Meningococcal Vaccination for Adolescents: Information for Healthcare Professionals

CDC recommends meningococcal vaccination for all adolescents. Follow the recommended immunization schedule to ensure that your patients get the meningococcal vaccines that they need.

• All 11 to 12 year olds should receive a single dose of meningococcal conjugate (MenACWY) vaccine.
• Since protection wanes, CDC recommends a booster dose at age 16 years. The booster dose provides protection during the ages when adolescents are at highest risk of meningococcal disease.
• Adolescents and young adults (16 through 23 years of age) may also receive a serogroup B meningococcal (MenB) vaccine. The preferred age at which to administer MenB vaccine is 16 through 18 years.
• CDC recommends that certain adolescents and young adults should receive a MenB vaccine. They include those at increased risk because of a serogroup B meningococcal disease outbreak and people with certain medical conditions.
• If a patient is receiving MenACWY and MenB vaccines at the same visit, MenABCWY vaccine may be administered instead.

Adolescents are at increased risk for meningococcal disease.

Anyone can get meningococcal disease. However, adolescents and young adults 16 through 23 years of age are at increased risk for meningococcal disease. In addition, college students have a slightly higher risk than other teens and young adults who are not attending college. Meningococcal bacteria can cause severe disease, including meningitis, bacteremia, and septicemia, resulting in permanent disabilities and even death.

There are 3 types of meningococcal vaccines available in the United States. Each type helps protect against different serogroups of meningococcal disease.

MenACWY vaccines provide protection against 4 serogroups: A, C, W, and Y. MenB vaccines provide protection against serogroup B. MenABCWY vaccine provides protection against all 5 serogroups.

You can administer MenACWY and MenB vaccines at the same time. You can also administer them, or MenABCWY vaccine, with other vaccines recommended for adolescents.

Vaccine providers may administer meningococcal and other vaccines during the same visit, but at different injection sites if feasible.

CDC recommends meningococcal vaccination for people identified as being at increased risk during outbreaks.

CDC supports state and local health departments in investigating outbreaks and implementing outbreak control measures. During a serogroup A, C, W, or Y meningococcal disease outbreak, CDC recommends MenACWY vaccination for people at increased risk because of the outbreak. During a serogroup B meningococcal disease outbreak, CDC recommends MenB vaccination for people at increased risk because of the outbreak. People who have previously received MenACWY or MenB vaccine and become at increased risk because of an outbreak may be recommended to receive a booster dose depending on how long it has been since they previously received the vaccine.

MenACWY Vaccines

A MenACWY booster dose helps protect adolescents during the ages they are at highest risk.

Protection from MenACWY vaccination wanes in most adolescents within 5 years. Based on that information, adolescents need a booster dose at age 16 years. The booster dose provides protection during the years when they are at highest risk of meningococcal disease.

MenACWY vaccines are safe.

CDC continually monitors the safety of all vaccines. For information about side effects, see the Meningococcal ACWY Vaccine Information Statement.

Many colleges require proof of MenACWY vaccination within 5 years before starting school.

CDC recommends that students receive a MenACWY vaccine within 5 years prior to starting college. This vaccination is required to attend many colleges.

The minimum booster dose interval is 8 weeks for MenACWY vaccines.

The minimum interval between doses is 8 weeks. However, healthy adolescents do not need a booster if the initial dose is given at or after age 16 years.

People with certain medical conditions need a 2-dose primary series of MenACWY vaccine and routine booster doses.

Vaccinate people with the following medical conditions with a 2-dose primary series of MenACWY vaccine administered 8 weeks apart:

• Complement component deficiency (e.g., C5-C9, properdin, factor H, factor D, or are taking a complement inhibitor such as Soliris® or Ultomiris®)
• Functional or anatomic asplenia (including sickle cell disease)
• HIV

Administer routine booster doses every 5 years throughout life to people with these medical conditions. Booster doses will help these patients maintain protection against meningococcal disease.

MenB Vaccines

CDC does not routinely recommend MenB vaccination for all adolescents.

Vaccine providers may choose to administer a MenB vaccine to adolescents and young adults 16 through 23 years of age. The preferred age at which to administer the vaccine is 16 through 18 years old.

Together, clinicians and patients or their parents can determine if MenB vaccination is appropriate for them. Clinicians, parents, teens, and young adults may want to consider the following when making this decision:

• Meningococcal disease is an uncommon but deadly disease. About 1 in 10 people who develop meningococcal disease will die, and up to 1 in 5 people who survive their meningococcal infection have lifelong health problems. These complications include loss of limbs, deafness, nervous system problems, or brain damage.
• MenB vaccines provide protection against most, but not all serogroup B strains circulating in the United States. However, studies suggest MenB vaccines offer only short-term protection. Available data suggest that protective antibodies decrease quickly (within 1 to 2 years) after MenB vaccination.
• College students, especially those who are freshmen, attend a 4-year university, live in on-campus housing, or participate in sororities and fraternities, have a higher risk of meningococcal disease than their peers who are not attending college. College campuses have reported outbreaks of serogroup B meningococcal disease during the last several years. Some colleges now require MenB vaccination.
• Clinical trials, studies during outbreaks, and ongoing safety monitoring have shown that MenB vaccines are safe.
• MenB vaccines only provide protection to the people who receive the vaccine. MenB vaccines do not provide protection to unvaccinated people through population or herd immunity.

