What is the recommended number of doses of meningococcal (meningitis) vaccine for a 15-year-old?

Meningococcal Vaccination for 15-Year-Olds

A 15-year-old adolescent should receive a primary dose of MenACWY vaccine if not previously vaccinated, followed by a booster dose at age 16-18 years. 1

Recommended Vaccination Schedule

For a 15-year-old, the meningococcal vaccination recommendations are as follows:

MenACWY Vaccine (Serogroups A, C, W, Y)

• If never vaccinated previously: One primary dose now
• If previously vaccinated before age 16: Will need a booster dose at age 16-18 years (at least 8 weeks after the primary dose)
• If previously vaccinated at age 15: Will need a booster dose 1-2 years later (at age 16-18)

The Advisory Committee on Immunization Practices (ACIP) specifically recommends:

• Primary dose at age 11-12 years
• Booster dose at age 16 years
• If first dose is given at age 13-15 years (as in this case), a booster should be given at age 16-18 years 1

MenB Vaccine (Serogroup B)

• Not routinely recommended for all 15-year-olds
• May be considered based on shared clinical decision-making when the adolescent reaches age 16-23 years (preferably 16-18 years) 1, 2

Clinical Considerations

Importance of Booster Dose

The booster dose for MenACWY is critical because:

• Antibody levels wane within 3-5 years after primary vaccination
• Research shows that a single dose of MenACWY has 69% effectiveness overall but wanes over time 2, 3
• A study demonstrated that 4 years after a MenACWY-D booster dose, high proportions (89.9-98.2%) of participants maintained protective antibody titers 3

Common Pitfalls to Avoid

1. Missing the booster dose: Failing to administer the booster dose at age 16-18 years significantly reduces protection during the highest risk period (late adolescence)
2. Confusing MenACWY and MenB vaccines: These protect against different serogroups and have different recommendations
3. Incorrect intervals: Minimum interval between MenACWY doses is 8 weeks 1
4. Interchanging MenB products: If MenB vaccination is later considered, the same product must be used for all doses in a series (MenB-FHbp and MenB-4C are NOT interchangeable) 2

Special Circumstances

For 15-year-olds with certain high-risk conditions, additional doses may be needed:

• Persistent complement component deficiencies: 2-dose primary series of MenACWY (8 weeks apart) and consideration of MenB series 1
• Anatomic or functional asplenia: 2-dose primary series of MenACWY (8 weeks apart) and consideration of MenB series 1
• HIV infection: 2-dose primary series of MenACWY (8 weeks apart) 1

Summary

For a typical healthy 15-year-old:

1. Administer one dose of MenACWY now if not previously vaccinated
2. Plan for a booster dose at age 16-18 years if primary dose was given before age 16
3. Consider MenB vaccination based on shared clinical decision-making when the adolescent reaches age 16-23 years

This approach ensures optimal protection during the period of highest risk for meningococcal disease in adolescents and young adults.