Table 1.

Vaccine product	Manufacturer	Trade name	Age group	Year licensed
Conjugate (serogroups A, C, W, and Y)
MenACWY-D	Sanofi Pasteur	Menactra^†	9 mos–55 yrs	2005
MenACWY-CRM	GlaxoSmithKline	Menveo^§	2 mos–55 yrs	2010
MenACWY-TT	Sanofi Pasteur	MenQuadfi^¶	≥2 yrs	2020
Protein based (directed at serogroup B)
MenB-FHbp	Pfizer	Trumenba**	10–25 yrs	2014
MenB-4C	GlaxoSmithKline	Bexsero^††	10–25 yrs	2015

Licensed and available* meningococcal vaccines — United States, 2020

Abbreviations: MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
*Two licensed meningococcal vaccines are no longer available in the United States (Menomune – A/C/Y/W-135 [Source: Menomune – A/C/Y/W-135. Package insert. Swiftwater, PA: Sanofi Pasteur; 2016. https://www.fda.gov/media/83562/download] and MenHibrix [Source: MenHibRix. Package insert. Rixensart, Belgium: GlaxoSmithKline Biologicals; 2012. https://www.fda.gov/media/83688/download]).
^† Source: Menactra. Package insert. Swiftwater, PA: Sanofi Pasteur; 2018. https://www.fda.gov/media/75619/download
^§ Source: Menveo. Package insert. Sovicille, Italy: GlaxoSmithKline Vaccines; 2019. https://www.fda.gov/media/78514/download
^¶ Source: MenQuadfi. Package insert Swiftwater, PA: Sanofi Pasteur; 2020. https://www.fda.gov/media/137306/download
**Source: Trumenba. Package insert. Philadelphia, PA: Pfizer; 2018. https://www.fda.gov/media/89936/download
^†† Source: Bexsero. Package insert. Sovicille, Italy: GlaxoSmithKline Vaccines; 2018. https://www.fda.gov/media/90996/download

Table 2.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur) or MenACWY-CRM (Menveo, GlaxoSmithKline) or MenACWY-TT (MenQuadfi, Sanofi Pasteur)	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2 mos–10 yrs	Not routinely recommended See Table 3 for persons at increased risk	No recommendations for use of MenB vaccines in this population*
11–23 yrs	Primary vaccination^†: 1 dose at age 11–12 yrs Booster: 1 dose at age 16 yrs if first dose administered before 16th birthday Catch-up vaccination: Although routine vaccination is only recommended for adolescents aged 11–18 yrs, MenACWY may be administered to persons aged 19–21 yrs who have not received a dose after their 16th birthday Note: MenACWY vaccines are interchangeable	Primary vaccination: MenB series at age 16–23 yrs on basis of shared clinical decision-making (preferred age 16–18 yrs) • MenB-FHbp^§: 2 doses at 0 and 6 mos • MenB-4C: 2 doses ≥1 mo apart Booster: Not routinely recommended unless the person becomes at increased risk for meningococcal disease Note: MenB-FHbp and MenB-4C are not interchangeable
≥24 yrs	Not routinely recommended See Table 3 for persons at increased risk	Not routinely recommended See Table 3 for persons at increased risk

Recommended meningococcal vaccines and administration schedules for children and adults — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
*MenB vaccines are licensed in the United States only for persons aged 10–25 years.
^†College freshmen living in residence halls should receive at least 1 dose of MenACWY within 5 years before college entry. The preferred timing of the most recent dose is on or after their 16th birthday. If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment. Adolescents who received a first dose after their 16th birthday do not need another dose before college entry unless it has been more than 5 years since the dose. Certain schools, colleges, and universities have policies requiring vaccination against meningococcal disease as a condition of enrollment.
^§When given to healthy adolescents who are not otherwise at increased risk for meningococcal disease, 2 doses of MenB-FHbp should be administered at 0 and 6 months. For persons at increased risk for meningococcal disease and for use during serogroup B meningococcal disease outbreaks, 3 doses of MenB-FHbp should be administered at 0, 1–2, and 6 months to provide earlier protection and maximize short-term immunogenicity.

Table 3.

