disease for persons at high risk who were previously vaccinated with Menomune – A/C/Y/W-135 vaccine. (1) (3) If Menomune – A/C/Y/W-135 vaccine is used for revaccination, the dose is 0.5mL administered subcutaneously.

6. Adverse Reactions/Side Effects

6.1. Data from Clinical Studies

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in clinical practice.

In three clinical trials primarily designed to assess the safety and immunogenicity of another vaccine, Menactra® [Meningococcal (Groups A, C, Y, W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine], participants were randomized to receive Menactra or Menomune – A/C/Y/W-135 vaccine, which was used as a control vaccine. In these three trials, 1519 children 2-10 years of age, 972 persons 11-18 years of age, and 1170 adults 18-55 years of age, respectively, received a dose of Menomune – A/C/Y/W-135 vaccine. Overall, of the children 2-10 years of age who received Menactra or Menomune – A/C/Y/W-135 vaccine, 68% were enrolled at US sites and 32% were enrolled at a Chilean site. The median ages of US and Chilean children were 6 and 5 years, respectively; 50.5% were males; and 92.0% were Caucasian. Among participants 11–55 years of age who received Menactra or Menomune – A/C/Y/ W-135 vaccine, all were enrolled at US sites; 54.8% were female; 87.7% were Caucasian.

Solicited local and systemic reactions were monitored daily for 7 days post-vaccination using a diary card. Information on serious adverse events was collected at interim clinic visits and by telephone interview conducted 6 months post-vaccination. At least 94% of participants from the three studies completed the 6-month follow-up.

Serious Adverse Events

Across the three studies, serious adverse events within 6-months following Menomune – A/C/Y/W-135 vaccine were reported in 0.7% of 1519 children 2-10 years of age, 0.6% of 972 persons 11-18 years of age, and 1.7% of 1170 persons 18-55 years of age.

Solicited Adverse Events1

The most commonly reported solicited adverse events in US children 2-10 years of age were injection site pain, irritability and diarrhea. (Table 1)

The most commonly reported solicited adverse events in adolescents, ages 11 - 18 years, and adults, ages 18 - 55 years, were injection site pain, headache and fatigue. (Table 2)