Administer MenB vaccines at 16 through 18 years of age to maximize protection when adolescents are at highest risk.

CDC recommends vaccine providers who choose to administer the MenB vaccine series give it in later adolescence. The preferred age at which to administer MenB vaccine is at 16 through 18 years. This timing maximizes the likelihood that vaccinated adolescents will have protection during the ages when they are at highest risk. Clinicians hopefully will see college-bound adolescents during a pre-college visit. If so, this visit provides an opportunity to initiate the MenB vaccine series for those who choose to receive it.

People with certain medical conditions need a primary series of MenB vaccine and routine booster doses.

Vaccinate people who have the following medical conditions with a primary series of MenB vaccine:

• Complement component deficiency (e.g., C5-C9, properdin, factor H, factor D, or are taking a complement inhibitor such as Soliris^® or Ultomiris^®)
• Functional or anatomic asplenia (including sickle cell disease)

The primary series for Bexsero^® requires 2 doses. Administer the second dose at least one month after the first dose. The primary series for Trumenba^® for people at increased risk requires 3 doses. Administer the second dose 1 to 2 months after the first dose. Administer the third dose 6 months after the first dose.

Administer a booster dose of MenB vaccine 1 year after series completion and then every 2 to 3 years thereafter, to people with these medical conditions.

MenB vaccines are safe.

Available data show that MenB vaccines are safe. Side effects like pain at the injection site, fever, and headache are common. These side effects usually resolve on their own within 3 to 5 days after vaccination. MenB vaccines are more reactogenic than other adolescent vaccines (i.e., HPV, MenACWY, and Tdap vaccine). They are likely to produce common or expected short-term side effects (especially pain at the injection site). There have been no unusual patterns of serious reactions associated with these vaccines.

For more information about side effects, see the Meningococcal B Vaccine Information Statement.

MenB vaccines require multiple doses.

Both MenB vaccine products require more than 1 dose for maximum protection. Adolescents 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 adolescents 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.

It does not matter which MenB vaccine you use.

CDC has no preference as to which MenB vaccine you use, but adolescents must receive the same vaccine product for all doses. If an adolescent receives different products for any of the doses, proceed with the next scheduled dose of the selected product with a minimum of 1 month since the last dose of either product.

You can refer people to multiple places for MenB vaccination if you do not stock a MenB vaccine.

College health centers or pharmacies may have MenB vaccines available.

MenABCWY Vaccine

CDC only recommends a MenABCWY vaccine as an option when a patient is receiving MenACWY and MenB vaccines at the same visit.

If a MenABCWY vaccine is not available, patients can still get MenACWY and MenB vaccines as two separate vaccinations.

It matters which MenB vaccine patients receive for their second dose after getting a MenABCWY vaccine.

People must get the same vaccine brand for all doses of MenB vaccine. If a patient receives MenABCWY vaccine, which includes the MenB vaccine Trumenba^®, then administer Trumenba^® for their additional MenB dose(s).

MenABCWY vaccine is safe.

Available data show that MenABCWY vaccine is safe. Side effects like pain at the injection site, fever, and headache are common. These side effects usually resolve on their own within 3 to 5 days after vaccination. The MenB component of this vaccine is more reactogenic than other adolescent vaccines (i.e., HPV, MenACWY, and Tdap vaccine). MenB vaccine is likely to produce common or expected short-term side effects (especially pain at the injection site). There have been no unusual patterns of serious reactions associated with MenABCWY vaccine.

For more information about side effects, see the

• Meningococcal ACWY Vaccine Information Statement
• Meningococcal B Vaccine Information Statement

People with certain medical conditions may get more than one dose of MenABCWY vaccine.

If a patient is receiving MenACWY and MenB vaccines at the same visit, MenABCWY may be given instead.

If a patient receives MenABCWY vaccine, which includes Trumenba^®, then administer:

• Trumenba^® for additional MenB dose(s) when MenACWY isn’t indicated
• Any MenACWY vaccine when MenB isn’t indicated

The minimum interval between MenABCWY doses is 6 months.

People with prolonged increased risk for serogroup A, C, W, or Y and B meningococcal disease need regular boosters. However, the recommended interval between doses varies by age and vaccine type. MenABCWY vaccine can be used only when both MenACWY and MenB vaccines are indicated at the same visit. Otherwise, MenACWY and MenB vaccines should be given separately as appropriate.