Meningococcal Vaccine Recommendations

Key points

  • CDC recommends meningococcal vaccination for all adolescents.
  • CDC also recommends meningococcal vaccination for children and adults at increased risk for meningococcal disease.
  • Follow the recommended immunization schedule to ensure that your patients get the meningococcal vaccines that they need.
A pediatric patient talks with healthcare provider after receiving vaccination.

Background

The United States uses 3 types of meningococcal vaccines. Each type helps protect against different serogroups of meningococcal disease.

MenACWY vaccines
  • 4 serogroups: A, C, W, and Y
MenB vaccines
  • 1 serogroup: B
MenABCWY
  • 5 serogroups: A, B, C, W, and Y

The following summarizes CDC's current age- and risk-based meningococcal vaccine recommendations by vaccine type. Access the official, full text of CDC's current and historical meningococcal vaccine recommendations.

MenACWY vaccination

All adolescents

All 11- to 12-year-old adolescents should receive a MenACWY vaccine. Since protection wanes, CDC recommends a MenACWY booster dose at age 16 years. The booster dose provides protection during the ages when adolescents are at highest risk.

Guidance for when initial vaccine was delayed

Booster dose timing and need varies for adolescents whose vaccinations are delayed from the recommended schedule. If the initial vaccine was given at ages 13 through 15 years, administer the booster at ages 16 through 18 years. If the initial vaccine was given at ages 16 or older, CDC doesn't recommend a booster dose.

Individuals at increased risk

In certain situations, individuals aged 2 months and older should receive

  • A 2-4-dose primary series
  • Regular booster doses if they remain at increased risk

Age under 7 years: Administer a booster dose 3 years after completion of the primary series and every 5 years thereafter.

Age 7 years or older: Administer a booster dose every 5 years.

Boosting during an outbreak

People who were previously vaccinated may need additional protection if they're part of a population at increased risk during an outbreakA. CDC recommends a booster dose for these individuals if 5 or more years have passed since the most recent MenACWY vaccine.

MenB vaccination

New dosing schedule for Bexsero‎

On August 19, 2024, the Food and Drug Administration approved a new dosing schedule for Bexsero(R). The Advisory Committee on Immunization Practices is anticipated to consider the new schedule at its October 2024 meeting. In the interim, healthcare providers should refer to the updated package insert for new dosing and schedule intervals.

Both MenB vaccine products require more than 1 dose for maximum protection. Individuals must receive the same vaccine product for all doses.

Adolescents and young adults

CDC recommends a shared clinical decision-making process to decide if MenB vaccination is appropriate for individual adolescents or young adults.

Administer 2 doses to those who want MenB vaccination:

  • Bexsero®: At least 1 month between doses
  • Trumenba®: 6 months between doses

Guidance on timing

The preferred age (16 through 18 years) maximizes protection during the ages of highest risk.

Healthcare providers 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.

Individuals at increased risk

In certain situations, individuals ages 10 years and older should receive

  • A multi-dose primary series
  • Regular booster doses
    • 1 year after series completion
    • Every 2 to 3 years thereafter

Number of doses and timing requirements vary for each vaccine product.

  • Bexsero®: 2 doses
    • Second dose at least 1 month after first dose
  • Trumenba®: 3 doses
    • Second dose 1 to 2 months after first dose
    • Third dose 6 months after first dose

Boosting during an outbreak

People who were previously vaccinated may need additional protection if they're part of a population at increased risk during an outbreakB. CDC recommends a booster dose for these individuals if a year or more has passed since the most recent MenB vaccine. There are also outbreak situations when public health authorities may recommend a booster dose after 6 months have passed since the most recent MenB vaccine.

MenABCWY vaccination

If someone's receiving MenACWY and MenB vaccines at the same visit, vaccine providers have 2 options:

  • Administer the individual vaccines at different injection sites
  • Administer MenABCWY vaccine instead

The minimum interval between MenABCWY doses is 6 months.

Implications for future vaccination

MenABCWY vaccine includes Trumenba®. For subsequent doses after MenABCWY, administer:

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

Guidance for use as a booster dose

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.

Resources

Contraindications and precautions

General Best Practice Guidelines for Immunization

Pink Book chapter on meningococcal disease

Immunization schedules

Child and adolescent immunization schedule

Adult immunization schedule

Meningococcal Vaccine Information Statements

MenACWY: English | Other languages

MenB: English | Other languages

  1. Specifically outbreaks involving serogroup A, C, W, or Y meningococcal disease
  2. Specifically outbreaks involving serogroup B meningococcal disease