Meningococcal Vaccination Recommendations for College Students
College students should receive one dose of MenACWY vaccine within 5 years before college entry and should consider MenB vaccination with either a 2-dose series of MenB-4C or a 2-dose series of MenB-FHbp (0,6 months) based on shared clinical decision-making. 1
MenACWY Vaccination
Primary Vaccination and Booster Requirements
- For first-year college students living in residence halls:
- Must receive at least 1 dose of MenACWY within 5 years before college entry
- Preferred timing: on or after 16th birthday
- If only 1 dose was administered before the 16th birthday, a booster dose should be administered before enrollment
- Students who received their first dose after their 16th birthday do not need another dose before college entry unless >5 years have elapsed since that dose 1
Dosing Schedule
- Standard adolescent schedule: 1 dose at age 11-12 years, booster at age 16 years
- MenACWY vaccines (MenACWY-D, MenACWY-CRM, or MenACWY-TT) are interchangeable 1
MenB Vaccination
Recommendations for Healthy College Students
- MenB vaccination is not routinely recommended for all college students but may be administered to individuals aged 16-23 years (preferred age 16-18 years) based on shared clinical decision-making 1
- This is particularly important given that MenB caused all meningococcal disease outbreaks at US colleges between 2011 and 2018 2
Dosing Options
- MenB-FHbp (Trumenba): 2-dose schedule at 0 and 6 months for healthy adolescents and young adults 1, 2
- MenB-4C (Bexsero): 2 doses administered ≥1 month apart 1
Important Considerations
- The two MenB vaccines are NOT interchangeable - the same product must be used for all doses 1
- For persons at increased risk for meningococcal disease (persistent complement deficiencies, asplenia, etc.), a different schedule is required:
- MenB-FHbp: 3-dose series (0,1-2, and 6 months)
- MenB-4C: 2 doses ≥1 month apart 1
Implementation Considerations
Timing and Completion
- Ensure completion of the full vaccination series before college entry
- MenB vaccines can be administered simultaneously with other vaccines indicated for this age group, but at different anatomic sites 1
- Studies show that only 17.2% of 17-year-olds received ≥1 dose of MenB vaccines, and ≤50% completed the series 3, highlighting the importance of emphasizing completion
Special Populations
- For students with high-risk conditions (complement deficiencies, asplenia, etc.):
- MenACWY: 2 doses ≥8 weeks apart with boosters every 5 years
- MenB: 3-dose series of MenB-FHbp or 2-dose series of MenB-4C with boosters every 2-3 years 1
Common Pitfalls to Avoid
- Incomplete vaccination: Failing to complete the multi-dose MenB series
- Mixing MenB products: Using different MenB vaccines interchangeably can result in inadequate protection
- Overlooking booster requirements: Students who received MenACWY before age 16 need a booster before college entry
- Focusing only on college-bound students: Non-college adolescents bear a significant disease burden and should also be considered for vaccination 3
- Ignoring timing: For MenACWY, vaccination must be within 5 years before college entry
Immune Response and Protection
- A booster dose of MenACWY induces a robust and rapid anamnestic response in adolescents and adults, regardless of whether MenACWY-CRM or MenACWY-D was administered 4-6 years earlier 4
- For MenB-FHbp, clinical evidence demonstrates strong and broadly protective immunogenicity in adolescents after primary vaccination, with immune persistence up to 48 months post-primary vaccination 2
By following these recommendations, college students can be appropriately protected against meningococcal disease, which can cause significant morbidity and mortality in this population.