Table 1: Percentage of US participants 2-10 years of age reporting solicited adverse events within 7 days following administration of Menomune - A/C/Y/W-135 vaccine
N=1019-1027*
EventAnyModerate Severe
%%%
% is based on N.
*
N = The total number of participants with data. The N is for 1027 participants for all solicited events except fever (N=1019).
†
Moderate: Discomforting, interfered with or limited usual arm movement, Severe: Disabling, child unable to move arm.
‡
Moderate: 1.0–2.0 inches; Severe: > 2.0 inches.
§
Oral equivalent temperature; Moderate: 38.4-39.4 ºC, Severe: ≥ 39.5ºC.
Moderate: Skipped 2 meals, Severe: skipped ≥ 3 meals.
#
Moderate: 2 episodes, Severe: ≥ 3 episodes.
Þ
Moderate: 3-4 episodes, Severe: ≥ 5 episodes.
ß
Moderate: Interferes with normal activities, Severe: disabling, unwilling to engage in play or interaction with others.
à
Moderate: 1-3 hours duration, Severe: > 3 hours duration.
è
These solicited adverse events were reported as present or absent only.
ð
Moderate: Decreased range of motion due to pain or discomfort, Severe: unable to move major joints because of pain.
General Disorders and Administration Site Conditions
Injection site reaction
Pain †26.12.50.0
Redness‡7.90.50.0
Induration‡4.20.60.0
Swelling‡2.80.30.0
Systemic events
Fever §5.21.70.2
Gastrointestinal disorders
Anorexia ¶8.71.30.8
Vomiting #2.70.70.6
Diarrhea Þ11.82.50.3
Nervous system disorders
Drowsiness ß11.22.50.5
Irritability à12.22.60.6
Seizures è0.0N/AN/A
Musculoskeletal and connective tissue disorders
Arthralgia ð5.30.70.0
Skin and subcutaneous disorders
Rash è3.0N/AN/A
Table 2: Percentage of participants 11-55 years of age reporting solicited adverse events within 7 days following administration of Menomune - A/C/Y/W-135 vaccine
Study 1
N*=970		Study 2
N*=1159
Participants 11-18 years of age Participants 18-55 years of age
EventAnyModerateSevereAnyModerateSevere
*
N=Total number of participants with data.
†
Moderate: Discomforting, interfered with or limited usual arm movement, Severe: Disabling, unable to move arm.
‡
Moderate: 1.0–2.0 inches; Severe: > 2.0 inches.
§
Moderate: Interferes with normal activities, Severe: disabling, requires bed rest.
Oral equivalent temperature. Study 1: Moderate: 38.5-39.4 ºC, Severe: ≥ 39.5ºC. Study 2: Moderate 39.0-39.9 ºC, Severe: ≥ 40.0 ºC.
#
Moderate: 3-4 episodes, Severe: ≥ 5 episodes.
Þ
Moderate: Skipped 2 meals, Severe: skipped ≥ 3 meals.
ß
Moderate: 2 episodes, Severe: ≥ 3 episodes.
à
Moderate: discomforting enough to interfere with activities, Severe: disabling requires bed rest and analgesics.
è
These solicited adverse events were reported as present or absent only.
General Disorders and Administration Site Conditions
Injection Site reaction
Pain†28.72.60.048.13.30.1
Redness‡5.70.40.016.01.90.1
Induration‡5.20.50.011.01.00.0
Swelling‡3.60.30.07.60.70.0
Systemic events
Fatigue§25.16.20.232.36.60.4
Malaise§16.83.40.422.34.70.9
Chills§3.50.40.15.61.00.0
Fever¶3.00.30.10.50.10.0
Gastrointestinal disorders
Diarrhea#10.21.30.014.02.90.3
AnorexiaÞ7.71.10.29.91.60.4
Vomitingß1.40.50.31.50.20.4
Nervous system disorders
Headacheà29.36.50.441.88.90.9
Seizureè0.0N/AN/A0.0N/AN/A
Musculoskeletal and connective tissue disorders
Arthralgia§10.22.10.116.02.60.1
Skin and subcutaneous disorders
Rashè1.4N/AN/A0.8N/AN/A
1
Events in Table 1 and Table 2 were collected in the clinical trials under "Solicited local and systemic reactions".

6.2. Data from Post-Marketing Experience

The following adverse events have been spontaneously reported during post-approval use of Menomune – A/C/Y/W-135 vaccine since 1993 through November 2008. Because these events were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or to establish a causal relationship to Menomune – A/C/Y/W-135 vaccine exposure.

The following adverse events were included based on severity, frequency of reporting or the strength of causal association to Menomune – A/C/Y/W-135 vaccine.

  • Immune system disorders
    Hypersensitivity, such as rash, urticaria, pruritus, dyspnoea, angioedema.
  • Nervous System Disorders
    Headache, vasovagal syncope, dizziness, paraesthesia, Guillain-Barré syndrome
  • Gastrointestinal disorders
    Nausea, vomiting, diarrhea
  • Musculoskeletal and Connective Tissue Disorders
    Myalgia, arthralgia
  • General Disorders and Administration Site Conditions
    Fever, injection site reaction, malaise, asthenia, chills, fatigue

8. Use In Specific Populations

11. Menomune Description

Menomune – A/C/Y/W-135, Meningococcal Polysaccharide Vaccine, Groups A, C, Y and W-135 Combined, is a vaccine for subcutaneous injection. Menomune – A/C/Y/W-135 vaccine consists of a sterile lyophilized preparation of the group-specific polysaccharide antigens from N meningitidis, Group A, Group C, Group Y and Group W-135. N meningitidis are cultivated with Mueller Hinton agar (7) and Watson Scherp (8) media. The purified polysaccharide is extracted from the N meningitidis cells and separated from the media by procedures which include centrifugation, detergent precipitation, alcohol precipitation, solvent or organic extraction and diafiltration. No preservative is added during manufacture.

The diluent (0.6 mL) for the single –dose presentation contains sterile, pyrogen-free distilled water without preservative. The diluent (6 mL) for the multi-dose presentation contains sterile, pyrogen-free distilled water and thimerosal, a mercury derivative, which is added as a preservative for the reconstituted vaccine. [See How Supplied/Storage and Handling (16).]