Risk group	MenACWY vaccine	MenB vaccine	Table
Persons with complement component deficiency (e.g., C5–C9, properdin, factor H, or factor D), including patients using a complement inhibitor	Aged ≥2 mos	Aged ≥10 yrs	4
Persons with functional or anatomic asplenia (including sickle cell disease)	Aged ≥2 mos	Aged ≥10 yrs	5
Persons with HIV infection	Aged ≥2 mos	No recommendation	6
Microbiologists routinely exposed to Neisseria meningitidis	Age appropriate*	Age appropriate^†	7
Persons exposed during an outbreak of meningococcal disease due to a vaccine-preventable serogroup	Aged ≥2 mos	Aged ≥10 yrs	8
Persons who travel to or live in countries where meningococcal disease is hyperendemic or epidemic	Aged ≥2 mos	No recommendation	9
College freshmen living in residence halls	Age appropriate*	No recommendation	10
Military recruits	Age appropriate*	No recommendation	10

Recommended meningococcal vaccines for persons at increased risk for meningococcal disease — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: HIV = human immunodeficiency virus; MenACWY = meningococcal groups A, C, W, and Y; MenB = meningococcal group B.
*Persons aged ≥2 months in these risk groups are recommended to receive MenACWY vaccination.
^†Persons aged ≥10 years in this risk group are recommended to receive MenB vaccination.

Table 4.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)^§ or MenACWY-CRM (Menveo, GlaxoSmithKline)^¶ or MenACWY-TT (MenQuadfi, Sanofi Pasteur)**	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2–23 mos	Primary vaccination: MenACWY-D (aged ≥9 mos): 2 doses ≥12 wks apart or MenACWY-CRM if first dose at age • 2 mos: 4 doses at 2, 4, 6, and 12 mos • 3–6 mos: See catch-up schedule^§§ • 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday)	No recommendations for use of MenB vaccines in this population^††
2–9 yrs	Primary vaccination^¶¶: MenACWY-D* or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk)^†††:** • Aged <7 yrs: Single dose at 3 yrs after primary vaccination and every 5 yrs thereafter • Aged ≥7 yrs: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	No recommendations for use of MenB vaccines in this population^††
≥10 yrs	Primary vaccination^††: MenACWY-D or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk)^†††: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	Primary vaccination^††: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person remains at increased risk)^§§§: Single dose at 1 yr after completion of primary vaccination and every 2–3 yrs thereafter Note: MenB-FHbp and MenB-4C are not interchangeable

Recommended vaccination schedule and intervals for persons with persistent complement deficiencies* (including patients using a complement inhibitor)^† — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
*Persistent complement deficiencies include C3, C5–C9, properdin, factor H, or factor D.
^†Includes eculizumab (Soliris) and ravulizumab (Ultomiris). Meningococcal vaccines should be administered at least 2 weeks before the first dose of complement inhibitor, unless the risk for delaying complement therapy outweighs the risk for developing meningococcal disease.
^§Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^¶Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
**Licensed in the United States only for persons aged ≥2 years.
^††Licensed in the United States only for persons aged 10–25 years. Vaccination of persons aged ≥26 years is considered off-label.
^§§If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
^¶¶Primary vaccination licensed as a single dose in persons aged 2–55 years for MenACWY-D and MenACWY-CRM or ≥2 years for MenACWY-TT. Two-dose primary series is considered off-label.
***MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children.
^†††Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
^§§§Licensed in the United States only for a primary series. Administration of booster doses is considered off-label.

Table 5.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)* or MenACWY-CRM (Menveo, GlaxoSmithKline)^† or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^§	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2–23 mos	Primary vaccination: MenACWY-CRM: If first dose at age • 2 mos: 4 doses at 2, 4, 6, and 12 mos • 3–6 mos: See catch-up schedule^¶ • 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday)	No recommendations for use of MenB vaccines in this population**
2–9 yrs	Primary vaccination^††: MenACWY-D^§§,¶¶: 2 doses ≥8 wks apart and ≥4 wks after completion of PCV13 series or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk):* • Aged <7 yrs: Single dose at 3 yrs after vaccination and every 5 yrs thereafter • Aged ≥7 yrs: Single dose at 5 yrs and every 5 yrs thereafter	No recommendations for use of MenB vaccines in this population**
≥10 yrs	Primary vaccination^††: MenACWY-D^¶¶: 2 doses ≥8 wks apart and ≥4 wks after completion of PCV13 series or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk):* Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	Primary vaccination: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person remains at increased risk)^†††: Single dose at 1 yr after completion of primary vaccination and every 2–3 yrs thereafter Note:** MenB-FHbp and MenB-4C are not interchangeable

