Meningococcal Vaccination Guidelines

Administration and Scheduling

• The Centers for Disease Control and Prevention (CDC) recommends that college students can safely receive both the meningococcal ACWY and meningococcal B vaccines at the same time, using different injection sites, as stated by the Advisory Committee on Immunization Practices (ACIP) 1
• College freshmen living in residence halls should receive at least 1 dose of MenACWY within 5 years before college entry, with the preferred timing of the most recent MenACWY dose being on or after their 16th birthday, according to the Advisory Committee on Immunization Practices (ACIP) 2
• If only 1 dose of MenACWY was administered before the 16th birthday, a booster dose should be administered before enrollment, as recommended by the Centers for Disease Control and Prevention 2
• The CDC recommends a first dose of MenACWY at age 11-12 years and a booster dose at age 16 years, with a minimum interval of 8 weeks between doses, for adolescents aged 11-18 years 3, 2

Vaccine Specificity and Dosing

• The two MenB vaccines (MenB-4C/Bexsero and MenB-FHbp/Trumenba) are not interchangeable; the same product must be used for all doses in a series, as stated by the Centers for Disease Control and Prevention 2
• The following table summarizes the recommended dosing schedules:

4, 5, 6, 2

• MenACWY and MenB vaccines can be administered concomitantly but at different anatomical sites 4, 2

Contraindications and Precautions

• Vaccination is contraindicated in persons with a history of severe allergic reaction to any component of the vaccine, according to the Centers for Disease Control and Prevention 3
• Vaccination should be deferred for persons with moderate or severe acute illness until the person's condition improves, as recommended by the Centers for Disease Control and Prevention 3
• Vaccine-specific contraindications include severe allergic reaction (anaphylaxis) to previous doses or vaccine components, and moderate or severe acute illness with fever (temporary precaution), as stated by the CDC 4

Post-Vaccination Care

• All healthcare personnel administering vaccinations should be aware of the potential for syncope after vaccination, especially among adolescents, and consider observing patients for 15 minutes after vaccination, as recommended by the Centers for Disease Control and Prevention 3
• Common adverse events of MenB vaccine include severe pain at injection site, fever, severe headache, fatigue, and muscle pain 7

Booster Vaccination

• For persons who previously completed a MenB primary series who remain at increased risk for meningococcal disease, booster vaccination should be administered according to the recommended schedule, as stated by the Centers for Disease Control and Prevention 2
• The American College of Physicians and the Centers for Disease Control and Prevention (CDC) recommend vaccination for persons with anatomical or functional asplenia, persistent complement component deficiencies, and microbiologists routinely exposed to isolates of Neisseria meningitidis, as well as those at risk during a meningococcal disease outbreak attributable to serogroup B 4
• The American Academy of Pediatrics and the CDC recommend vaccination for first-year college students living in residence halls, as well as for those with anatomical or functional asplenia, persistent complement component deficiencies, HIV infection, or microbiologists routinely exposed to Neisseria meningitidis, and for those traveling to countries with hyperendemic or epidemic meningococcal disease 4, 7
• College students, particularly those living in residence halls, have a higher risk of serogroup B meningococcal disease during outbreaks, with a 200-1400-fold increased risk 7
• The American Academy of Pediatrics recommends that MenB vaccination be considered through shared clinical decision-making for adolescents and young adults aged 16-23 years, particularly for college students due to recent outbreaks of serogroup B meningococcal disease on college campuses 2, 7
• The CDC recommends MenB vaccination for persons aged 10 years and older with persistent complement component deficiencies, including inherited or chronic deficiencies in C3, C5-C9, properdin, factor D, or factor H 2, 7
• Booster doses of MenB vaccine are recommended for persons who remain at increased risk for meningococcal disease 2