Meningococcal vaccination recommendations for persons age ≥2 years during an outbreak in the United States^[1,2]

Persons who are at risk during an outbreak attributable to a vaccine group	Individuals with exposure to group A, C, W, Y	Individuals with exposure to serogroup B*
Healthy persons with no immunizations against meningococcal disease
2 through 6 months old	MenACWY-CRM: 3 doses, ≥8 weeks apart 4th dose at age 12 months	No recommendations
7 through 23 months old	2 doses of MenACWY-CRM^¶, 12 weeks apart	No recommendations
2 through 9 years old	1 dose of MenACWY	No recommendations
≥10 years old	1 dose of MenACWY	Either: MenB-4C: 2 doses, ≥4 weeks apart, or MenB-FHbp: 3 doses on a 0-, 1- to 2-, and 6-month schedule
Patients who have completed an age-appropriate primary series of meningococcal vaccine
2 through 6 years old	1 dose if ≥3 years since last dose of MenACWY vaccine	No recommendations
7 through 9 years old	1 dose if ≥5 years since last dose of MenACWY vaccine	No recommendations
≥10 years	1 dose if ≥5 years since last dose of MenACWY vaccine	1 dose if ≥1 year since completing primary MenB vaccine^Δ

This table is meant for use with UpToDate content related to meningococcal vaccination. Refer to UpToDate content for additional details. Detailed recommendations for outbreak management are available from the CDC. Consult local public health authorities to identify persons who require vaccination.

Two MenACWY are licensed in the United States:
- MenACWY-CRM (Menveo)
- MenACWY-TT (MenQuadfi)
MenACWY-D (Menactra) was discontinued in 2022.

Although each of the MenACWY vaccine formulations use a different protein conjugate, the products are considered interchangeable in persons ≥2 years of age. The same vaccine product is recommended, but not required, for all doses.
Two MenB vaccines are licensed in the United States:
- MenB-4C (Bexsero)
- MenB-FHbp (Trumenba)
MenB vaccines are not interchangeable; the same brand must be used for each dose of the primary series and all booster doses.

MenACWY: meningococcal groups A, C, W, and Y conjugate vaccine; MenB: serogroup B meningococcal vaccine; CDC: United States Centers for Disease Control and Prevention.

* For healthy persons ≥10 years of age with incomplete MenB immunization, the schedule varies with the vaccine formulation and number of doses received:

Single dose of MenB-4C: Give second dose of MenB-4C ≥1 month after the first dose.
Single dose of MenB-FHbp: Complete a 3-dose series (0-, 1-, and 6-month schedule).
Two doses of MenB-FHbp with second dose <6 months after the first: Give a third dose according to the recommended schedule. If the second dose was given at ≥6 months after the first dose, no additional doses are needed.

If the vaccine type of any previous doses received is not known, the primary series should be restarted and completed using either MenB-4C or MenB-FHbp, since the MenB vaccines are not interchangeable.

¶ For children age 7 through 23 months, the second dose of MenACWY-CRM should be given at age ≥12 months.

Δ A booster dose interval of ≥6 months may be considered by public health officials to avoid missed opportunities for vaccination. Similarly, if the formulation used for the primary series is unavailable or unknown and cannot be quickly determined, any type of MenB vaccine may be administered. However, if possible, the same formulation of MenB vaccine that was used for the primary series should be used, since there are no data on the efficacy of using a different formulation for the booster dose.

References:

Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020; 69:1.
Centers for Disease Control and Prevention. Guidance for the Evaluation and Public Health Management of Suspected Outbreaks of Meningococcal Disease. https://www.cdc.gov/meningococcal/downloads/meningococcal-outbreak-guidance.pdf (Accessed on October 26, 2020).

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Meningococcal vaccination recommendations for persons age ≥2 years during an outbreak in the United States[1,2]

Meningococcal vaccination recommendations for persons age ≥2 years during an outbreak in the United States^[1,2]