Recommended vaccination schedule and intervals for persons with anatomic and functional asplenia (including sickle cell disease) — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine; PCV = pneumococcal conjugate vaccine.
*Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^†Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^§Licensed in the United States only for persons aged ≥2 years.
^¶If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
**Licensed in the United States only for persons aged 10–25 years. Vaccination of persons aged ≥26 years is considered off-label.
^††Primary vaccination licensed as a single dose in persons aged 2–55 years for MenACWY-D and MenACWY-CRM or ≥2 years for MenACWY-TT. Two-dose primary series is considered off-label.
^§§MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children.
^¶¶Because of the high risk for invasive pneumococcal disease, children with functional or anatomic asplenia or human immunodeficiency virus infection should not be vaccinated with MenACWY-D (Menactra) before age 2 years to avoid interference with the immune response to PCV. If MenACWY-D is used in a person (of any age) with these conditions, it should not be administered until at least 4 weeks after completion of all PCV doses.
***Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
^†††Licensed in the United States only for a primary series. Administration of booster doses is considered off-label.

Table 6.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)* or MenACWY-CRM (Menveo, GlaxoSmithKline)^† or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^§	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2–23 mos	Primary vaccination: MenACWY-CRM: If first dose at age • 2 mos: 4 doses at 2, 4, 6, and 12 mos • 3–6 mos: See catch-up schedule^¶ • 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday)	No recommendations for use of MenB vaccines in these populations unless otherwise indicated (in persons aged ≥10 yrs)
≥2 yrs	Primary vaccination: MenACWY-D^††,§§: 2 doses ≥8 wks apart and ≥4 wks after completion of PCV13 series or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk)^¶¶:** • Aged <7 yrs: Single dose at 3 yrs after primary vaccination and every 5 yrs thereafter • Aged ≥7 yrs: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	See Table 2 for recommendations in persons aged 16–23 yrs

Recommended vaccination schedule and intervals for persons with human immunodeficiency virus infection — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine; PCV = pneumococcal conjugate vaccine; Td = tetanus and diphtheria toxoids vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine.
*Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^†Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^§Licensed in the United States only for persons aged ≥2 years.
^¶If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
**Primary vaccination licensed as a single dose in persons aged 2–55 years for MenACWY-D and MenACWY-CRM or ≥2 years for MenACWY-TT. Two-dose primary series is considered off-label.
^††MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children. MenACWY-D may be given at any time in relation to Tdap or Td.
^§§Because of the high risk for invasive pneumococcal disease, children with functional or anatomic asplenia or human immunodeficiency virus infection should not be vaccinated with MenACWY-D (Menactra) before age 2 years to avoid interference with the immune response to PCV. If MenACWY-D is used in a person (of any age) with functional or anatomic asplenia or HIV infection, it should not be administered until at least 4 weeks after completion of all PCV doses.
^¶¶Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.

Table 7.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)* or MenACWY-CRM (Menveo, GlaxoSmithKline)^† or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^§	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
≥10 yrs	Primary vaccination: MenACWY-D or MenACWY-CRM or MenACWY-TT: 1 dose Boosters (if person remains at increased risk):** Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	Primary vaccination^¶: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person remains at increased risk)^††: Single dose at 1 yr after completion of primary vaccination and every 2–3 yrs thereafter Note: MenB-FHbp and MenB-4C are not interchangeable

Recommended vaccination schedule and intervals for microbiologists routinely exposed to isolates of Neisseria meningitidis — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
*Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^†Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^§Licensed in the United States only for persons aged ≥2 years.
^¶Licensed in the United States only for persons aged 10–25 years. Vaccination of persons aged ≥26 years is considered off-label.
**Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
^††Licensed in the United States only for a primary series. Administration of booster doses is considered off-label.

Table 8.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)^† or MenACWY-CRM (Menveo, GlaxoSmithKline)^§ or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^¶	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2–23 mos	Primary vaccination: MenACWY-D (aged ≥9 mos): 2 doses ≥12 wks apart or MenACWY-CRM: If first dose at age • 2 mos: 4 doses at 2, 4, 6, and 12 mos • 3–6 mos: See catch-up schedule^†† • 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday)	No recommendations for use of MenB vaccines in this population**
2–9 yrs	Primary vaccination: MenACWY-D^§§ or MenACWY-CRM or MenACWY-TT: 1 dose Boosters (if previously vaccinated and identified as being at increased risk)^¶¶: • Aged <7 yrs: Single dose if ≥3 yrs since vaccination • Aged ≥7 yrs: single dose if ≥5 yrs since vaccination	No recommendations for use of MenB vaccines in this population**
≥10 yrs	Primary vaccination: MenACWY-D or MenACWY-CRM or MenACWY-TT: 1 dose Boosters (if person previously vaccinated and identified as being at increased risk during an outbreak)^¶¶: • Aged <7 yrs: Single dose if ≥3 yrs since vaccination • Aged ≥7 yrs: Single dose if ≥5 yrs since vaccination	Primary vaccination: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person previously vaccinated and identified as being at increased risk during an outbreak):* Single dose if ≥1 yr after MenB primary series completion (≥6 mos interval might also be considered by public health professionals) Note: MenB-FHbp and MenB-4C are not interchangeable

