Meningococcal Vaccination Dosing Schedule
The recommended meningococcal vaccination dosing schedule varies by age, risk factors, and vaccine type, with most healthy adolescents requiring a single dose at age 11-12 years followed by a booster at age 16 years to ensure protection during the highest risk period. 1
General Population Dosing by Age Group
Infants and Young Children (2-23 months)
- For high-risk infants starting at 2 months of age:
- MenACWY-CRM: 4-dose series at 2,4,6, and 12 months of age 1
- For infants starting at 3-6 months: Follow catch-up schedule with doses at 8-week intervals until 7 months, then additional dose at ≥7 months, followed by final dose ≥12 weeks later and after the 1st birthday 1
- For infants starting at 7-23 months: 2 doses with second dose ≥12 weeks after first dose and after the 1st birthday 1
Children (2-10 years)
- Healthy children: Generally not routinely recommended unless at increased risk
- Children with high-risk conditions:
- MenACWY-D: 2 doses ≥8 weeks apart and ≥4 weeks after completion of PCV13 series, OR
- MenACWY-CRM or MenACWY-TT: 2 doses ≥8 weeks apart 1
Adolescents and Adults (11-55 years)
- Healthy adolescents:
- Primary vaccination: Single dose at age 11-12 years
- Booster dose: At age 16 years (to ensure protection during highest risk period) 1
- Adults through age 55:
- Single dose of MenACWY for those at increased risk 1
Older Adults (≥56 years)
- MPSV4 is the only licensed meningococcal vaccine for adults aged ≥56 years
- For meningococcal vaccine-naïve persons who need a single dose: MPSV4 is preferred
- For those previously vaccinated with MenACWY who need revaccination: MenACWY is preferred 1
Special Risk Groups Dosing
Persons with Complement Deficiencies or on Complement Inhibitors
Ages 2 months-9 years:
- MenACWY-CRM: 4-dose series (if starting at 2 months) or 2-dose series (if older)
- Boosters: If <7 years old, give booster 3 years after primary series and every 5 years thereafter
- If ≥7 years old, give booster 5 years after primary series and every 5 years thereafter 1
Ages ≥10 years:
- MenACWY: 2-dose primary series ≥8 weeks apart
- MenB: Also recommended (MenB-FHbp: 3 doses at 0,1-2, and 6 months OR MenB-4C: 2 doses ≥1 month apart)
- Boosters: MenACWY every 5 years; MenB every 2-3 years 1
Persons with Anatomic or Functional Asplenia
- Similar schedule to complement deficiencies, but important note:
Microbiologists Routinely Exposed to N. meningitidis
- Single dose of MenACWY with booster every 5 years if exposure is ongoing 1
International Travelers
- Single dose of MenACWY for those traveling to meningitis belt of sub-Saharan Africa (especially during dry season December-June)
- Booster if last dose was ≥5 years ago
- Required by Saudi Arabia for Hajj pilgrims if not vaccinated within previous 3 years 1
Booster Dose Recommendations
- Children who received primary series before age 7: First booster 3 years after primary series, then every 5 years
- Persons ≥7 years: Booster every 5 years if continued risk 1
- For MenB vaccines: Booster 1 year after primary series and every 2-3 years thereafter (for high-risk individuals) 1
Important Clinical Considerations
- Timing with other vaccines: MenACWY-D should be given either before or at the same time as DTaP to avoid interference with immune response 1
- Vaccine interchangeability: MenB-FHbp and MenB-4C are not interchangeable 1
- Administration route: All meningococcal vaccines are given by intramuscular injection as a 0.5 mL dose 2
- Vaccine effectiveness: Studies show effectiveness of approximately 69% overall for MenACWY-D, with waning protection 3-8 years post-vaccination (61% effectiveness), supporting the need for booster doses 3
By following these age-specific and risk-based dosing schedules, clinicians can optimize protection against meningococcal disease and minimize morbidity and mortality associated with this potentially devastating infection.