Vaccines and Preventable Diseases:

Meningococcal Vaccine: Who and When to Vaccinate
For Healthcare Providers

There are two meningococcal vaccines available in the United States:

• Meningococcal polysaccharide vaccine (MPSV4)
• Meningococcal conjugate vaccine (MCV4)

 

Who Needs to be Vaccinated?

Preteens and Teens

In adolescents, those ages 16 through 21 years have the highest rates of meningococcal disease. Even though the disease is not very common, we want to prevent as many adolescents as possible from getting it. Meningococcal bacteria can cause severe disease, including meningitis and sepsis, resulting in permanent disabilities and even death.

Routine recommendation

All 11-12 years olds should be vaccinated with meningococcal conjugate vaccine (MCV4). Now, a booster dose should be given at age 16 years. For adolescents who receive the first dose at age 13 through 15 years, a one-time booster dose should be administered, preferably at age 16 through 18 years, before the peak in increased risk. Adolescents who receive their first dose of MCV4 at or after age 16 years do not need a booster dose.

Booster shot recommendation

When MCV4 was first recommended for adolescents in 2005, the expectation was that protection would last for 10 years; however, currently available data suggest it wanes in most adolescents within 5 years. Based on that information, a single dose at the recommended age of 11 or 12 years may not offer protection through the adolescent years at which risk for meningococcal infection is highest (16 though 21 years of age). If we didn’t recommend a booster dose, adolescents at highest risk would not be well protected.

For patients who are about to start college and got their first dose more than 5 years ago

For the best protection, we recommend that these patients receive a booster dose. Meningococcal vaccination is required to attend many colleges. The Advisory Committee on Immunization Practices (ACIP) suggests that students receive the vaccine less than 5 years before starting school.

Booster dose for patients younger than 16 years who you might not see again

It’s recommended that you use your clinical judgment in a situation where you may not have another opportunity to provide the booster dose to this patient. The minimum interval between doses is 8 weeks.

Polysaccharide versus conjugate vaccine

Only the meningococcal conjugate vaccine is recommended for adolescents. However, a first dose of meningococcal vaccine administered as polysaccharide vaccine can be counted as valid in the adolescent schedule. The booster dose of meningococcal vaccine should always be conjugate vaccine (among persons younger than 56 years). If polysaccharide vaccine is inadvertently administered as the booster dose CDC recommends revaccination with conjugate vaccine.

Adolescents with HIV

Adolescents aged 11 through 18 years with HIV should be routinely vaccinated with a 2-dose primary series administered 2 months apart. Those adolescents should also receive the routine booster dose at age 16 years if the primary series is received before the 16th birthday.

Booster dose interval

Adolescents age 16 through 18 years can get the booster dose at any time. The minimum interval between doses is 8 weeks.

Safety of booster dose

Available data suggests that the booster dose is very safe, but vaccine safety will continue to be monitored.

For additional details, consult the Meningococcal Vaccine Information Statement (2 pages) (compliant) and the Adolescent Immunization Schedule.

Adults

See also: Adult Immunization Schedule

Adults should get either the meningococcal polysaccharide vaccine (56 years and older) or the meningococcal conjugate vaccine (19 through 55 years) if:

• They are a college freshmen living in a dormitory
• They are a military recruit
• They have complement component deficiency
• They have functional or anatomic asplenia
• They are a microbiologist who is routinely exposed to Neisseria meningitidis (the causal pathogen)
• They are traveling or residing in countries in which the disease is common.

In October 2010, ACIP voted to recommend a two-dose primary series of MCV4 given 2 months apart for 2 through 54 year olds with the above listed health conditions.

A booster dose is recommended every 5 years if the adult remains at increased risk.

For additional details, consult the Meningococcal Vaccine Information Statement (2 pages) and the Adult Immunization Schedule.

Healthcare Personnel Vaccination Recommendations (1 page)

Infants and Children

The meningococcal conjugate vaccine (MCV4) is recommended for certain high risk children from ages 9 months through 10 years.

The high risk children for whom this vaccine is recommended include children who travel to, and United States citizens who reside in, countries where meningococcal meningitis is hyperendemic or epidemic (e.g. the African Meningitis Belt), persons with persistent complement component deficiencies (e.g., C5-C9, properdin, factor H, or factor D), persons with functional or anatomic asplenia, and children who are in a defined risk group during a community or institutional meningococcal disease outbreak. However, 9 through 23 month old children with functional or anatomic asplenia are NOT recommended to receive the vaccine.

A 2-dose primary series is recommended for any child with the risk factors described above whose first dose was received before their second birthday. Persons at increased risk because of complement component deficiencies and persons with functional or anatomic asplenia should receive a two dose primary series 2 months apart and then get a booster dose every 5 years. Children aged 9 months-6 years at increased risk are recommended to be revaccinated 3 years after their primary series, and then at 5 year intervals if they remain at risk.

In October 2010, ACIP voted to recommend a two-dose primary series of MCV4 given 2 months apart for 2 through 54 year olds with medical risk factors (complement component deficiency, functional or anatomic asplenia). In April 2011, ACIP voted to recommend MCV4 for children 9 through 23 months of age with certain medical risk factors (complement component deficiency).

For additional details, consult the Meningococcal Vaccine Information Statement (2 pages) and the Childhood Immunization Schedule.

 

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