Administering Meningococcal Vaccines

This page provides a brief summary of guidance for administering meningococcal vaccines, including route, number of doses, and co-administration with other vaccines.

 

Visual Inspection

Do not use any meningococcal vaccine or diluent (if applicable) beyond the expiration date printed on the label.

Prior to administration, visually inspect the vaccine for particulate matter and/or discoloration. If these conditions exist, do NOT use.

 

Route, Site, and Needle Size

Meningococcal conjugate and serogroup B meningococcal vaccines should be administered by the intramuscular route. The preferred site for infants and young children is the vastus lateralis muscle in the anterolateral thigh. The preferred injection site in older children and adults is the deltoid muscle. A needle length appropriate for the age and size of the person receiving the vaccine should be used.

 

Number and Timing of Doses

Meningococcal Conjugate Vaccines

A meningococcal conjugate vaccine (Menactra^® or Menveo^®) is generally administered to adolescents as one primary dose at 11 to 12 years of age and one booster dose at 16 years of age. The minimum interval between doses is at least 8 weeks.

Patients 2 years of age and older who are initiating vaccination and have complement component deficiencies, functional or anatomic asplenia, or HIV should receive a two-dose primary series 2 months apart. For patients at prolonged increased risk for meningococcal disease, CDC recommends booster doses of meningococcal conjugate vaccine after completion of the primary series. If the most recent dose was received at age 7 years or later, a booster dose should be administered 5 years later. If the most recent dose was received before age 7 years, a booster dose should be administered 3 years later. Additional boosters should be administered every 5 years thereafter throughout life as long as the person remains at increased risk for meningococcal disease.

The number of doses and schedule for patients under 2 years of age varies by vaccine product. See package inserts for specific guidance.

Serogroup B Meningococcal Vaccines

Both serogroup B meningococcal vaccine products require more than one dose for maximum protection. The same vaccine product must be used for all doses.

• Bexsero:^® Administer two doses (0, ≥1 month after first dose).
• Trumenba:^® Administer two or three doses
  • Administer two doses (0, 6 months after first dose) to healthy adolescents who are not at increased risk for serogroup B meningococcal disease.
  • Administer three doses (0, 1 to 2 months after first dose, 6 months after first dose) to adolescents who are at increased risk for meningococcal disease (including during outbreaks of serogroup B meningococcal disease).

 

Predrawing Vaccine Doses

Predrawing vaccine doses is not recommended because there are no data on the stability of vaccines stored in syringes filled by healthcare professionals. Vaccine vials should not be opened until time of administration.

After reconstitution administer Menveo^® within 8 hours or discard.

Administration with Other Vaccines

Meningococcal conjugate and serogroup B meningococcal vaccines may be administered during the same visit, but at a different injection site, if feasible. Meningococcal vaccines can also be administered during the same visit with other vaccines, but at a different injection site, if feasible. Each vaccine should be administered with a separate syringe.

Meningococcal Conjugate Vaccines

• Post licensure studies showed no differences in safety or immune response when quadrivalent meningococcal conjugate vaccines are administered during the same visit with the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine.
• Children with functional or anatomic asplenia or HIV are NOT recommended to receive Menactra^® until 2 years of age in order to avoid interference with the immunologic response to the infant series of pneumococcal conjugate vaccine (PCV13). CDC recommends that infants 2 through 23 months of age with functional or anatomic asplenia or HIV either receive Menveo^® or wait until 2 years of age to receive Menactra^®.
  • In healthy children 9 through 23 months of age, Menactra^® can be administered with other vaccines during the same visit, but at a different injection site, if feasible.
• New data suggest the potential for interference in the response to all 4 meningococcal vaccine antigens when Menactra^® is administered 30 days after DTaP. This interference is not observed when Menactra^®is administered 30 days before DTaP or when Menactra^®is co-administered with DTaP. CDC recommends that if Menactra^® is to be administered to a child at increased risk for meningococcal disease, Menactra^®be given either before or concomitantly with DTaP. Alternatively, Menveo^® may be administered.

Serogroup B Meningococcal Vaccines

• On the basis of available data and expert opinion, Bexsero^® or Trumenba^® may be administered with other vaccines during the same visit, but at a different injection site, if feasible.
  • Studies showed no differences in immune response when Trumenba^® is administered during the same visit with the following vaccines: Tdap, polio vaccine (IPV), or meningococcal conjugate vaccine. There was also no immunological interference observed for three of the four vaccine antigens in the quadrivalent human papillomavirus vaccine (4vHPV). One month after the third dose of 4vHPV, no immunological interference was observed for all four vaccine antigens.

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