About Meningococcal Vaccines
Currently, there are 5 meningococcal vaccines licensed and available in the United States. Learn about the composition, types, immunogenicity, and effectiveness of these vaccines, as well as view package inserts, below.
Types and Composition of Meningococcal Vaccines
Of the 5 meningococcal vaccines available in the United States: 3 are conjugate vaccines and 2 are recombinant protein vaccines. Meningococcal vaccines also vary by the number of serogroups they provide protection against. Both recombinant protein vaccines are monovalent vaccines. This means the Food and Drug Administration licensed them to provide protection against 1 serogroup (B). In contrast, the conjugate vaccines provide protection against 4 serogroups (A, C, W, and Y), making them quadrivalent vaccines.
Meningococcal Conjugate or MenACWY Vaccines
Sanofi Pasteur formulates each 0.5-milliliter (mL) dose of Menactra® in sodium phosphate buffered isotonic sodium chloride solution. Each dose contains 4 micrograms (µg) each of meningococcal A, C, W, and Y polysaccharides conjugated to approximately 48 µg of diphtheria toxoid protein carrier. It does not contain a preservative or an adjuvant. The manufacturer supplies it as a liquid in a single-dose vial.
GlaxoSmithKline formulates each 0.5-mL dose of Menveo® to consist of 2 portions:
- 10 µg of lyophilized meningococcal serogroup A (MenA) capsular polysaccharide conjugated to CRM197
- 5 μg each of capsular polysaccharide of serogroup C, W, and Y (MenCWY) conjugated to CRM197 in 0.5 mL of phosphate buffered saline
Vaccine providers reconstitute the lyophilized MenA component with the MenCWY liquid component before injection. It does not contain a preservative or an adjuvant.
Sanofi Pasteur formulates each 0.5-milliliter (mL) dose of MenQuadfi® to contain 10 µg each of meningococcal A, C, W, and Y polysaccharides conjugated to approximately 55 µg of tetanus toxoid protein carrier. It does not contain a preservative or an adjuvant. The manufacturer supplies it as a liquid in a single-dose vial.
Serogroup B Meningococcal or MenB Vaccines
GlaxoSmithKline formulates each 0.5-mL dose of Bexsero® to contain:
- 50 µg each of recombinant proteins Neisserial adhesin A (NadA), Neisserial Heparin Binding Antigen (NHBA), and factor H binding protein (fHbp)
- 25 µg of Outer Membrane Vesicles (OMV)
- 5 milligrams (mg) aluminum hydroxide (0.519 mg of Al3+)
- 125 mg sodium chloride
- 776 mg histidine
- 10 mg sucrose at pH 6.4 – 6.7
Each dose contains less than 0.01 µg kanamycin (by calculation).
Pfizer formulates each 0.5-mL dose of Trumenba® to contain:
- 60 µg each of 2 lipidated fHBP variants (total of 120 µg of protein)
- 0.018 mg of polysorbate 80
- 0.25 mg of Al³+
- 10 millimolar (mM) histidine buffered saline at pH 6.0
Immunogenicity and Vaccine Effectiveness
- Conjugate: A type of vaccine that joins a protein to an antigen in order to improve the protection the vaccine provides
- Recombinant protein: A type of vaccine that contains protein antigens
Incidence of meningococcal disease has declined in the United States since the 1990s and remains low today. Much of the decline occurred prior to routine use of MenACWY vaccines. In addition, serogroup B meningococcal disease declined even though MenB vaccines were not available until the end of 2014.
CDC first recommended adolescents get a MenACWY vaccine in 2005. Since then, the incidence of meningococcal disease in adolescents caused by serogroups C, Y, and W decreased by over 90% (note: serogroup A meningococcal disease continues to be very rare in the United States). Other age groups that CDC does not recommend routine MenACWY vaccination for did not see this large of a percent decline. These data suggest MenACWY vaccines have provided protection to those vaccinated, but not to the larger, unvaccinated community through population or herd immunity. Experts also believe MenB vaccines do not provide protection to unvaccinated people through population immunity. As part of the licensure process, both MenACWY and MenB vaccines demonstrated that they produce an immune response. This immune response suggests the vaccines are protective (summarized from package inserts below), but effectiveness data are limited. Since meningococcal disease is uncommon, many people need to get these vaccines in order to measure their effectiveness.
Available data suggest that protection from MenACWY vaccines decreases in many adolescents within 5 years. Getting the 16-year-old MenACWY booster dose is critical to maintaining protection when adolescents are most at risk for meningococcal disease. Available data on MenB vaccines suggest that protective antibodies also decrease quickly (within 1 to 2 years) after vaccination. MenB booster doses are important for those who remain at increased risk of serogroup B meningococcal disease.
Consult the following package inserts for proper storage and handing details, shelf life, and reconstitution instructions: