ACIP recommends meningococcal vaccination only for high-risk children younger than 11 years. ACIP defines high-risk children age 2 months and older as (1) those with persistent complement component deficiency (an immune system disorder) or who take a complement inhibitor (including eculizumab [Soliris] or ravulizumab [Ultomiris]), (2) those with functional or anatomic asplenia, (3) those with HIV infection, (4) those traveling to or residing in an area of the world where meningococcal disease is hyperendemic or epidemic or (5) those identified by public health officials as being at risk during a community outbreak attributable to a vaccine serogroup. Menveo (MenACWY-CRM), in its two-vial formulation requiring reconstitution, is approved for children age 2 months and older; the one-vial formulation that does not require reconstitution may be administered to children age 10 years or older. Menactra (MenACWY-D) is approved for children age 9 months and older. MenQuadfi (MenACWY-TT) is approved for children age 2 years and older.
For children with functional or anatomic asplenia, Menactra should not be administered until at least 4 weeks after the pneumococcal conjugate vaccine vaccination series is completed. Children at increased risk for meningococcal disease should receive booster doses as long as they remain at increased risk.