Which patients should receive a 2-dose schedule of MenB vaccine?

Healthy adolescents who are not at increased risk for meningococcal B disease should receive 2 doses of Trumenba (MenB-FHbp, Pfizer) or Bexsero (MenB-4C, GSK) administered at 0 and 6 months. If the second dose is given at an interval of less than 6 months, a third dose should be given at least 4 months after the 2nd dose.

For people age 10 years and older at increased risk for meningococcal B disease, 3 doses of Trumenba or Bexsero should be administered at 0, 1–2, and 6 months. The 3-dose series should be used for all people with functional or anatomic asplenia, people with persistent complement component deficiency (an immune system disorder) or those who take a complement inhibitor (examples include eculizumab [Soliris], ravulizumab [Ultomiris], and sutimlimab [Sanofi]), microbiologists who work with meningococcal isolates in a laboratory, and people exposed during serogroup B outbreaks.

Penbraya (MenABCWY, Pfizer) contains MenB-Fhbp (Trumenba) and is FDA-licensed for ages 10 through 25 years as a two-dose series, given 6 months apart, for vaccination against all 5 serogroups. For adolescents or adults not at increased risk for meningococcal disease, if Penbraya is used for dose 1 of MenB, Trumenba should be administered for the second dose of MenB. For people age 10 years or older (including those older than age 25 years) at increased risk of meningococcal disease, ACIP recommends that Penbraya may be used for additional MenACWY and MenB doses (including booster doses) when both vaccines would be given on the same clinic day and at least 6 months have elapsed since most recent Penbraya dose.