After reconstitution with diluent the vaccine is a clear colorless liquid suspension. Each 0.5 mL dose contains 50 mcg of polysaccharide from each of serogroups A, C, Y and W-135. Reconstituted vaccine from a multi-dose vial also contains 25 mcg mercury per dose.

Each dose of vaccine contains 2.5 mg to 5 mg of lactose added as a stabilizer. (9)

Potency is evaluated by measuring the molecular size of each polysaccharide component using a column chromatography method as standardized by the US Food and Drug Administration (FDA) and the World Health Organization (WHO) (10) for Meningococcal Polysaccharide Vaccine.

14. Clinical Studies

Effectiveness of Menomune – A/C/Y/W-135 vaccine was inferred by evaluating the proportion of children 2-10 years of age achieving a pre-specified level of serum bactericidal antibody and the proportion of persons 11-55 years of age achieving a 4-fold increase from baseline in serum bactericidal antibody, for each serogroup. Evidence for clinical efficacy against serogroup specific meningococcal disease in school-age children and adults has been obtained from historical field trials and observational studies with other high molecular weight polysaccharide vaccines containing meningococcal serogroup A and/or C components. (6) No studies have been conducted to evaluate the efficacy of meningococcal polysaccharide vaccines against disease due to serogroups Y and W-135.

Menomune – A/C/Y/W-135 vaccine was used as the control vaccine in three US, multi-center, clinical trials designed primarily to evaluate the immunogenicity and safety of Menactra vaccine in children (2–10 years old), adolescents (11–18 years old), and adults (18–55 years old), respectively. In these trials, participants in the control arm received a dose of Menomune–A/C/Y/W-135 vaccine. Sera were obtained before and approximately 28 days after vaccination.

The Serum Bactericidal Assay (SBA) used to test sera contained an exogenous complement source that was either human (SBA-H) or, when correlated to SBA-H, baby rabbit (SBA-BR). (13)

Data on immune responses, as measured by SBA-H, following Menomune–A/C/Y/W-135 vaccine in a subset of children 2–10 years old are presented in Table 3. Data on immune responses, as measured by SBA-BR, following Menomune–A/C/Y/W-135 vaccine in adolescents and adults are presented in Table 4.
Table 3: Bactericidal Antibody Responses* to Menomune-A/C/Y/W-135 vaccine 28 Days After Vaccination for Subsets of Participants Aged 2-3 and 4-10 Years
Menomune-A/C/Y/W-135 vaccine
Aged 2-3 Years
N†=50-53		Menomune–A/C/Y/W-135 vaccine
Aged 4-10 Years
N†=84
Serogroup(95% CI) ‡Serogroup(95% CI) ‡
The study was designed to show the safety and immunogenicity of Menactra vaccine are non-inferior to that of Menomune–A/C/Y/W-135 vaccine. The table shows the immune response in Menomune–A/C/Y/W-135 vaccine participants from this study.
*
Serum Bactericidal Assay with an exogenous human complement (SBA-H) source.
†
N = Number of subset participants with at least one valid serology result at Day 0 and Day 28.
‡
The 95% CI for the Geometric Mean Titer (GMT) was calculated based on an approximation to the normal distribution.
A% ≥ 1:86450,77A% ≥ 1:85544,66
GMT107,12GMT76,9
C% ≥ 1:83825,53C% ≥ 1:84837,59
GMT115,21GMT127,18
Y% ≥ 1:87359,84Y% ≥ 1:89284,97
GMT1811,27GMT4633,66
W-135% ≥ 1:83320,47W-135% ≥ 1:87968,87
GMT53,6GMT2014,27

In participants 2-3 years of age with undetectable pre-vaccination SBA titers (ie, <4 at Day 0), rates of seroconversion (defined as SBA titer ≥8 at Day 28) following Menomune-A/C/Y/W-135 vaccine were 55%, serogroup A (n=16/29); 30%, serogroup C (n=13/43); 57%, serogroup Y (n=17/30); 26%, serogroup W-135 (n=11/43).