Recommended vaccination schedule and intervals for persons who are at risk during an outbreak* attributable to a vaccine serogroup — Advisory Committee on Immunization Practices, United States, 2020

Table 9.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)^† or MenACWY-CRM (Menveo, GlaxoSmithKline)^§ or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^¶	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
2–23 mos	Primary vaccination: MenACWY-D (aged ≥9 mos)**: 2 doses ≥12 wks apart (may be administered as early as ≥8 wks apart in travelers) or MenACWY-CRM: If first dose at age • 2 mos: 4 doses at 2, 4, 6, and 12 mos • 3–6 mos: See catch-up schedule^§§ • 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday)	No recommendations for use of MenB vaccines in this population unless otherwise indicated^††
≥2 yrs	Primary vaccination: MenACWY-D or MenACWY-CRM or MenACWY-TT: 1 dose Boosters (if person remains at increased risk)^¶¶,* • Aged <7 yrs: Single dose at 3 yrs after primary vaccination and every 5 yrs thereafter • Aged ≥7 yrs: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter	See Table 2 for recommendations in persons aged 16–23 yrs

Recommended vaccination schedule and intervals for persons who travel to or are residents of countries where meningococcal disease is hyperendemic or epidemic* — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine; Td = tetanus and diphtheria toxoids vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine.
*For international travelers, vaccination is recommended for those visiting the parts of sub-Saharan Africa known as the meningitis belt during the dry season (December–June). Vaccination may also be considered for travelers to countries that contain areas included in the meningitis belt but who travel to areas outside of the meningitis belt zone. Advisories for travelers to other countries are issued by CDC when epidemics of meningococcal disease caused by vaccine-preventable serogroups are detected. Traveler's health information is available from CDC toll free by calling 1-877-394-8747 (1-877-FYI-TRIP) or at https://wwwnc.cdc.gov/travel. Additional information about geographic areas for which vaccination is recommended can be obtained from international health clinics for travelers and state health departments.
^†Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^§Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^¶Licensed in the United States only for persons aged ≥2 years.
**MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children. MenACWY-D may be given at any time in relation to Tdap or Td.
^††Some countries recommend routine use of MenB vaccines for infants; persons living in these countries might follow the vaccination recommendations of these countries.
^§§If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
^¶¶Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
***International travelers should receive a booster dose of MenACWY if the last dose was administered 3–5 or more years previously (depending on the age at most recent dose received). Vaccination is required by the Kingdom of Saudi Arabia (KSA) for all travelers to Mecca during the Hajj and Umrah pilgrimages. Travelers should confirm current vaccination requirements with the KSA embassy.

Table 10.

Age group	Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)^† or MenACWY-CRM (Menveo, GlaxoSmithKline)^§ or MenACWY-TT (MenQuadfi, Sanofi Pasteur)^¶	Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline)
≥10 yrs	Primary vaccination: MenACWY-D or MenACWY-CRM or MenACWY-TT: 1 dose Boosters:** • College freshmen living in residence halls: Not routinely recommended unless person becomes at increased risk due to another indication • Military recruits: Every 5 yrs on basis of assignment^††	No recommendations for use of MenB vaccines in this population unless otherwise indicated See Table 2 for recommendations in persons aged 16–23 yrs

Recommended vaccination schedule and intervals for college freshmen living in residence halls* and military recruits — Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
*College freshmen living in residence halls should receive at least 1 dose of MenACWY within 5 years before college entry. The preferred timing of the most recent dose is on or after their 16th birthday. If only 1 dose of vaccine was administered before the 16th birthday, a booster dose should be administered before enrollment. Adolescents who received a first dose after their 16th birthday do not need another dose before college entry unless it has been more than 5 years since the dose. Some schools, colleges, and universities have policies requiring vaccination against meningococcal disease as a condition of enrollment.
^†Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^§Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
^¶Licensed in the United States only for persons aged ≥2 years.
**Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
^††Vaccination recommendations for military personnel are made by the U.S. Department of Defense on the basis of high-risk travel requirements.

