Administering Meningococcal Vaccines

This page provides a brief summary of guidance for administering meningococcal vaccines, including route, number of doses, and co-administration with other vaccines.

Visual Inspection

Do not use any meningococcal vaccine or diluent (if applicable) beyond the expiration date printed on the label.

Prior to administration, visually inspect the vaccine for particulate matter and/or discoloration. If these conditions exist, do NOT use.

Route, Site, and Needle Size

Administer meningococcal conjugate (MenACWY) and serogroup B meningococcal (MenB) vaccines by the intramuscular route. The preferred site for infants and young children is the vastus lateralis muscle in the anterolateral thigh. The preferred injection site in older children and adults is the deltoid muscle. Use a needle length appropriate for the age and size of the person receiving the vaccine.

Number and Timing of Doses

MenACWY Vaccines

Administer MenACWY vaccines (Menactra^®, Menveo^® [either one- or two-vial presentation], or MenQuadfi^®) to adolescents as 1 primary dose at 11 to 12 years of age. Administer 1 booster dose at 16 years of age. The minimum interval between doses is at least 8 weeks.

Patients 2 years of age or older should receive a 2-dose primary series (Menactra^®, Menveo^® [two-vial presentation only], or MenQuadfi^®) 2 months apart if they have

• Complement component deficiencies
• Complement inhibitor use (including Soliris® or Ultomiris®)
• Functional or anatomic asplenia
• HIV

The number of doses and schedule for patients under 2 years of age varies by vaccine product. See package inserts for specific guidance.

For patients at prolonged increased risk for meningococcal disease, CDC recommends MenACWY booster doses after completion of the primary series. For patients who received their most recent dose before age 7 years, administer the booster dose 3 years later. For patients who received their most recent dose at age 7 years or older, administer the booster dose 5 years later. Administer boosters every 5 years thereafter throughout life as long as the person remains at increased risk for meningococcal disease.

MenB Vaccines

Both MenB vaccine products require more than 1 dose for maximum protection. Patients must receive the same vaccine product for all doses.

• Bexsero:^® Administer 2 doses. Administer the second dose at least 1 month after the first dose.
• Trumenba:^® Administer 2 or 3 doses.
  • Administer 2 doses to healthy adolescents who are not at increased risk for serogroup B meningococcal disease. Administer the second dose 6 months after the first dose.
  • Administer 3 doses to people 10 years of age or older who are at increased risk for meningococcal disease. This includes during outbreaks of serogroup B meningococcal disease. Administer the second dose 1 to 2 months after the first dose. Administer the third dose 6 months after the first dose.

For patients at prolonged increased risk for meningococcal disease, CDC recommends MenB booster doses after completion of the primary series. Administer a booster dose of MenB vaccine 1 year after series completion and then every 2 to 3 years thereafter.

Predrawing Vaccine Doses

Do not predraw vaccine doses. There are no data on the stability of vaccines stored in syringes filled by healthcare professionals. Do not open vaccine vials until time of administration.

After reconstitution, administer Menveo^® two-vial presentation within 8 hours or discard.

Administration with Other Vaccines

Vaccine providers may administer MenACWY and MenB vaccines during the same visit, but at a different injection site, if feasible. Providers can also administer meningococcal and other vaccines during the same visit, but at a different injection site, if feasible. Administer each vaccine with a separate syringe.

MenACWY Vaccines

• Vaccine providers can administer MenACWY with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), human papillomavirus (HPV), and MenB vaccines.
• Healthy children 9 through 23 months of age can receive Menactra^® with other vaccines. However, children with functional or anatomic asplenia or HIV should NOT receive Menactra^® before the age of 2 years. This timing avoids interference with the immunologic response to the infant series of pneumococcal conjugate vaccine (PCV). CDC recommends infants 2 through 23 months of age with functional or anatomic asplenia or HIV receive Menveo^® two-vial presentation. If Menactra^® is  used in individuals aged 2 years or older who have functional or anatomic asplenia or HIV, it should not be administered until at least 4 weeks after completion of all PCV doses.
• Children can receive Menactra^® before or concomitantly with diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccines. This timing avoids interference with the immunologic response to the meningococcal vaccine antigens that occurs when administering Menactra^® after DTaP. Alternatively, children can receive Menveo^® two-vial presentation or MenQuadfi^®, regardless of timing of DTaP vaccination.

MenB Vaccines

• On the basis of available data and expert opinion, Bexsero^® or Trumenba^® may be administered with Tdap, HPV, and MenACWY vaccines. If received during the same visit, vaccine providers should administer the vaccines at a different injection site, if feasible.