How many doses of MenB (Meningococcal B) vaccine do children need?

Meningococcal B Vaccine Dosing Schedule for Children

For meningococcal B (MenB) vaccination, children need 2-3 doses depending on their age, risk factors, and the specific vaccine used (MenB-FHbp/Trumenba or MenB-4C/Bexsero).

Standard Recommendations by Age Group

Infants and Young Children (2-9 years)

• No routine MenB vaccination is recommended for healthy children under 10 years 1
• For high-risk children 2-9 years (with complement deficiencies, asplenia, etc.), MenB vaccines are not recommended 1

Adolescents (10-23 years)

• Healthy adolescents (16-23 years, preferred age 16-18 years):

  • MenB-FHbp (Trumenba): 2 doses at 0 and 6 months 1, 2
  • MenB-4C (Bexsero): 2 doses at least 1 month apart 1
  • Given based on shared clinical decision-making 2

• High-risk adolescents ≥10 years (complement deficiencies, asplenia, etc.):

  • MenB-FHbp (Trumenba): 3 doses at 0,1-2, and 6 months 1, 2
  • MenB-4C (Bexsero): 2 doses at least 1 month apart 1

Important Considerations

Risk-Based Dosing

• The 3-dose schedule (0,1-2, and 6 months) is specifically recommended for individuals at increased risk, including:
  • Persons with persistent complement component deficiencies
  • Persons taking complement inhibitors
  • Persons with anatomic or functional asplenia
  • Microbiologists routinely exposed to N. meningitidis
  • Persons in outbreak settings 2, 3

Booster Doses

• For high-risk individuals who remain at risk:
  • A single booster dose 1 year after primary vaccination
  • Additional boosters every 2-3 years if risk continues 1, 2

Vaccine Interchangeability

• MenB-FHbp (Trumenba) and MenB-4C (Bexsero) are NOT interchangeable 2
• The same product must be used for all doses in a series 2

Clinical Considerations

Immune Response and Protection

• Antibody persistence varies by age group, with more sustained response in adults compared to children 4
• In infants, bactericidal titers may decay almost to baseline by 7 months after the third dose 4
• A fourth dose in toddlers shows marked immune response, suggesting memory 4

Timing Considerations

• Timely vaccination is critical for early protection against MenB disease due to high incidence in early childhood 5
• Studies show many children who developed MenB disease were either unvaccinated or under-vaccinated 5

Common Adverse Reactions

• Most common reactions within 7 days after Bexsero administration:
  • Pain at injection site (≥85%)
  • Fatigue (≥40%)
  • Headache (≥35%)
  • Myalgia (≥30%)
  • Chills (≥15%) 2

Practical Implementation

• MenB vaccines may be administered with other age-appropriate vaccines at different anatomic sites 2
• Administer as a 0.5-mL intramuscular injection 2
• Delay MenB vaccination until after pregnancy unless benefits outweigh potential risks 2

Remember that vaccination schedules may change as new evidence emerges, so always consult the most current guidelines from the Advisory Committee on Immunization Practices (ACIP).