Table 11.

Age group	Indication
≥2 yrs	Administration of a 2-dose MenACWY primary series in persons at increased risk for serogroups A, C, W, or Y meningococcal diseaseRepeated booster doses of MenACWY for certain persons who remain at increased risk for serogroups A, C, W, or Y meningococcal disease (MenACWY-D and MenACWY-CRM are licensed for a single booster dose for persons aged 15–55 yrs if at least 4 yrs have elapsed since the last dose. MenACWY-TT is licensed for a single booster dose for persons aged ≥15 yrs if at least 4 yrs have elapsed since the last dose of MenACWY)
≥10 yrs	MenB booster doses in certain persons who remain at increased risk for serogroup B meningococcal disease
≥26 yrs	MenB primary series administration in persons at increased risk for serogroup B meningococcal disease
≥56 yrs	Administration of MenACWY-D or MenACWY-CRM in persons at increased risk for serogroups A, C, W, or Y meningococcal disease

Off-label meningococcal vaccination recommendations for persons at increased risk for meningococcal disease, by age group and indication— Advisory Committee on Immunization Practices, United States, 2020

Abbreviations: MenACWY = quadrivalent meningococcal conjugate vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB = serogroup B meningococcal vaccine.

Box 1.

ACIP recommends MenACWY vaccination for the following groups: • Routine vaccination for adolescents aged 11 or 12 years, with a booster dose at age 16 years. • Routine vaccination of persons aged ≥2 months at increased risk for meningococcal disease (dosing schedule varies by age and indication, and interval for booster dose varies by age at time of previous vaccination): • Persons with certain medical conditions including anatomic or functional asplenia, complement component deficiencies (e.g., C3, C5-C9, properdin, factor H, or factor D), complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]) use, or human immunodeficiency virus infection. • Microbiologists with routine exposure to Neisseria meningitidis isolates. • Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among men who have sex with men [MSM]). • Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic. • Unvaccinated or undervaccinated first-year college students living in residence halls. • Military recruits. • Booster doses for previously vaccinated persons who become or remain at increased risk. ACIP recommends MenB vaccination for the following groups: • Routine vaccination of persons aged ≥10 years at increased risk for meningococcal disease (dosing schedule varies by vaccine brand; boosters should be administered at 1 year after primary series completion, then every 2–3 years thereafter): • Persons with certain medical conditions, such as anatomic or functional asplenia, complement component deficiencies, or complement inhibitor use. • Microbiologists with routine exposure to N. meningitidis isolates. • Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among MSM). • Vaccination of adolescents and young adults aged 16–23 years with a 2-dose MenB series on the basis of shared clinical decision-making. The preferred age for MenB vaccination is 16–18 years. Booster doses are not recommended unless the person becomes at increased risk for meningococcal disease. • Booster doses for previously vaccinated persons who become or remain at increased risk.
Abbreviations: ACIP = Advisory Committee on Immunization Practices; MenACWY = quadrivalent (serogroups A, C, W, Y) meningococcal conjugate vaccine; MenB = serogroup B meningococcal vaccine.

ACIP recommends MenACWY vaccination for the following groups:
• Routine vaccination for adolescents aged 11 or 12 years, with a booster dose at age 16 years.
• Routine vaccination of persons aged ≥2 months at increased risk for meningococcal disease (dosing schedule varies by age and indication, and interval for booster dose varies by age at time of previous vaccination):
   • Persons with certain medical conditions including anatomic or functional asplenia, complement component deficiencies (e.g., C3, C5-C9, properdin, factor H, or factor D), complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]) use, or human immunodeficiency virus infection.
   • Microbiologists with routine exposure to Neisseria meningitidis isolates.
   • Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among men who have sex with men [MSM]).
   • Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic.
   • Unvaccinated or undervaccinated first-year college students living in residence halls.
   • Military recruits.
• Booster doses for previously vaccinated persons who become or remain at increased risk.
ACIP recommends MenB vaccination for the following groups:
• Routine vaccination of persons aged ≥10 years at increased risk for meningococcal disease (dosing schedule varies by vaccine brand; boosters should be administered at 1 year after primary series completion, then every 2–3 years thereafter):
   • Persons with certain medical conditions, such as anatomic or functional asplenia, complement component deficiencies, or complement inhibitor use.
   • Microbiologists with routine exposure to N. meningitidis isolates.
   • Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among MSM).
• Vaccination of adolescents and young adults aged 16–23 years with a 2-dose MenB series on the basis of shared clinical decision-making. The preferred age for MenB vaccination is 16–18 years. Booster doses are not recommended unless the person becomes at increased risk for meningococcal disease.
• Booster doses for previously vaccinated persons who become or remain at increased risk.

