Meningococcal disease is a serious bacterial infection that can lead to meningitis, an inflammation of the membranes covering the brain and spinal cord, or meningococcemia, a bloodstream infection. This disease can progress rapidly, and even with treatment, it can result in severe complications or death. Vaccination provides a reliable method for preventing this potentially life-threatening condition.
Types of Meningococcal Vaccines
Two primary types of meningococcal vaccines are available in the United States to protect against different strains of Neisseria meningitidis. Meningococcal conjugate (MenACWY) vaccines offer protection against serogroups A, C, W, and Y. These serogroups cause a significant portion of cases.
Serogroup B meningococcal (MenB) vaccines target serogroup B, which causes most remaining cases in adolescents and young adults. These vaccine types have different recommended schedules and target specific bacterial strains, playing a distinct role in comprehensive protection.
Standard Vaccination Schedules
Routine meningococcal vaccination typically begins during adolescence. The meningococcal conjugate (MenACWY) vaccine is routinely recommended for adolescents, with the first dose administered at 11 or 12 years of age. A booster dose of the MenACWY vaccine is recommended at 16 years of age for continued protection during late adolescence and early adulthood.
For serogroup B meningococcal (MenB) vaccines, recommendations apply to individuals aged 16 through 23 years, with a preferred age of 16 through 18 years. Two different MenB vaccines are available, and the number of doses depends on the specific vaccine product used. One MenB vaccine is given as a two-dose series, with the second dose administered at least one month after the first. The other MenB vaccine is given as a two-dose series (second dose at least six months after first) or a three-dose series (second dose at least one month after first, third dose at least four months after second). Completing the full series provides intended protection. These schedules aim to protect individuals during periods of increased risk.
Vaccination for Specific Risk Factors
Certain situations necessitate additional or alternative meningococcal vaccination schedules due to increased risk. Individuals with specific medical conditions, such as persistent complement component deficiencies or asplenia, require MenACWY vaccination with a two-dose primary series. These individuals also typically receive booster doses of MenACWY every three to five years, depending on their age at the last dose.
People with HIV also have an elevated risk and should receive a two-dose primary series of MenACWY vaccine. For those whose risk is ongoing, regular booster doses are necessary, with specific intervals determined by healthcare providers. Microbiologists routinely exposed to Neisseria meningitidis isolates are another group for whom vaccination is recommended due to occupational risk.
Travel to or residence in areas where meningococcal disease is hyperendemic or epidemic also warrants vaccination. During an outbreak of meningococcal disease, public health officials may recommend vaccination for specific populations to control the spread. These specific risk factors often require more frequent doses or vaccination at different ages than the standard schedule to provide adequate protection.
Addressing Missed Doses
If a meningococcal vaccine dose is missed, it is generally not necessary to restart the entire series. The missed dose should be administered as soon as feasible to ensure completion and intended protection.
For adolescents who have missed routine MenACWY doses, or if MenB vaccine doses are missed, the remaining doses in the series should be given to complete the regimen. Consulting a healthcare provider is important for personalized guidance on catching up on any missed doses.