Who should receive the MenB (Meningococcal serogroup B) vaccine, specifically a 20-year-old?

MenB Vaccination Recommendations for a 20-Year-Old

For a 20-year-old, MenB vaccination is recommended if they have specific risk factors, while healthy individuals may receive it based on shared clinical decision-making, with preferred administration between ages 16-23 years. 1, 2

Risk-Based Recommendations (Category A - Strong Recommendation)

MenB vaccination is routinely recommended for persons aged 10 years and older with the following risk factors:

• Persistent complement component deficiencies including:

  • Inherited or chronic deficiencies in C3, C5-C9, properdin, factor D, or factor H
  • Persons receiving eculizumab (Soliris) 1

• Anatomic or functional asplenia, including sickle cell disease 1

• Microbiologists who routinely work with Neisseria meningitidis isolates 1

• During outbreaks of serogroup B meningococcal disease 1, 2

Recommendations for Healthy 20-Year-Olds (Category B - Optional Recommendation)

For healthy 20-year-olds without risk factors:

• MenB vaccination may be administered based on shared clinical decision-making 1, 2
• The preferred age range is 16-23 years (optimal timing is 16-18 years) 1
• The purpose is to provide short-term protection against most strains of serogroup B meningococcal disease 1

Vaccine Options and Dosing

Two MenB vaccines are available:

1. MenB-FHbp (Trumenba):

   • For healthy individuals: 2-dose series (0,6 months) 2, 3
   • For high-risk individuals: 3-dose series (0,1-2,6 months) 1, 3

2. MenB-4C (Bexsero):

   • 2-dose series (≥1 month apart) for all groups 1, 2

Important Considerations

• Not interchangeable: The two MenB vaccines are not interchangeable - the same product must be used for all doses 2

• College students: While first-year college students living in residence halls should receive MenACWY vaccine, MenB is not routinely recommended for all college students 2

• Simultaneous administration: MenB vaccines can be administered with other age-appropriate vaccines at different anatomic sites 2

• New pentavalent option: A pentavalent vaccine (MenACWY-TT/MenB-FHbp) may be used when both MenACWY and MenB are indicated at the same visit 4

Clinical Perspective

The decision to vaccinate a healthy 20-year-old with MenB should consider:

• While meningococcal disease is rare in the US (0.18 per 100,000 population), it can be life-threatening 1
• Approximately 50-60 cases of serogroup B meningococcal disease occur annually in adolescents and young adults 11-24 years of age in the United States 1
• College outbreaks of serogroup B disease have shown a 200-1400-fold increased risk during outbreak periods 1

Remember that MenB vaccination is distinct from MenACWY vaccination, which is routinely recommended for first-year college students living in residence halls, military recruits, and travelers to endemic areas 1, 2.