Meningitis is a serious bacterial infection causing inflammation of the protective membranes surrounding the brain and spinal cord. This condition can lead to severe health problems, including brain damage, hearing loss, or even death, often progressing rapidly within hours. Vaccination serves as a primary preventative measure against certain types of bacterial meningitis.
Understanding Meningitis Vaccine Types
There is not a single meningitis vaccine; instead, different types protect against specific strains of the bacteria Neisseria meningitidis. The meningococcal conjugate vaccines, known as MenACWY, target serogroups A, C, W, and Y. Common brand names for these vaccines include Menactra, Menveo, and MenQuadfi.
The serogroup B meningococcal vaccine, or MenB, provides protection against serogroup B. Bexsero and Trumenba are common brand names for MenB vaccines. A pentavalent MenABCWY vaccine, Penbraya, is also available, combining protection against serogroups A, B, C, W, and Y. These vaccine types address distinct bacterial strains, leading to varied vaccination recommendations and schedules.
Standard Vaccination Recommendations
The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC), provides standard guidelines for meningococcal vaccination. For the MenACWY vaccine, adolescents receive their first dose at 11 or 12 years of age. A booster dose is recommended at age 16 to ensure continued protection through young adulthood, a period of heightened risk.
The MenB vaccine is recommended for adolescents and young adults aged 16 to 23 years, but is considered a “shared clinical decision,” meaning healthcare providers discuss benefits and risks with individuals and families to determine appropriateness, as it’s not a universal recommendation. If vaccinated, MenB vaccines like Bexsero and Trumenba involve a two-dose series. Bexsero doses are given at 0 and 6 months, with a potential third dose if the second is given early. Trumenba is also a two-dose series, typically at 0 and 6 months.
Booster Doses and Specific Situations
Beyond the standard adolescent schedule, additional meningitis vaccine doses or different schedules may be necessary for specific populations due to increased exposure risks. College students living in residential housing face a higher risk of meningococcal disease due to close living conditions. A MenACWY booster dose is important for these students if their initial dose was received before age 16.
Military recruits are also recommended for MenACWY vaccination because of crowded living environments in barracks. Individuals traveling to regions where meningococcal disease is common, such as the “meningitis belt” in sub-Saharan Africa or for the Hajj and Umrah pilgrimages in Saudi Arabia, should receive MenACWY vaccination. Some countries, like Saudi Arabia, require proof of MenACWY vaccination for entry.
Certain medical conditions also necessitate additional vaccination against meningococcal disease. Individuals with asplenia (including sickle cell disease), persistent complement component deficiencies, or those taking complement inhibitor medications like eculizumab or ravulizumab are at increased risk. These individuals require a multi-dose primary series and regular booster doses for ongoing protection, depending on the vaccine type and their specific condition. Microbiologists handling Neisseria meningitidis isolates also face an occupational risk and should be vaccinated with both MenACWY and MenB, requiring periodic boosters while their risk persists.