What is the recommended interval between the two doses of Trumenba (Meningococcal B vaccine)?

Recommended Interval Between Two Doses of Trumenba (Meningococcal B Vaccine)

For healthy adolescents and young adults aged 16-23 years who are not at increased risk for meningococcal disease, the two doses of Trumenba should be administered at 0 and 6 months. 1

Dosing Schedules Based on Risk Status

Two-Dose Schedule (Standard Schedule)

• Target population: Healthy adolescents and young adults aged 16-23 years (preferred age 16-18 years) 1
• Dosing interval: 0 and 6 months 1
• Important note: If the second dose is administered earlier than 6 months after the first dose, a third dose should be administered at least 4 months after the second dose 1, 2

Three-Dose Schedule (High-Risk Schedule)

• Target population: Persons aged ≥10 years at increased risk for meningococcal disease 1, 3
  • Those with persistent complement component deficiencies
  • Persons taking complement inhibitors (e.g., eculizumab)
  • Those with anatomical or functional asplenia (including sickle cell disease)
  • Microbiologists routinely exposed to Neisseria meningitidis
  • Persons during serogroup B meningococcal disease outbreaks
• Dosing interval: 0,1-2, and 6 months 1
• Alternative: If the second dose is administered at an interval of ≥6 months, a third dose does not need to be administered 1

Key Considerations for Administration

• Minimum interval: The minimum interval between any two doses of MenB vaccine is 4 weeks 1, 3
• Vaccine interchangeability: The two MenB vaccines (Trumenba and Bexsero) are NOT interchangeable; the same product must be used for all doses in a series 1, 3
• Concomitant administration: MenB vaccines may be administered with other age-appropriate vaccines at different anatomic sites 1
• Pregnancy: Delay MenB vaccination until after pregnancy unless at increased risk and vaccination benefit outweighs potential risks 1

Immune Response and Duration of Protection

• Immune responses decline after primary vaccination but remain detectable in many subjects at 48 months 4
• The 6-month interval between doses in the two-dose schedule provides robust immune responses 4, 5
• After two doses with a 6-month interval, 90.8%-93.5% of subjects achieved protective antibody titers against MenB strain A22, and 98.4%-100% against strain A56 5
• Shorter intervals between doses may result in lower immune responses against some strains, particularly those expressing subfamily B factor H binding proteins 5

Common Pitfalls and Caveats

• Dosing error: If the second dose is administered earlier than 6 months after the first dose in healthy adolescents, a third dose must be given at least 4 months after the second dose 1
• Risk assessment: Incorrectly assessing a patient's risk status may lead to using the wrong dosing schedule
• Vaccine selection: Using different MenB vaccines to complete a series is not recommended as they are not interchangeable 1, 3
• Documentation: Ensure proper documentation of which MenB vaccine product is used to avoid inadvertent product switching

The 6-month interval between doses in the two-dose schedule is optimal for developing robust immune responses in healthy adolescents and young adults, while the three-dose schedule with shorter intervals between initial doses is recommended for high-risk individuals to provide earlier protection.