Meningococcal Vaccine Recommendations

Below are summaries of recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP). For the full text of the recommendations, see Meningococcal ACIP Vaccine Recommendations.

Routine MenACWY Vaccination of Adolescents

All 11 to 12 year olds should receive a meningococcal conjugate 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.

• For adolescents who receive the first dose at age 13 through 15 years, administer a booster dose at age 16 through 18 years, before the period of increased risk.
• Adolescents who receive their first dose of MenACWY vaccine at or after age 16 years do not need a booster dose.
• Adolescents who are at increased risk due to medical conditions need a 2-dose primary series of MenACWY vaccine administered 8 weeks apart, as well as regular booster doses every 5 years.
• CDC also recommends a booster dose for those at increased risk due to an outbreak if 5 or more years have passed since receiving MenACWY.

MenB Vaccination of Adolescents

Adolescents and young adults (16 through 23 years old) may also receive a serogroup B meningococcal vaccine. The preferred age for receipt is 16 through 18 years so adolescents have protection during the ages of increased risk.

CDC recommends that certain adolescents and young adults should receive a serogroup B meningococcal vaccine.  They include those at increased risk because of a serogroup B meningococcal disease outbreak and people with certain medical conditions or taking certain medications. These include

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

Those at increased risk need regular booster doses.

• Administer a booster dose of MenB vaccine 1 year after series completion and then every 2 to 3 years thereafter.
• For those at increased risk due to an outbreak who previously received the MenB vaccine series, CDC recommends a booster dose if a year or more has passed since primary series completion.

MenACWY Vaccination of Younger Children and Adults at Increased Risk

In certain situations, younger children (down to 2 months old) and adults should receive MenACWY vaccines. Some people are at increased risk for serogroup A, C, W, or Y meningococcal disease due to

• Having certain medical conditions
  • Complement component deficiency (e.g., C5-C9, properdin, factor H, factor D)
  • Functional or anatomic asplenia (including sickle cell disease)
  • HIV
• Taking specific medications
  • Complement inhibitor (e.g., Soliris^® or Ultomiris^®)
• Traveling or residing in countries in which serogroup A, C, W, or Y meningococcal disease is common
• Working in specific professions or living in specific settings
  • Microbiologist who is routinely exposed to Neisseria meningitidis (the causal pathogen)
  • Military recruit
  • First-year college student living in a residence hall and are not up to date with this vaccine
• Being a part of a community experiencing a serogroup A, C, W or Y meningococcal disease outbreak

Those who remain at increased risk need regular booster doses.

• For children under the age of 7 years, administer a booster dose 3 years after completion of the primary series and every 5 years thereafter.
• For children 7 years old or older and adults, administer a booster dose 5 years after completion of the primary series and every 5 years thereafter.

Special considerations for use of Menactra® for people with functional or anatomic asplenia or HIV

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^®.

People 2 years of age or older with functional or anatomic asplenia or HIV should not receive Menactra^® at the same time as PCV. They should either receive Menveo^® or MenQuadfi^® when they get PCV or wait and receive Menactra^® 4 weeks after completion of all PCV doses.

Special considerations for concomitant use of Menactra^® and DTaP

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^® or MenQuadfi^®, regardless of timing of DTaP vaccination.

MenB Vaccination of Adults at Increased Risk

MenB vaccines are not approved for use in people under 10 years old. Adults should receive a MenB vaccine if they are at increased risk for serogroup B meningococcal disease due to

• Having certain medical conditions
  • Complement component deficiency (e.g., C5-C9, properdin, factor H, factor D)
  • Functional or anatomic asplenia (including sickle cell disease)
• Taking specific medications
  • Complement inhibitor (e.g., Soliris^® or Ultomiris^®)
• Working in specific professions or settings
  • Microbiologist who is routinely exposed to Neisseria meningitidis (the causal pathogen)
• Being a part of a community experiencing a serogroup B meningococcal disease outbreak

Those who remain at increased risk need regular booster doses.

• Administer a booster dose of MenB vaccine 1 year after series completion and then every 2 to 3 years thereafter.
• For those at increased risk due to an outbreak who previously received the MenB vaccine series, CDC recommends a booster dose if a year or more has passed since primary series completion.

Contraindications and Precautions

Do not administer meningococcal vaccines to:

• A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose
• A person who has a severe allergy to any vaccine component

If otherwise indicated, vaccine providers may administer meningococcal vaccines to pregnant or breastfeeding women.

• MenACWY: Give to pregnant women at increased risk for serogroup A, C, W, or Y meningococcal disease
• MenB: Give to pregnant women at increased risk for serogroup B meningococcal disease if the provider and patient deem that the benefits of vaccination outweigh the risks

Vaccine providers may administer meningococcal vaccines, if the provider and parent or patient deems the benefits to outweigh the risks, to:

• A person who has a moderate or severe acute illness with or without fever