Abbreviations: ACIP = Advisory Committee on Immunization Practices; MenACWY = quadrivalent (serogroups A, C, W, Y) meningococcal conjugate vaccine; MenB = serogroup B meningococcal vaccine.

Meningococcal vaccination recommendations — Advisory Committee on Immunization Practices, United States, 2020

Box 2.

2005 FDA licensed MenACWY-D for persons aged 11–55 years. ACIP recommended routine vaccination of adolescents with a single MenACWY-D dose at age 11–12 years and persons aged 11–55 years at increased risk for meningococcal disease. 2006 Because of limited vaccine supply, MenACWY-D vaccination was limited to cohorts of adolescents entering high school and college and persons aged 11–55 years at increased risk for meningococcal disease. 2007 After vaccine supply became sufficient, ACIP recommended vaccination for all adolescents aged 11–18 years. FDA expanded licensure of MenACWY-D to children aged 2–10 years, and ACIP recommended routine vaccination of children in this age group at increased risk for meningococcal disease. 2010 FDA licensed a second vaccine, MenACWY-CRM, for persons aged 11–55 years. ACIP added a MenACWY booster dose at age 16 years and recommended a 2-dose primary series be used for certain persons aged 11–55 years at increased risk for meningococcal disease because of asplenia, persistent complement component deficiency, or human immunodeficiency virus (HIV) infection (with another indication for vaccination). 2011 FDA extended licensure of MenACWY-CRM to children aged 2–10 years and of MenACWY-D to those aged 9–23 months. ACIP recommended a 2-dose primary series of MenACWY-D for children aged 9–23 months at increased risk for meningococcal disease. 2012 FDA licensed Hib-MenCY-TT and ACIP recommended a 4-dose primary series for children aged 2–8 months at increased risk for meningococcal disease. 2013 FDA extended licensure of MenACWY-CRM to children aged 2–23 months and ACIP recommended a 4-dose primary series for children in this age group at increased risk for meningococcal disease. 2014 FDA licensed MenB-FHbp as a 3-dose series for persons aged 10–25 years. 2015 FDA licensed MenB-4C as a 2-dose series for persons aged 10–25 years. ACIP recommended persons at increased risk for serogroup B meningococcal disease receive a MenB series, and persons aged 16–23 years were recommended to be vaccinated with a MenB series on the basis of shared clinical decision-making. 2016 FDA licensed MenB-FHbp as a 2-dose series for persons aged 10–25 years. 2016 ACIP recommended persons with HIV infection be routinely vaccinated with a 2-dose MenACWY primary series. 2017 ACIP updated its recommendations for use of MenB-FHbp following a change in licensure that allowed both a 2- and 3-dose series. Distribution of MPSV4 and Hib-MenCY-TT was discontinued in the United States. 2019 ACIP recommended that persons with certain medical conditions and microbiologists routinely exposed to Neisseria meningitidis isolates receive a MenB booster dose 1 year after primary series completion, then every 2–3 years thereafter. During an outbreak, a single MenB booster dose was recommended if it had been ≥1 year since primary series completion (interval of ≥6 months may be considered if recommended by public health officials). 2020 FDA licensed MenACWY-TT for persons aged ≥2 years.
Abbreviations: ACIP = Advisory Committee on Immunization Practices; FDA = Food and Drug Administration; Hib-MenCY-TT = meningococcal groups C and Y and Haemophilus influenzae type b tetanus toxoid vaccine (MenHibrix); MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine (Menveo); MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine (Menactra); MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine (MenQuadfi); MenB = serogroup B meningococcal vaccine; MenB-4C = meningococcal group B vaccine (Bexsero); MenB-FHbp = meningococcal group B vaccine (Trumenba); MPSV4 = meningococcal polysaccharide vaccine, groups A, C, Y, and W combined (Menomune – A/C/Y/W-135).

