Meningococcal Vaccine: Who and When to Vaccinate
For Healthcare Providers
There are two meningococcal vaccines available in the United States:
- Meningococcal polysaccharide vaccine
- Meningococcal conjugate vaccine
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.
All 11-12 years olds should be vaccinated with meningococcal conjugate vaccine. 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 meningococcal conjugate vaccine at or after age 16 years do not need a booster dose.
Booster shot recommendation
When meningococcal conjugate vaccine 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.
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 first-year college student living in a residence hall
- 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 meningococcal conjugate vaccine 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.
Meningococcal conjugate vaccine (Menactra®, Menveo®, MenHibrix®) is recommended for certain children at increased risk from ages 2 months through 10 years.
This vaccine is routinely recommended for children at increased risk for meningococcal disease, including those:
- With certain medical conditions (persistent complement component deficiencies (e.g., C5-C9, properdin, factor H, or factor D) and functional or anatomic asplenia)
- Who travel to specific countries
- Who are in a defined risk group during a community or institutional meningococcal disease outbreak
Children with functional or anatomic asplenia are NOT recommended to receive Menactra® until 2 years of age in order to avoid interference with the immunologic response to the infant series of pneumococcal conjugate vaccine (PCV). ACIP recommends that infants 2 through 23 months of age with functional or anatomic asplenia either receive Menveo® or MenHibrix® or wait until 2 years of age to receive Menactra®. Persons over 2 years of age 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 who received their primary series when aged 2 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.
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