The Advisory Committee on Immunization Practice’s (ACIP’s) updated guidance for meningococcal serogroups A, C, W, and Y vaccine (MenACWY) and meningococcal serogroup B vaccine (MenB) was recently published in the MMWR Recommendations and Reports. This publication, Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020, replaces and consolidates all previously published ACIP meningococcal vaccine recommendations. The descriptive terminology “shared clinical decision-making” has been added for the 2-dose MenB vaccination series in persons age 16–23 years. The guidance also contains new recommendations for off-label administration of booster doses of MenB for persons at increased risk for serogroup B meningococcal disease, including microbiologists and people age >10 years with persistent complement deficiencies, complement inhibitor use, or anatomic or functional asplenia. Booster doses are recommended one year following completion of a MenB primary series followed by MenB booster doses every 2–3 years thereafter. A one-time booster dose also is recommended for persons at increased risk during an outbreak.
A summary (from Box 1, found on page 3 of the publication) of the ACIP recommendations for MenACWY and MenB vaccines is reprinted below.
ACIP recommends MenACWY vaccination for the following groups:
- Routine vaccination for adolescents age 11 or 12 years, with a booster dose at age 16 years.
- Routine vaccination of persons age >2 months at increased risk for meningococcal disease (dosing schedule varies by age and indication, and interval for booster dose varies by age at time of previous vaccination):
- Persons with certain medical conditions including anatomic or functional asplenia, complement component deficiencies (e.g., C3, C5–C9, properdin, factor H, or factor D), complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]) use, or human immunodeficiency virus infection.
- Microbiologists with routine exposure to Neisseria meningitidis isolates.
- Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among men who have sex with men [MSM]).
- Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic.
- Unvaccinated or undervaccinated first-year college students living in residence halls.
- Military recruits.
- Booster doses for previously vaccinated persons who become or remain at increased risk.
ACIP recommends MenB vaccination for the following groups:
- Routine vaccination of persons age >10 years at increased risk for meningococcal disease (dosing schedule varies by vaccine brand; boosters should be administered at 1 year after primary series completion, then every 2–3 years thereafter):
- Persons with certain medical conditions, such as anatomic or functional asplenia, complement component deficiencies, or complement inhibitor use.
- Microbiologists with routine exposure to Neisseria meningitidis isolates.
- Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among MSM).
- Vaccination of adolescents and young adults age 16–23 years with a 2-dose MenB series on the basis of shared clinical decision-making. The preferred age for MenB vaccination is 16–18 years. Booster doses are not recommended unless the person becomes at increased risk for meningococcal disease.
- Booster doses for previously vaccinated persons who become or remain at increased risk.
Additional Resources
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