03 Santoli mening 508

CDC ACIP — Vaccine Advisory Committee

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VFC Resolution Update:  Meningococcal Vaccines
Jeanne Santoli, MD, MPH
April 16, 2025National Center for Immunization & Respiratory Diseases

•Orange font/highlight in the presentation is used to indicate changes to 
the resolution in comparison to the prior approved version.Note
•The purpose of this resolution is to update the resolution to incorporate a 
new combination pentavalent vaccine. Purpose of the Resolution
Eligible Groups
•  Children aged 2 months through 10 years who are at increased risk for meningococcal 
disease attributable to serogroups A, C, W, and Y, including:
-Children who have persistent complement component deficiencies (including inherited or 
chronic deficiencies in C3, C5 -C9, properdin, factor H, or factor D)
-Children taking a complement inhibitor (e.g., eculizumab [Soliris], ravulizumab [Ultomiris ])
-Children who have anatomic or functional asplenia, including sickle cell disease
-Children infected with human immunodeficiency virus (HIV)
-Children traveling to or residing in countries in which meningococcal disease is hyperendemic or epidemic, particularly if contact with local population will be prolonged 
-Children identified to be at increased risk because of a meningococcal disease outbreak 
attributable to serogroups A, C, W, or Y
•  All children aged 11 through 18 yearsMeningococcal Conjugate Vaccines ( MenACWY)
Recommended Vaccination Schedule and Intervals
•The table below lists meningococcal conjugate vaccines currently available to prevent 
meningococcal disease attributable to serogroups A, C, W, and Y. Meningococcal Conjugate Vaccines ( MenACWY)
Vaccine Type Brand
(1)Age 
indication 
(pediatric)Children at increased riskChildren not at 
increased risk
2m through 23m 2ythrough 18y Booster Doses
Primary:  1 dose 
at age 11 -12y 
(or 13y  -18y) if 
not vaccinated 
previously
Booster:  1 dose 
at age 16y (if 
vaccinated at 
11y  -12y) or 1 
dose at 16y -
18y (if 
vaccinated at 
13y -15y)Men-ACWY -
CRM 
(lyophilized)Menveo 
Two-Vial  2m –18y Initiating at 2m : 4 
doses, at 2, 4, 6, and 12m
Initiating at 7 -
23m:  2 doses, 12 
wksapartFor children with persistent complement deficiencies, 
complement 
inhibitor use (2), functional or anatomic asplenia, or 
HIV: 2 doses, 
≥8 wksapart
Other children 
at increased 
risk: 1 doseFor children who 
remain at increased 
ri sk and compl eted 
the primary dose or 
series at age:
< 7y:  ad d itional d ose 
3 years after primary; 
boosters should be 
repeated every 5 
years
>7y:  ad d itional d ose 
5 yrs after primary; 
boosters should be 
repeated every 5 
yearsMen-ACWY -
CRM (liquid)M enveo One-Via l10y –18y Not ind icated
Men-ACWY -TT M enQuadfi 2y –18y Not ind icated
Table Notes
(1) Use of brand names is not meant to preclude the use of other comparable US licensed 
vaccines
(2) Includes eculizumab (Soliris) and ravulizumab (Ultomiris )
Recommended schedules and intervals for meningococcal conjugate vaccines can be found at  
Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization 
Practices, United States, 2020 | MMWR
Recommended dosage Refer to product package inserts.
Contraindications and Precautions
Contraindications and Precautions can be found in the package inserts available at Vaccines 
Licensed for Use in the United States | FDAMeningococcal Conjugate Vaccines ( MenACWY)
Eligible Groups
•  Children aged 10 through 18 years at increased risk for serogroup B meningococcal 
disease, including: 
-Children who have persistent complement component deficiencies (including inherited or 
chronic deficiencies in C3, C5 -C9, properdin, factor H, or factor D)
-Children taking a complement inhibitor (e.g., eculizumab [Soliris], ravulizumab [Ultomiris ]) 
-Children who have anatomic or functional asplenia, including sickle cell disease
-Children identified to be at increased risk because of a meningococcal disease outbreak 
attributable to serogroup B
•  Children aged 16 through 18 years who are not at increased risk for serogroup B 
meningococcal disease may also be vaccinated when shared clinical decision -making 
favors administration of MenB . Serogroup B Meningococcal Vaccines ( MenB )
Recommended Vaccination Schedule and IntervalsSerogroup B Meningococcal Vaccines ( MenB )
Vaccine (1), (3) Age Group Dosing Schedule (Primary 
Series)Dosing Schedule (Booster Dose)
MenB -4C 
(Bexsero, GSK)
MenB -FHbp
(Trumenba , Pfizer)10y -18y -Persons at increased risk 
for meningococcal disease 
including during 
serogroup B outbreaks: 
Three doses (0, 1 -2, and 6 
month schedule)
-Adolescents who are not 
at increased risk for 
meningococcal disease: Two doses (0, 6 month schedule) (2)-For children at increased risk due to 
