August 15, 2021
Meningococcal B Vaccination
The Neisseria meningitides bacteria cause invasive diseases in the form of meningitis and sepsis. There are at least 13 strains of Neisseria meningitides, but the A, B, C, W, and Y serogroups account for the vast majority of invasive disease.1 Persons aged 16 to 23 are at an increased risk of contracting meningococcal infections. However, the incidence of Meningococcal Type B (Men B) disease is low and seems to be getting lower. It is estimated that approximately 200 cases per year are found in the United States.
There are only two Vaccines for Men B:
- MenB-FHbp or “Trumenba” given in either a 2-dose series with doses administered at least 6 months apart or a 3-dose series with the second and third doses administered 1–2 and 6 months after the first dose.
- MenB-4C or “Bexero” given in 2 dose series at least 1 month apart.
NORMAL RISK PATIENTS:
ACIP determined that insufficient evidence exists to make a routine public health recommendation that all adolescents be vaccinated with MenB vaccine, thus given a Category B Recommendation, which calls for personalized clinical decision-making between clinician and patient.
HIGH RISK PATIENTS:
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ACIP recommended that persons with these certain medical conditions and microbiologists routinely exposed to Neisseria meningitidis isolates receive a MenB booster dose 1 year after primary series completion, then every 2–3 years thereafter. During an outbreak, a single MenB booster dose was recommended if it had been ≥1 year since primary series completion.
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MenB is routinely recommended for these groups:
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People age 10 years and older who have functional or anatomic asplenia (including sickle cell disease)
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People age 10 years and older who have persistent complement component deficiency (an immune system disorder) or who take a complement inhibitor such as eculizumab (Soliris, Alexion Pharmaceuticals) or ravulizumab (Ultomiris, Alexion Pharmaceuticals)
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People age 10 years and older who are exposed during an outbreak caused by serogroup B
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Microbiologists who work with meningococcal isolates in a laboratory
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MenB vaccines work differently and receiving mismatched MenB doses might result in inadequate protection.
PRECAUTIONS:
Pregnant women and persons who have moderate or severe acute illness with or without fever should only receive the vaccine if the clinician and patient deem that the benefits far outweigh the risks. A person with an allergy to any component of the vaccine or a severe reaction after a previous dose should not receive the vaccine.
REFERENCES:
- Hambrosky J, Kroger A, Wolfe S, eds. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine Preventable Diseases. 13th ed. Washington, D.C. Public Health Foundation; 2015.
- MacNeil J, Rubin L, Temitope F, Ortega-Sanchez I. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices. MMWR. 2015;64(41):1171-1176