This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk.In addition, ACIP recommends routine use of MenB vaccine series among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B. ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults aged 16-23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.
Conflict of interest statementAll authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed. This report includes discussion of the unlabeled use of meningococcal vaccines in the following situations: Two-dose primary series of quadrivalent meningococcal conjugate vaccine (MenACWY) for persons aged ≥2 years at increased risk for meningococcal disease because of certain underlying medical condition (i.e., persons who have persistent complement component deficiencies, complement inhibitor use, anatomic or functional asplenia, or HIV infection). Repeated booster doses of MenACWY for certain persons who remain at increased risk for meningococcal disease for a prolonged period. MenACWY-D and MenACWY-CRM are licensed for a single booster dose for persons aged 15–55 years if at least 4 years have elapsed since the last dose; MenACWY-TT is licensed for a single booster dose for persons aged ≥15 years if at least 4 years have elapsed since the last dose of MenACWY. The administration of MenACWY-D or MenACWY-CRM in certain persons aged ≥56 years at increased risk for meningococcal disease. The administration of a MenB vaccine in certain persons aged ≥26 years at increased risk for meningococcal disease. The administration of MenB booster doses for certain persons aged ≥10 years who remain at increased risk for meningococcal disease.
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