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Routine meningococcal vaccination recommendations for healthy adolescents and young adults age 11 through 23 years in the United States

Routine meningococcal vaccination recommendations for healthy adolescents and young adults age 11 through 23 years in the United States
Meningococcal vaccine Primary dose(s) Booster dose(s)
MenACWY
(for those age 11 through 21 years)*

1 dose at age 11 through 21 years*; preferred age: 11 through 12 years

MenACWY (any licensed vaccine):

  • MenACWY-CRM (Menveo)
  • or
  • MenACWY-TT (MenQuadfi)
  • or
  • MenACWY-TT/MenB-FHbp (Penbraya; may use if the patient also requires MenB-FHbp at that visit)Δ

1 dose at age 16 to 21 years.

  • If the first dose is given after age 16, a booster is not needed unless the person is at increased risk for meningococcal disease.
  • College freshmen living in residence halls should receive ≥1 dose of MenACWY ≤5 years before college entry.

MenACWY (any licensed vaccine):

  • MenACWY-CRM (Menveo)
  • or
  • MenACWY-TT (MenQuadfi)
  • or
  • MenACWY-TT/MenB-FHbp (Penbraya; may use if the patient also requires MenB-FHbp at that visit)Δ
MenB
(for those age 16 through 23 years based on shared decision-making)¶Δ

2 doses administered 6 months apart◊; preferred age: 16 through 18 years

Either:

  • MenB-4C (Bexsero)
  • or
  • MenB-FHbp (Trumenba). MenACWY-TT/MenB-FHbp (Penbraya) may replace either dose of MenB-FHbp if the patient also requires MenACWY at that visit.

MenB formulations are not interchangeable. A single manufacturer's MenB products must be used for each dose of the primary series and all booster doses (if applicable).

 Not routinely recommended unless the person becomes at risk (eg, develops condition associated with increased risk of severe meningococcal disease, exposed during an outbreak, has occupational risk).
This table is meant for use with UpToDate content on meningococcal vaccination. Refer to UpToDate content for additional details, including meningococcal vaccination of persons at increased risk of meningococcal disease and details of shared decision-making.
  • Two MenACWY are licensed in the United States:
    • MenACWY-CRM (Menveo)
    • MenACWY-TT (MenQuadfi)
  • MenACWY-D (Menactra) was discontinued in 2022.
  • Another MenACWY-TT vaccine (Nimenrix) is licensed in some countries outside the United States. In the United States, it is available as a component of the combination vaccine MenACWY-TT/MenB-FHbp (Penbraya), which is approved for use in persons 10 to 25 years of age.
  • Although each of the MenACWY vaccine formulations use a different protein conjugate, the products are considered interchangeable in persons ≥2 years of age. The same vaccine product is recommended, but not required, for all doses. The minimum interval between doses is 8 weeks.
  • Two MenB vaccines are licensed in the United States:
    • MenB-4C (Bexsero)
    • MenB-FHbp (Trumenba; is also a component of the combination vaccine MenACWY-TT/MenB-FHbp [Penbraya])

ACIP: Advisory Committee on Immunization Practices; MenACWY: meningococcal groups A, C, W, and Y conjugate vaccine; MenB: serogroup B meningococcal vaccine.

* Although the ACIP recommends routine MenACWY vaccination only for adolescents age 11 through 18 years, MenACWY may be given to persons age 19 through 21 years who have not received a dose. This is particularly important for those who are going to attend college and is applicable to other congregate living settings.

¶ Given the seriousness of meningococcal disease and efficacy and safety of available formulations, we suggest MenB for persons age 16 through 23 years. The rationale for this approach is discussed in the topic on meningococcal vaccination.

Δ If the patient receives MenACWY-TT/MenB-FHbp (Penbraya) as the first dose of MenB, they must complete the MenB series with a dose of MenB-FHbp (Trumenba) 6 months later. MenACWY-TT/MenB-FHbp may only replace the second dose of the MenB series if the first dose was MenB-FHbp (Trumenba).

◊ Sometimes there are unexpected deviations in the schedule.

  • If the second dose is administered <6 months after the first dose, a third dose should be administered ≥4 months after the second dose.
  • If the second dose is administered >6 months after the first dose, it is valid and does not need to be repeated.
References:
  1. Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020; 69:1.
  2. Immunization Action Coalition. Meningococcal ACWY vaccine recommendations by age and risk factor. https://www.immunize.org/catg.d/p2018.pdf (Accessed on October 26, 2020).
  3. Immunization Action Coalition. Meningococcal B vaccine recommendations by age and risk factor. https://www.immunize.org/catg.d/p2035.pdf (Accessed on October 26, 2020).
  4. Schillie S, Loehr J, Chen WH, et al. New dosing interval and schedule for the Bexsero MenB-4C Vaccine: Updated recommendations of the Advisory Committee on Immunization Practices — United States, October 2024. MMWR Morb Mortal Wkly Rep 2024; 73:1124.
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