2005 FDA licensed MenACWY-D for persons aged 11–55 years. ACIP recommended routine vaccination of adolescents with a single MenACWY-D dose at age 11–12 years and persons aged 11–55 years at increased risk for meningococcal disease.
2006 Because of limited vaccine supply, MenACWY-D vaccination was limited to cohorts of adolescents entering high school and college and persons aged 11–55 years at increased risk for meningococcal disease.
2007 After vaccine supply became sufficient, ACIP recommended vaccination for all adolescents aged 11–18 years. FDA expanded licensure of MenACWY-D to children aged 2–10 years, and ACIP recommended routine vaccination of children in this age group at increased risk for meningococcal disease.
2010 FDA licensed a second vaccine, MenACWY-CRM, for persons aged 11–55 years. ACIP added a MenACWY booster dose at age 16 years and recommended a 2-dose primary series be used for certain persons aged 11–55 years at increased risk for meningococcal disease because of asplenia, persistent complement component deficiency, or human immunodeficiency virus (HIV) infection (with another indication for vaccination).
2011 FDA extended licensure of MenACWY-CRM to children aged 2–10 years and of MenACWY-D to those aged 9–23 months. ACIP recommended a 2-dose primary series of MenACWY-D for children aged 9–23 months at increased risk for meningococcal disease.
2012 FDA licensed Hib-MenCY-TT and ACIP recommended a 4-dose primary series for children aged 2–8 months at increased risk for meningococcal disease.
2013 FDA extended licensure of MenACWY-CRM to children aged 2–23 months and ACIP recommended a 4-dose primary series for children in this age group at increased risk for meningococcal disease.
2014 FDA licensed MenB-FHbp as a 3-dose series for persons aged 10–25 years.
2015 FDA licensed MenB-4C as a 2-dose series for persons aged 10–25 years. ACIP recommended persons at increased risk for serogroup B meningococcal disease receive a MenB series, and persons aged 16–23 years were recommended to be vaccinated with a MenB series on the basis of shared clinical decision-making.
2016 FDA licensed MenB-FHbp as a 2-dose series for persons aged 10–25 years.
2016 ACIP recommended persons with HIV infection be routinely vaccinated with a 2-dose MenACWY primary series.
2017 ACIP updated its recommendations for use of MenB-FHbp following a change in licensure that allowed both a 2- and 3-dose series. Distribution of MPSV4 and Hib-MenCY-TT was discontinued in the United States.
2019 ACIP recommended that persons with certain medical conditions and microbiologists routinely exposed to Neisseria meningitidis isolates receive a MenB booster dose 1 year after primary series completion, then every 2–3 years thereafter. During an outbreak, a single MenB booster dose was recommended if it had been ≥1 year since primary series completion (interval of ≥6 months may be considered if recommended by public health officials).
2020 FDA licensed MenACWY-TT for persons aged ≥2 years.

Abbreviations: ACIP = Advisory Committee on Immunization Practices; FDA = Food and Drug Administration; Hib-MenCY-TT = meningococcal groups C and Y and Haemophilus influenzae type b tetanus toxoid vaccine (MenHibrix); MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM₁₉₇ conjugate vaccine (Menveo); MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine (Menactra); MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine (MenQuadfi); MenB = serogroup B meningococcal vaccine; MenB-4C = meningococcal group B vaccine (Bexsero); MenB-FHbp = meningococcal group B vaccine (Trumenba); MPSV4 = meningococcal polysaccharide vaccine, groups A, C, Y, and W combined (Menomune – A/C/Y/W-135).

Timeline of meningococcal vaccine licensure and recommendations, United States, 2005—2020

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CME / ABIM MOC / CE

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Authors: Sarah A. Mbaeyi, MD; Catherine H. Bozio, PhD; Jonathan Duffy, MD; Lorry G. Rubin, MD; Susan Hariri, PhD; David S. Stephens, MD; Jessica R. MacNeil, MPH
CME / ABIM MOC / CE Released: 12/21/2020
THIS ACTIVITY HAS EXPIRED
Valid for credit through: 12/21/2021

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Target Audience and Goal Statement

This activity is intended for public health officials, infectious disease clinicians, internists, pediatricians, family practitioners, nurses, pharmacists, and other clinicians involved in vaccination against meningococcal diseases.

The goal of this activity is to describe updated recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States.

Upon completion of this activity, participants of the health care team will be able to:

Describe Advisory Committee on Immunization Practices (ACIP) recommendations for use of meningococcal vaccines in adolescents and young adults, according to recent guidance
Determine ACIP recommendations for use of meningococcal vaccines in persons at increased risk for meningococcal disease, according to recent guidance
Identify other ACIP recommendations for use of meningococcal vaccines, according to recent guidance

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Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Sarah A. Mbaeyi, MD

Division of Bacterial Diseases
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Sarah A. Mbaeyi, MD, has disclosed no relevant financial relationships.

