Yes. The 2020 ACIP recommendations for MenB include a booster dose schedule for MenB vaccination of people at high risk for meningococcal serogroup B disease. The first booster dose is recommended one year after completion of the primary series, with a subsequent booster dose administered every 2–3 years thereafter, as long as risk remains. Because MenB vaccine brands are not interchangeable, all doses, including booster doses, should be of the same MenB brand. If the brand of the primary series is not known or not available, CDC recommends restarting the primary series with the available product.
Last reviewed:
July 15, 2023
Eculizumab (Soliris) and the related long-acting compound, ravulizumab (Ultomiris) bind to C5 and inhibit the terminal complement pathway. People with persistent complement component deficiency due to an immune system disorder or use of a complement inhibitor are at increased risk for meningococcal disease even if fully vaccinated. This patient should be given a series of MenACWY vaccine, MenACWY (2 doses separated by at least 8 weeks) and a 2- or 3-dose series (depending on brand) of MenB vaccine. The patient should receive regular booster doses of MenACWY and MenB as long as he remains at risk: a booster dose of MenACWY every 5 years and a booster dose of MenB one year after completion of the primary series, followed by a booster dose of MenB every 2–3 years thereafter.
Because patients treated with complement inhibitors can develop invasive meningococcal disease despite vaccination, clinicians using Soliris or Ultomiris also may consider antimicrobial prophylaxis for the duration of complement inhibitor therapy.
Last reviewed:
July 15, 2023
Recommendations to separate MenACWY and PCV only apply to one of the three MenACWY vaccines, MenACWY-D (Menactra), and also only apply to individuals with functional or anatomic asplenia or HIV infection. So, you do may administer the recommended vaccines at the same time. A 10-year-old with persistent complement component deficiency also should receive a 2- or 3-dose series (depending on brand) of MenB vaccine.
As long as the child remains at high risk of meningococcal disease due to complement inhibitor use, booster doses of both MenACWY and MenB are recommended. A MenACWY booster dose should be given every 5 years and a MenB booster dose should be given one year after the completion of the primary series, followed by a booster dose every 2–3 years thereafter.
Because patients treated with complement inhibitors can develop invasive meningococcal disease despite vaccination, clinicians using Soliris or Ultomiris also may consider antimicrobial prophylaxis for the duration of complement inhibitor therapy.
Last reviewed:
July 15, 2023
Yes. Studies from the United States, South Africa, and the United Kingdom have shown that people with HIV infection have a risk of invasive meningococcal disease that is 11–24 times higher than the general population. In the United States, this excess risk is specifically for serogroups C, W, and Y. ACIP recommends routine MenACWY vaccination of all HIV-infected people 2 months of age and older. Children younger than age 2 years should be vaccinated using a multidose schedule based upon age (see the Immunize.org document “Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor,” available at www.immunize.org/catg.d/p2018.pdf for details).
People age 2 years and older with HIV infection who have not been previously vaccinated should receive a 2-dose primary series of MenACWY (doses separated by at least 8 weeks). People with HIV infection who have previously received one dose of MenACWY should receive a second dose at the earliest opportunity (at least 8 weeks after the previous dose) and then receive booster doses at the appropriate intervals. ACIP does not recommend routine meningococcal serogroup B vaccination of people with HIV infection: MenB may be given based upon shared clinical decision-making to people with HIV who are age 16 through 23 years old, preferably between ages 16 and 18 years.
Last reviewed:
July 15, 2023
Either Trumenba (MenB-FHbp) or the Bexsero MenB vaccine brand (MenB-4C) may be used for people with HIV infection. If Trumenba is administered, the CDC meningococcal subject matter experts recommend that the 3-dose schedule should be used. People with HIV infection do not appear to be at higher risk for meningococcal serogroup B disease, but because of their HIV infection they might not respond to the vaccine as well, the 3-dose schedule is preferred. When Bexsero is used, the schedule is 2 doses, regardless of risk status. Booster doses of MenB are not recommended for people with HIV in the absence of another indication for MenB vaccination.
Last reviewed:
July 15, 2023
Use of either brand of MenB in persons younger than age 10 years is off-label in the U.S. There is no ACIP recommendation for use of this vaccine for this age group.
Bexsero (MenB-4C) has been studied among infants and is approved for infants by the European Medicines Agency (the European version of the U.S. Food and Drug Administration). It is routinely recommended for infants in the United Kingdom (see www.nhs.uk/conditions/vaccinations/pages/meningitis-b-vaccine.aspx for details). A clinician may choose to use a vaccine off-label if, in their opinion, the benefit of the vaccine exceeds the risk from the vaccine.
Last reviewed:
July 15, 2023
ACIP recommends that microbiologists who work with meningococcal isolates in a laboratory receive both MenB and MenACWY vaccines. MenB can be given at the same time as any other vaccine. You can administer either two doses of Bexsero (MenB-4C) 4 weeks apart, or three doses of Trumenba (MenB-FHbp) on a 0-, 1–2-, and 6-month schedule.
Because protective antibody levels begin to wane within 1–2 years after completing the primary series, ACIP recommends a booster dose of MenB one year after completing the primary series, followed by a booster dose every 2–3 years thereafter, as long as risk remains. MenB vaccine brands work differently and are not interchangeable. All doses, including booster doses, should be of the same brand. If the brand of the primary series is not known or is not available, restart the primary series with the available brand.
Last reviewed:
July 15, 2023
MenB is not specifically recommended for immunosuppressed people. However, after discussing the pros and cons of vaccination (also known as shared clinical decision-making), people age 16 through 23 years who are not at increased risk may receive routine MenB vaccination with either a 2-dose series of Bexsero (MenB-4C) 4 weeks apart, or a 2-dose series of Trumenba (MenB-FHbp) 6 months apart.
Last reviewed:
July 15, 2023
ACIP does not recommend routine MenB vaccination for travel to countries in sub-Saharan Africa or to other countries for which MenACWY vaccine is recommended. Meningococcal disease in these areas is generally not caused by serogroup B.
Last reviewed:
July 15, 2023
