What are the recommendations for Bexsero (Meningococcal B vaccine) administration?

Bexsero (Meningococcal B Vaccine) Administration Recommendations

Bexsero (MenB-4C) is recommended as a 2-dose series administered at least 1 month apart for individuals aged 10-25 years, with specific indications for routine use in high-risk populations and consideration for healthy adolescents aged 16-23 years (preferably 16-18 years) based on shared clinical decision-making. 1, 2

Indications for Vaccination

Category A Recommendation (Routine Use)

• Individuals ≥10 years with increased risk for serogroup B meningococcal disease:
  • Persistent complement component deficiencies (including those receiving eculizumab)
  • Anatomic or functional asplenia (including sickle cell disease)
  • Microbiologists routinely exposed to Neisseria meningitidis isolates
  • Persons identified to be at risk during serogroup B meningococcal disease outbreaks 1

Category B Recommendation (Shared Clinical Decision-Making)

• Healthy adolescents and young adults aged 16-23 years (preferred age 16-18 years) for short-term protection against most strains of serogroup B meningococcal disease 1

Administration Schedule

• Bexsero (MenB-4C): 2-dose series administered at least 1 month apart 1, 2
• The minimum interval between any two doses of MenB vaccine is 4 weeks 1
• The same product must be used for all doses in a series (MenB vaccines are NOT interchangeable) 1, 2

Co-administration with Other Vaccines

• Bexsero may be administered concomitantly with other vaccines indicated for this age group
• When co-administered, use different anatomic sites if feasible 1

Special Populations

Pregnant and Lactating Women

• Vaccination should be deferred in pregnant or lactating women unless:
  • The woman is at increased risk for serogroup B meningococcal disease
  • After consultation with her healthcare provider, the benefits of vaccination are considered to outweigh potential risks 1

College Students

• First-year college students living in residence halls should receive at least one dose of MenACWY within 5 years before college entry
• MenB vaccines may be considered for college students based on shared clinical decision-making 1, 2

Safety Profile

• Most common adverse reactions within 7 days after Bexsero administration:
  • Pain at injection site (≥85%)
  • Fatigue (≥40%)
  • Headache (≥35%)
  • Myalgia (≥30%)
  • Chills (≥15%) 1
• No significant increased risk for serious adverse events has been identified in clinical trials 1, 3

Effectiveness and Duration of Protection

• Bexsero provides protection against diverse MenB strains 4
• Antibody titers decline significantly one year after vaccination 3
• Booster doses may be needed for continued protection, particularly in high-risk groups 2

Common Pitfalls and Considerations

1. Vaccine Interchangeability: MenB vaccines (Bexsero and Trumenba) are NOT interchangeable - ensure the same product is used for all doses in a series 1, 2

2. Different Dosing Schedules: Do not confuse Bexsero's 2-dose schedule with Trumenba's variable schedule (2 or 3 doses depending on indication) 1

3. Limited Duration of Protection: Be aware that antibody titers decline significantly after one year, which may be important for high-risk individuals 3

4. Outbreak Response: During outbreaks, vaccination should be initiated promptly, but be aware that early protection after a single dose is likely to be low 5

5. Timing with Complement Inhibitors: For patients using complement inhibitors, meningococcal vaccines should be administered at least 2 weeks before starting the inhibitor 2

By following these recommendations, healthcare providers can appropriately administer Bexsero to help protect eligible individuals against serogroup B meningococcal disease, which remains an important cause of morbidity and mortality despite its rarity.