Meningococcal Vaccines Overview
The current Advisory Committee on Immunization Practices (ACIP) Meningococcal Vaccine Recommendations are published on this CDC webpage.
This CDC report published in September 2020 also contains new recommendations for administering booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed based on the availability of new data or licensure of new meningococcal vaccines.
Three quadrivalent meningococcal conjugate (MenACWY) vaccines are currently licensed and available in the United States: 1) meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D) (Menactra); 2) meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM197 conjugate vaccine (MenACWY-CRM) (Menveo); and 3) meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine (MenACWY-TT) (MenQuadfi) (Table 1). Additional information is available in the package inserts (66–68).
In addition, two serogroup B meningococcal (MenB) vaccines are licensed and available in the United States: 1) MenB-FHbp (Trumenba) and 2) MenB-4C (Bexsero) (Table 1). MenB-FHbp consists of two purified recombinant lipidated FHbp antigens, one from each FHbp subfamily (A and B). MenB-4C consists of three recombinant proteins (neisserial adhesin A [NadA], factor H binding protein [FHbp] fusion protein from subfamily B, and neisserial heparin-binding antigen [NhbA] fusion protein) and outer membrane vesicles (OMVs) containing outer membrane protein porin A (PorA) serosubtype P1.4. Additional information on MenB vaccines is available in the package inserts (69,70).
Two additional licensed meningococcal vaccines are no longer available in the United States: 1) a quadrivalent (serogroups A, C, W, and Y) meningococcal polysaccharide vaccine (MPSV4) (Menomune – A/C/Y/W-135) and 2) a combined Haemophilus influenzae type b and meningococcal serogroups C and Y conjugate vaccine (Hib-MenCY-TT) (MenHibrix) (71,72).
ACIP Meningococcal Vaccination Recommendations
ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years.
The ACIP also recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk.
Also, ACIP recommends routine use of MenB vaccine series among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B.
The ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults aged 16–23 years based on shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.