ACIP Supports Meningitis B Vaccine for Teens, Young Adults

Diana Swift

October 23, 2015

The federal Advisory Committee on Immunization Practices (ACIP) has recommended considering serogroup B meningococcal (MenB) vaccinations for adolescents and young adults aged 16 to 23 years. This will provide short-term protection against most strains of serogroup B meningococcal disease, a rare but life-threatening illness seen in recent years on college campuses.

Although overall MenB incidence stands at a historic low in the United States (0.18 per 100,000 individuals), since 2009, seven outbreaks, with 41 cases and three deaths, have occurred on college campuses. An estimated 15 to 29 cases and two to five deaths could be prevented annually with routine adolescent MenB vaccination at ages 11, 16, or 18 years, according to the authors of the recommendation, led by Jessica R. MacNeil, MPH, from the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.

The recommendation is designated Category B (for individual clinical decision making). The recommendations for meningococcal vaccinations are being modified because two serogroup B meningococcal vaccines were recently licensed by the US Food and Drug Administration and approved for use in persons aged 10 to 25 years, the ACIP notes.

ACIP concluded that immunization in later adolescence would maximize the likelihood of protection lasting into the highest age-related risk period. The recommendation was published in the October 23 issue of the Morbidity and Mortality Weekly Report.

ACIP currently recommends routine vaccination of all adolescents aged 11 to 12 years with a quadrivalent meningococcal conjugate vaccine (MenACWY), with a booster at 16 years of age.

After evaluating immunogenicity and safety data from 12 clinical trials of two different MenB vaccines, ACIP also now supports MenB vaccination for all youths aged 16 to 23 years rather than college students only. It expanded the target group "primarily because an important number of serogroup B meningococcal disease cases occurs in persons aged 18–23 years who are not attending college, and vaccinating college students only is estimated to prevent the fewest cases and deaths among all the options considered," MacNeil and colleagues write.

Recommendations

  • The preferred age bracket for MenB vaccination is 16 to 18 years (Category B).

  • MenB vaccine should be administered as a three-dose series of MenB-FHbp (Trumenba, Wyeth Pharmaceuticals, Inc.) or a two-dose series of MenB-4C (Bexsero, Novartis Vaccines). The two vaccines are not interchangeable, and the same product must be used for all doses. They may be given concomitantly with other vaccines indicated for this age group, but preferably at a different anatomic site.

  • In pregnant and lactating women, vaccination should be delayed unless a woman is at increased risk and unless, after consultation with her healthcare provider, the benefits are considered to outweigh the potential risks.

  • College campuses that have recently experienced outbreaks of MenB should continue to follow earlier ACIP recommendations for outbreaks that advocate vaccination for persons 10 years or older.

  • Before administering MenB vaccines, healthcare providers should consult the package insert for precautions, warnings, and contraindications. Adverse events should be reported to the Vaccine Adverse Event Reporting System.

Morb Mortal Wkly Rep. 2015;64:1171-1176. Full text

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