Risk factor | MenACWY | MenB for those ≥10 years of age | ||
Primary dose(s) | Booster dose(s) if increased risk persists | Primary dose(s) | Booster dose(s) if increased risk persists | |
Immunodeficiency that increases the risk of meningococcal disease | ||||
Complement component deficiency (eg, C3, C5-C9, properdin, factor H, factor D) or use of complement inhibitors (eg, eculizumab, ravulizumab)*¶ or Anatomic or functional asplenia including sickle cell disease | 2 doses of any MenACWY, ≥8 weeks apart¥ |
| 3 doses of either MenB formulation at 0-, 1- to 2-, and 6-months.¥‡ 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. | 1 year after completion of primary series and every 2 to 3 years thereafter. |
Persons with HIV | 2 doses of any MenACWY, ≥8 weeks apart |
| MenB is not recommended unless it is otherwise indicated (eg, age 16 through 23 years based on shared decision-making).† | |
Increased risk of exposure to meningococcal disease | ||||
Microbiologists routinely exposed to meningococcus | 1 dose of any MenACWY¶¥ |
| 3 doses of either MenB formulation at 0-, 1- to 2-, and 6-months.¥‡ 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. | 1 year after completion of primary series and every 2 to 3 years thereafter. |
Persons who travel to or are residents of countries where meningococcal disease is hyperendemic or epidemicΔ | 1 dose of any MenACWY¶ |
| MenB is not recommended unless it is otherwise indicated (eg, age 16 through 23 years based on shared decision-making)†. | |
Unvaccinated or undervaccinated college freshmen living in residence halls◊ | 1 dose of any MenACWY¶ |
| ||
Unvaccinated or undervaccinated military recruits | 1 dose of any MenACWY¶ |
|
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 risk who are <2 years of age, routine meningococcal vaccination of adolescents and young adults, and information about immunizations during meningococcal outbreaks. Some of the recommendations above are considered off-label (eg, administration of a 2-dose primary series for MenACWY, repeated booster doses of MenACWY or MenB).
CDC: United States Centers for Disease Control and Prevention; MenACWY: meningococcal groups A, C, W, and Y conjugate vaccine; MenB: serogroup B meningococcal vaccine.
* Meningococcal vaccines should be administered ≥2 weeks before the first dose of complement inhibitor, unless the risk for delaying complement therapy outweighs the risk for developing meningococcal disease.
¶ Patients at increased risk of exposure who also have an immunodeficiency that increases the risk of meningococcal disease should receive the 2-dose primary series.
Δ Vaccination is recommended for international travelers visiting the parts of sub-Saharan Africa known as the meningitis belt during the dry season (December to June). The CDC issues advisories for other countries during epidemics of vaccine-preventable serogroups. Additional traveler's health information is available from the CDC.
◊ College freshmen living in residence halls should receive ≥1 dose of MenACWY ≤5 years before college entry (preferably at age ≥16 years). If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment.
§ Vaccination recommendations for military personnel are made by the United States Department of Defense on the basis of high-risk travel requirements.
¥ For persons aged 10 to 25 years who require MenACWY and MenB at the same time, MenACWY-TT/MenB-FHbp (Penbraya) can be used for some of the doses, eg:
Since MenB vaccines are not interchangeable, MenB-4C cannot be substituted for MenB-FHbp and MenACWY-TT/MenB-FHbp cannot replace MenB-4C (Bexsero). MenACWY-TT/MenB-FHbp should not be administered at intervals <6 months.
‡ Sometimes there are unexpected deviations in the schedule.
† For such persons, a two dose MenB series is sufficient. Refer to the UpToDate table that discusses routine vaccination for healthy children and adolescents.