Catherine H. Bozio, PhD

Division of Bacterial Diseases
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Catherine H. Bozio, PhD, has disclosed no relevant financial relationships.

Jonathan Duffy, MD

Immunization Safety Office
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Jonathan Duffy, MD, has disclosed no relevant financial relationships.

Lorry G. Rubin, MD

Steven and Alexandra Cohen Children’s Medical Center of New York
New Hyde Park, New York
Hofstra North Shore-LIJ School of Medicine
Hempstead, New York

Disclosures

Disclosure: Lorry G. Rubin, MD, has disclosed no relevant financial relationships.

Susan Hariri, PhD

Division of Bacterial Diseases
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Susan Hariri, PhD, has disclosed no relevant financial relationships.

David S. Stephens, MD

Emory University School of Medicine
Atlanta, Georgia

Disclosures

Disclosure: David S. Stephens, MD, has disclosed no relevant financial relationships.

Jessica R. MacNeil, MPH

Office of the Director
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia

Disclosures

Disclosure: Jessica R. MacNeil, MPH, has disclosed no relevant financial relationships.

CME Author

Laurie Barclay, MD

Freelance writer and reviewer

Medscape, LLC

Disclosures

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

Associate Director
Accreditation and Compliance
Medscape, LLC

Disclosures

Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.

CE Reviewer

Esther Nyarko, PharmD

Associate Director
Accreditation and Compliance
Medscape, LLC

Disclosures

Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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From Morbidity & Mortality Weekly Report

CME / ABIM MOC / CE

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Authors: Sarah A. Mbaeyi, MD; Catherine H. Bozio, PhD; Jonathan Duffy, MD; Lorry G. Rubin, MD; Susan Hariri, PhD; David S. Stephens, MD; Jessica R. MacNeil, MPHFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED

CME / ABIM MOC / CE Released: 12/21/2020

Valid for credit through: 12/21/2021

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Summary and Introduction

Summary

This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of 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 on the basis of availability of new data or licensure of new meningococcal vaccines.

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. 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.

In addition, 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. 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 on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.

Introduction

Meningococcal disease is a serious bacterial infection that primarily presents as meningitis, bacteremia, or both. Three quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate (MenACWY) vaccines and two serogroup B meningococcal (MenB) vaccines are licensed and available in the United States and are recommended by CDC's Advisory Committee on Immunization Practices (ACIP) for the prevention of meningococcal disease caused by these serogroups (Table 1) (Box 1).^[1–13] Details about groups recommended to receive meningococcal vaccination, number of vaccine doses, dosing regimens, contraindications, precautions, and special circumstances are described elsewhere in this report.

This report compiles and summarizes all previously published ACIP recommendations for use of meningococcal vaccines in the United States (Box 2).^[1–15] It also clarifies certain existing recommendations and contains new recommendations for administration of booster doses of MenB vaccine among persons aged ≥10 years at increased risk for serogroup B meningococcal disease. This report is intended for use by clinicians and public health providers for guidance regarding the use of meningococcal vaccines.

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Methods

CME / ABIM MOC / CE Information

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

Table 1.

Table 2.

Table 3.

Table 4.

Table 5.

Table 6.

Table 7.

Table 8.

Table 9.

Table 10.

Table 11.

Box 1.

Box 2.

References

Faculty and Disclosures

Faculty

Sarah A. Mbaeyi, MD

Catherine H. Bozio, PhD

Jonathan Duffy, MD

Lorry G. Rubin, MD

Susan Hariri, PhD

David S. Stephens, MD

Jessica R. MacNeil, MPH

CME Author

Laurie Barclay, MD

CME Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

CE Reviewer

Esther Nyarko, PharmD

CME / ABIM MOC / CE

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Target Audience and Goal Statement

Disclosures

Faculty

Sarah A. Mbaeyi, MD

Catherine H. Bozio, PhD

Jonathan Duffy, MD

Lorry G. Rubin, MD

Susan Hariri, PhD

David S. Stephens, MD

Jessica R. MacNeil, MPH

CME Author

Laurie Barclay, MD

CME Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

CE Reviewer

Esther Nyarko, PharmD

Accreditation Statements

For Physicians

For Nurses

For Pharmacists

Instructions for Participation and Credit

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Summary and Introduction

Summary

Introduction

Table of Contents