In participants 4-10 years of age with undetectable pre-vaccination SBA titers (ie, <4 at Day 0), rates of seroconversion (defined as SBA titer ≥8 at Day 28) following Menomune–A/C/Y/W-135 vaccine were 48%, serogroup A (n=10/21); 38%, serogroup C (n=19/50); 84%, serogroup Y (n=38/45); 68%, serogroup W-135 (n=26/38).

Table 4: Bactericidal Antibody Responses* to Menomune – A/C/Y/W-135 Vaccine 28 Days After Vaccination for Participants Aged 11-18 and 18-55 Years
Menomune–A/C/Y/W-135 vaccine
Aged 11-18 Years
N†=423		Menomune–A/C/Y/W-135 vaccine
Aged 18-55 Years
N†=1098
Both studies (11-18 and 18-55 years of age) were designed to show the safety and immunogenicity of Menactra vaccine are non-inferior to that of Menomune–A/C/Y/W-135 vaccine. The table shows the immune response in Menomune–A/C/Y/W-135 vaccine participants from these studies.
*
Serum Bactericidal Assay with baby rabbit complement (SBA-BR).
†
N = Number of participants with valid serology results at Day 0 and Day 28.
‡
The 95% CI for the GMT was calculated based on an approximation to the normal distribution.
§
The proportion of subjects with a ≥ 4-fold rise from baseline in SBA-BR titer for N. meningitidis for each of the serogroups A, C, Y and W-135, 28 days following vaccination with Menomune–A/C/Y/W-135 vaccine.
Serogroup(95% CI) ‡Serogroup(95% CI) ‡
A% ≥4-fold rise§92.4(89.5, 94.8)A% ≥4-fold rise§84.6(82.3, 86.7)
GMT3246(2910, 3620)GMT4114(3832, 4417)
C% ≥4-fold rise§88.7(85.2, 91.5)C% ≥4-fold rise§89.7(87.8, 91.4)
GMT1639(1406, 1911)GMT3469(3148, 3823)
Y% ≥4-fold rise§80.1(76.0, 83.8)Y% ≥4-fold rise§79.4(76.9, 81.8)
GMT1228(1088, 1386)GMT2449(2237, 2680)
W-135% ≥4-fold rise§95.3(92.8, 97.1)W-135% ≥4-fold rise§94.4(92.8, 95.6)
GMT1545(1384, 1725)GMT1871(1723, 2032)

In participants 11-18 years of age with undetectable pre-vaccination SBA titers (ie, <8 at Day 0), rates of seroconversion (defined as a ≥ 4-fold rise in Day 28 SBA titers) following Menomune-A/C/Y/W-135 vaccine were 100%, serogroup A (n=93/93); 99%, serogroup C (n=151/152); 100%, serogroup Y (n=47/47); 99%, serogroup W-135 (n=138/139).

In participants 18-55 years of age with undetectable pre-vaccination SBA titers (ie, <8 at Day 0), rates of seroconversion (defined as a ≥ 4-fold rise in Day 28 SBA titers) following Menomune-A/C/Y/W-135 vaccine were 99%, serogroup A (n=143/144); 98%, serogroup C (n=297/304); 97%, serogroup Y (n=221/228); 99%, serogroup W-135 (n=325/328).

