What is the recommended series for Meningococcal B (MenB) vaccine?

Meningococcal B Vaccine Series Recommendations

For meningococcal B (MenB) vaccination, there are two available vaccines with specific dosing schedules: MenB-FHbp (Trumenba) requires either a 2-dose or 3-dose series depending on risk factors, while MenB-4C (Bexsero) requires a 2-dose series.

Vaccine Options and General Considerations

Two serogroup B meningococcal vaccines are currently licensed in the United States for persons aged 10-25 years 1:

• MenB-FHbp (Trumenba)
• MenB-4C (Bexsero)

Important considerations:

• The vaccines are not interchangeable - the same product must be used for all doses in a series 1, 2
• Either vaccine can be used when indicated; ACIP does not state a product preference 1
• MenB vaccines can be administered simultaneously with other age-appropriate vaccines, but at different anatomic sites 1, 2

Recommended Schedules by Risk Category

1. For Healthy Adolescents and Young Adults (16-23 years, preferred age 16-18 years)

Based on shared clinical decision-making:

• MenB-FHbp (Trumenba): 2-dose series at 0 and 6 months

  • 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

• MenB-4C (Bexsero): 2-dose series at 0 and ≥1 month apart 1

  • Recent update (2024): The recommended interval has been extended to 0 and 6 months 3

2. For Persons at Increased Risk for Meningococcal Disease (≥10 years)

Increased risk groups include:

• Persons with persistent complement component deficiencies
• Persons taking complement inhibitors (e.g., eculizumab)
• Persons with anatomical or functional asplenia
• Microbiologists routinely exposed to Neisseria meningitidis
• Persons at risk during serogroup B meningococcal disease outbreaks

Recommended schedules:

• MenB-FHbp (Trumenba): 3-dose series at 0,1-2, and 6 months 1, 2

  • If the second dose is administered at an interval of ≥6 months, a third dose does not need to be administered
  • If the third dose is administered earlier than 4 months after the second dose, a fourth dose should be administered at least 4 months after the third dose 1

• MenB-4C (Bexsero): 2-dose series at 0 and ≥1 month apart 1

  • Recent update (2024): A 3-dose series (0,1-2, and 6 months) is now also recommended for persons at increased risk 3

Booster Dose Recommendations

For persons who remain at increased risk for meningococcal disease:

• A single booster dose is recommended 1 year after primary vaccination
• Additional boosters should be administered every 2-3 years if risk continues 2

Special Considerations

• If a dose of MenB vaccine was received but the product is unknown, the series must be restarted with either product to ensure proper completion 1
• If doses were administered using different MenB products, select one product to complete the series; the dose from the non-selected product should be considered invalid 1
• For situations requiring repeat doses, use a minimum interval of 4 weeks between any 2 doses 1

Common Pitfalls to Avoid

1. Mixing vaccine products: MenB-FHbp and MenB-4C are not interchangeable; using different products may result in inadequate protection 1, 2

2. Incorrect dosing intervals: Administering doses too close together may result in suboptimal immune response

3. Confusing MenB with MenACWY vaccines: These target different serogroups and have different schedules

4. Failing to complete the series: Incomplete vaccination may not provide adequate protection against meningococcal disease

5. Missing booster doses for high-risk individuals: Those at continued risk require boosters to maintain protection

By following these specific recommendations based on risk factors and vaccine type, clinicians can ensure optimal protection against meningococcal serogroup B disease.