What is the recommended schedule for the Meningitis C (Neisseria meningitidis serogroup C) vaccine?

Recommended Schedule for Meningococcal C Vaccination

The recommended schedule for Meningococcal C vaccination varies by age and risk factors, with quadrivalent meningococcal conjugate vaccines (MenACWY) being the preferred option as they provide broader protection against multiple serogroups including C. 1

Standard Recommendations by Age Group

Infants and Young Children (2 months to 10 years)

• For healthy children: Not routinely recommended unless they have specific risk factors
• For high-risk children:
  • Ages 2-18 months: 4-dose primary series of Hib-MenCY-TT at 2,4,6, and 12-15 months 1
  • Ages 9-23 months with complement deficiencies: 2-dose series of MenACWY-D with doses 12 weeks apart 1
  • Ages 2-10 years with risk factors: Single dose of MenACWY (either MenACWY-D or MenACWY-CRM) 1

Adolescents (11-21 years)

• Routine vaccination: 1 dose at age 11-12 years with a booster at age 16 years 1
• If first dose given at age 16 years or older: No booster needed 1
• College freshmen living in residence halls: Should receive MenACWY if not vaccinated within 5 years 1

Special Risk Groups Requiring Vaccination

Persons with Persistent Complement Component Deficiencies

• Ages 9 months to 55 years: 2-dose primary series of MenACWY 8-12 weeks apart 1
• Ages 2-18 months: 4-dose primary series of Hib-MenCY-TT 1
• Booster doses: Every 5 years; if primary series received before age 7, first booster at 3 years 1

Persons with Anatomic or Functional Asplenia

• Ages 2-55 years: 2-dose primary series of MenACWY 8-12 weeks apart 1
• Ages 2-18 months: 4-dose primary series of Hib-MenCY-TT 1
• Ages 19-23 months: Defer MenACWY until age 2 years and completion of PCV-13 series 1
• Booster doses: Same schedule as complement deficiencies 1

International Travelers

• Recommended for those visiting meningitis belt of sub-Saharan Africa during dry season (December-June) 1
• Children 9-23 months can receive second dose as early as 8 weeks after first dose before travel 1
• Booster dose needed if last dose was ≥5 years ago 1

Important Considerations

Vaccine Types

• MenACWY vaccines (MenACWY-D, MenACWY-CRM, or MenACWY-TT) are interchangeable 2
• Conjugate vaccines are preferred over polysaccharide vaccines due to longer duration of protection and potential for herd immunity 1

Efficacy and Duration of Protection

• Conjugate vaccines induce stronger immune responses than polysaccharide vaccines, especially in young children 1
• Studies show waning immunity after single-dose vaccination in early childhood, with 63% of children having inadequate protection approximately 2 years after vaccination 3
• Long-term studies show better persistence of protection after adolescent booster doses 4

Common Pitfalls to Avoid

• Don't use polysaccharide vaccines in young children: They provide limited efficacy of short duration 1
• Don't miss booster doses: Protection wanes rapidly after primary vaccination, especially in young children 3
• Don't use MenACWY-D before age 2 years in children with asplenia: It may interfere with pneumococcal vaccine response 1
• Don't assume Hib-MenCY-TT provides complete protection for travelers: It doesn't protect against serogroups A and W-135 1

Serogroup B Considerations

• Separate MenB vaccines are available for protection against serogroup B disease 2
• MenB vaccination is recommended for persons aged ≥10 years with complement deficiencies, asplenia, or during outbreaks 2

The implementation of meningococcal conjugate vaccine programs has significantly reduced the incidence of invasive meningococcal disease, with evidence of both direct protection and herd immunity in countries with high vaccination coverage 1.