15. References

1
Centers for Disease Control and Prevention. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2005;54 (No. RR - 7): 1-21.
2
Centers for Disease Control and Prevention. Revised recommendations of the Advisory Committee on Immunization Practices to vaccinate all persons aged 11-18 years with meningococcal conjugate vaccine. MMWR 2007;56:794-5.
3
Centers for Disease Control and Prevention. Recommendation from the Advisory Committee on Immunization Practices (ACIP) for use of quadrivalent meningococcal conjugate vaccine (MCV4) in children aged 2-10 years at increased risk for invasive meningococcal disease. MMWR 2007;56:1265-6.
4
Recommendations of the Advisory Committee on Immunization Practices (ACIP) General Recommendations on Immunization. MMWR 2006 December 01;55(RR15):1-48.
5
Reingold AL, et al. Age-specific differences in duration of clinical protection after vaccination with meningococcal polysaccharide A vaccine. Lancet. 1985;No.8447:114-118.
6
Granoff DM, et al. Meningococcal vaccines. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 5th ed. Philadelphia, PA: WB Saunders Company; 2008:399-434.
7
Mueller H, et al. A protein-free medium for primary isolation of the gonococcus and meningococcus. Proc Soc Exp Biol Med 1941;48:330.
8
Watson RG, et al. The specific hapten of group C (group II a) meningococcus. II. Chemical nature. J Immunol. 1958;81:337.
9
Tiesjema RH, et al. Enhanced stability of meningococcal polysaccharide vaccines by using lactose as a menstruum for lyophilization. Bull WHO 1977;55:43-48.
10
WHO Technical Report Series, 1981;No.658.
11
Mäkelä PH, et al. Evolution of conjugate vaccines. Expert Rev Vaccines 2002;1(3):399-410.
12
Goldschneider I, et al. Human immunity to the meningococcus. I. The Role of Humoral Antibodies. J Exp Med 1969;129:1307-1326.
13
Maslanka SE, et al. Standardization and a Multilaboratory Comparison of Neisseria meningitidis Serogroup A and C Serum Bactericidal Assays. Clin and Diag Lab Immunol 1997;156-167.

Rx only

Product information
as of January 2009

Manufactured by:
Sanofi Pasteur Inc.
Swiftwater PA 18370 USA

5484

MENOMUNE - A/C/Y/W-135 COMBINED
neisseria meningitidis group a polysaccharide antigen, a, neisseria meningitidis group c polysaccharide antigen, a, neisseria meningitidis group y polysaccharide antigen, a and neisseria meningitidis group w-135 polysaccharide antigen, a kit
Product Information
Product TypeVACCINEItem Code (Source)NDC:49281-489
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:49281-489-911 in 1 PACKAGE
Quantity of Parts
Part #Package QuantityTotal Product Quantity
Part 11 VIAL, MULTI-DOSE 5 mL
Part 21 VIAL 6 mL
Part 1 of 2
MENOMUNE - A/C/Y/W-135 COMBINED
neisseria meningitidis group a polysaccharide antigen, a, neisseria meningitidis group c polysaccharide antigen, a, neisseria meningitidis group y polysaccharide antigen, a and neisseria meningitidis group w-135 polysaccharide antigen, a injection
Product Information
Route of AdministrationSUBCUTANEOUS
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Neisseria Meningitidis Group A Polysaccharide Antigen, A (UNII: 1I86B47NY4) (Neisseria Meningitidis Antigen - UNII:V3TP2MD7F3) Neisseria Meningitidis Antigen50 ug in 0.5 mL
Neisseria Meningitidis Group C Polysaccharide Antigen, A (UNII: 837RU6905N) (Neisseria Meningitidis Antigen - UNII:V3TP2MD7F3) Neisseria Meningitidis Antigen50 ug in 0.5 mL
Neisseria Meningitidis Group Y Polysaccharide Antigen, A (UNII: CBZ4BH7TJ1) (Neisseria Meningitidis Antigen - UNII:V3TP2MD7F3) Neisseria Meningitidis Antigen50 ug in 0.5 mL
Neisseria Meningitidis Group W-135 Polysaccharide Antigen, A (UNII: 9F8QQ6EER1) (Neisseria Meningitidis Antigen - UNII:V3TP2MD7F3) Neisseria Meningitidis Antigen50 ug in 0.5 mL
Inactive Ingredients
Ingredient NameStrength
LACTOSE (UNII: J2B2A4N98G)
SODIUM CHLORIDE (UNII: 451W47IQ8X)
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
15 mL in 1 VIAL, MULTI-DOSE
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
BLABLA10392411/23/1981
Part 2 of 2
STERILE, PRESERVATIVE-FREE, PYROGEN-FREE, DISTILLED WATER
water injection
Product Information
Route of AdministrationSUBCUTANEOUS
Inactive Ingredients
Ingredient NameStrength
Water (UNII: 059QF0KO0R)
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
16 mL in 1 VIAL
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
BLABLA10392411/23/1981
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
BLABLA10392411/23/1981
Labeler - Sanofi Pasteur Inc. (086723285)
Establishment
NameAddressID/FEIBusiness Operations
Sanofi Pasteur Inc.086723285MANUFACTURE

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