Clarify the Latest Meningococcal Vaccine Recommendations

Questions are swirling about meningococcal vaccination...due to new combo meningococcal ABCWY vaccines and changes in dosing schedules.

Meningococcal disease is rare. But about 15% of cases are fatal...and up to 20% result in long-term complications, such as brain damage.

Ensure eligible patients get the right vaccine at the right time.

Meningococcal ACWY vaccines. Continue to give 1 dose of quadrivalent meningococcal vaccine (Menveo, MenQuadfi) to all adolescents at age 11 or 12 years...plus a booster at age 16.

Also recommend MenACWY vaccination for patients 2 months and up at increased risk...such as those with asplenia, including sickle cell disease. The dosing schedule depends on age, risks, and prior vaccines.

Keep in mind, MenACWY vaccines are interchangeable.

But stay alert for mix-ups when ordering, prepping doses, etc.

For example, Menveo comes as a 2-vial formulation that requires reconstitution...and a 1-vial product that does not.

The 2-vial Menveo can be used for ages 2 months and up...the 1-vial Menveo for ages 10 years and up...and MenQuadfi for ages 2 years and up.

Meningococcal B vaccines. Continue to ADD a MenB series (Bexsero, Trumenba) for patients 10 years and up at increased risk (asplenia, etc).

But when giving Bexsero to these patients, now give THREE doses at 0, 1 to 2, and 6 months...just like with Trumenba.

For patients 16 to 23 years NOT otherwise at risk of meningococcal B disease, weigh pros and cons of vaccination...to reach a shared decision.

For instance, explain that the risk of meningococcal B goes up if living in a college dorm or being in a fraternity or sorority.

If patients 16 through 23 years want MenB vaccine, give 2 doses of Bexsero or Trumenba. And now, give the second Bexsero dose at 6 months...similar to Trumenba. Use the SAME brand for all doses...and any boosters.

Combo MenABCWY vaccines. Consider a new 5-in-1 vaccine as an option when a patient 10 years or older needs MenACWY and MenB at the same visit.

Penbraya contains MenACWY plus Trumenba.

And a combo that contains Menveo and Bexsero is slated for approval.

Point out that patients who get Penbraya will need to get Trumenba for any future MenB doses...since MenB vaccines aren’t interchangeable.

See our Meningococcal Vaccines chart and our Meningococcal Vaccination algorithm for advice on outbreaks, costs, and more.

• Chart: Comparison of Meningococcal Vaccines
  
• Algorithm: Meningococcal Vaccination