Our patient is starting college with no documented doses of meningococcal ACWY vaccine and has had titers drawn. The lab test was positive for A, C, W, and Y. Lab reference values show >2.1 as “suggestive of protection.” Can we accept this titer in lieu of documented MenACWY vaccine doses?

No. There are no acceptable serologic titers that can be used as evidence of protection against meningococcal A, C, W, and Y disease. In addition, the immunologic studies used for licensing purposes (serum bactericidal assay, SBA) are likely different from the serologic titers obtained at a doctor’s office (IgG antibody, for example). It is not clear what sort of testing is shown in the results you sent. However, even if SBA results are available, they cannot be used to assess whether there is a level of protection at the individual level.