I have a 28-year-old patient who received a 2-dose primary meningococcal B (MenB) vaccine series of Bexsero, with doses given 1 month apart, in 2015 when her spleen was removed. At that time, the ACIP did not have a recommendation for MenB booster doses and did not recommend a 3-dose Bexsero series. Do I need to give her a new primary series?

In August 2024, FDA changed the dosing interval for a 2-dose series of Bexsero (MenB-4C, GSK) from 1 month to 6 months, and recommends that people who receive a second dose of Bexsero less than 6 months after dose 1 receive a third dose at least 6 months after dose 1 and at least 4 months after dose 2. However, no additional primary series doses are recommended for people who previously completed the 2-dose series with the shorter interval, in accordance with the licensed and recommended Bexsero schedule at the time.

In June 2019, ACIP voted to recommend MenB booster doses for people at ongoing increased risk of meningococcal serogroup B disease and the recommendation was published in 2020 (www.cdc.gov/mmwr/volumes/69/rr/pdfs/rr6909a1-H.pdf). As long as you use Bexsero (MenB-4C) as the booster dose, this patient should be given a booster dose of Bexsero now and receive subsequent booster doses every 2–3 years.

The two types of MenB vaccine work differently and are not interchangeable. The only time ACIP recommends restarting the primary series is if the brand used for the primary series is not known or is unavailable.