complement deficiency, complement inhibitor 
use, or functional or anatomic asplenia: 
A booster dose is recommended if it has been a  
least one year since primary series; repeat every 
2-3 years as long as risk remains.
-For children at increased risk due to a 
serogroup B outbreak:
A booster dose is recommended if it has been a  
least one year since primary series. If recommended by public health officials, 
booster dose may be given if it has been at leas  
6 months since primary series.  
-Booster doses are not recommended for 
adolescents who are not at increased risk for 
meningococcal disease.
Table Notes
(1)  Use of brand names is not meant to preclude the use of other comparable US licensed vaccines. 
(2)  If the second dose is administered earlier than 6 months after the first dose, a third dose should 
be administered at least 4 months after the second dose.  
(3)  MenB vaccines are not interchangeable by manufacturer. Administration of a B component 
vaccine ( MenB or MenACWY -TT/MenB -FHbp or MenACWY -CRM/MenB -4C) requires that 
subsequent B component vaccine doses be from the same manufacturer.
Recommended dosage Refer to product package inserts. 
Contraindications and Precautions
Contraindications and Precautions can be found in the package inserts available at Vaccines 
Licensed for Use in the United States | FDASerogroup B Meningococcal Vaccines ( MenB )
Eligible Groups
Children who are indicated to receive MenACWY and MenB vaccines, including: 
•Children aged 10 through 18 years who are at increased risk for meningococcal 
disease attributable to serogroups A, C, W, Y , and B, including:
-Children who have persistent complement component deficiencies (including 
inherited or chronic deficiencies in C3, C5 -C9, properdin, factor H, or factor D)
-Children taking a complement inhibitor (e.g., eculizumab [Soliris], ravulizumab
[Ultomiris ])
-Children who have anatomic or functional asplenia, including sickle cell disease
•Children aged 16 through 18 years for whom both MenACWY and MenB are 
indicated to be given at the same time and shared clinical decision -making favors 
administration of MenB vaccine.Combination Pentavalent Serogroup A, C, W, Y , and B 
Meningococcal Vaccines ( MenACWY -MenB )
The table below displays dosing schedules for the combination pentavalent vaccines
MenACWY -TT/MenB -FHbp (Penbraya ) and MenACWY -CRM/MenB -4C (Penmenvy) (1).Combination Pentavalent Serogroup A, C, W, Y , and B 
Meningococcal Vaccines ( MenACWY -MenB )
Children at Increased Risk (10y through 18y)
Children not at Increased RiskDosing Schedule 
(Primary Series) Dosing Schedule (Boosters)
For children with persistent complement 
deficiencies, complement inhibitor use (2), 
or functional or anatomic asplenia who are 
due for both MenACWY and MenB
vaccination: 1 dose may be given in lieu of 
MenACWY and MenB . 
If subsequent doses of MenACWY and/or 
MenB (3) are indicated less than 6 months 
after a dose of combination pentavalent 
vaccine ,  the vaccines should be given 
separately according to the MenACWY and 
MenB tables above. For subsequent doses, where both MenACWY and MenB are 
indicated and at least 6 months 
have passed since administration of a previous dose of combination pentavalent vaccine, a second 
dose of combination pentavalent vaccine from the same manufacturer may be 
used (3). Initial dose: 
May be given in lieu of MenACWY and MenB when 
both vaccines are indicated at the same visit (e.g., age 16 years) and shared clinical decision -making 
favors administration of MenB .
Second dose: The MenB series should then be completed with a
MenB component from the same manufacturer (3).  
Table Notes
(1) Use of brand names is not meant to preclude the use of other comparable US licensed vaccines.
(2) Includes eculizumab (Soliris) and ravulizumab (Ultomiris ).
(3) MenB vaccines are not interchangeable by manufacturer. Administration of a B component 
vaccine ( MenB , MenACWY -TT/MenB -FHbp , or MenACWY -CRM/MenB -4C ) requires that subsequent 
B component vaccine doses be from the same manufacturer.
Recommended dosage Refer to product package inserts. 
Contraindications and Precautions
Contraindications and Precautions can be found in the package inserts available at Vaccines Licensed 
for Use in the United States | FDACombination Pentavalent Serogroup A, C, W, Y , and B 
Meningococcal Vaccines ( MenACWY- MenB )
•[If an ACIP recommendation or notice regarding meningococcal vaccination is 
published within 6 months following this resolution, the relevant language above (except in the eligible groups sections) will be replaced with the language in the 
recommendation and incorporated by reference to the publication URL.]Statement Regarding Update Based on Published  Documents