Should dorm students get the meningitis (meningococcal) vaccine?

Meningococcal Vaccination for Dorm Students

College freshmen living in dormitories should get the meningococcal vaccine as they are at a modestly increased risk for meningococcal disease compared to other persons their age, and vaccination will decrease their risk of morbidity and mortality from this potentially fatal infection. 1

Risk Assessment for College Students

The risk of meningococcal disease varies among college students:

• Highest risk: Freshmen living in dormitories (5.1 cases per 100,000) 2
• Moderate risk: All college freshmen
• Lower risk: Non-freshmen college students (similar to general population) 1

Vaccination Recommendations

For Dormitory Residents

• College freshmen who live in dormitories are at 3.6 times higher risk of meningococcal disease compared to other college students 2
• The quadrivalent meningococcal conjugate vaccine (MenACWY) provides protection against serogroups A, C, W, and Y, which account for approximately 68% of cases in college students 2

Duration of Protection

• Vaccine effectiveness wanes over time:
  • 79% effective in the first year after vaccination
  • 69% effective at 1-3 years post-vaccination
  • 61% effective at 3-8 years post-vaccination 3
• High proportions (89.9-98.2%) of individuals maintain protective antibody titers for at least 4 years after a booster dose 4

Implementation Considerations

While the Advisory Committee on Immunization Practices (ACIP) notes that vaccination of all college students may not be cost-effective for society as a whole, they specifically recommend:

1. Medical providers should inform incoming and current college freshmen, particularly those in dormitories, about meningococcal disease and vaccination benefits 1
2. College freshmen who want to reduce their risk should receive the vaccine 1
3. Colleges should inform dormitory residents about meningococcal disease and vaccine availability 1

Special Considerations

• Revaccination: Consider revaccination for freshmen who were vaccinated more than 3-5 years earlier 1
• Higher risk students: Those with immune deficiencies, those traveling to endemic areas, or those working in laboratories with potential N. meningitidis exposure should definitely be vaccinated 1
• Serogroup B protection: The standard quadrivalent vaccine does not protect against serogroup B, which accounts for a significant proportion of cases. Specific MenB vaccines are now available for people aged 10-25 years 5

Institutional Policies

Most colleges and universities (95%) either require or recommend meningococcal vaccination, with 53% requiring it. However, policies specifically addressing MenB vaccines are less common, with only about half of institutions having such policies 6.

Common Pitfalls

1. Assuming complete protection: The quadrivalent vaccine does not protect against serogroup B disease
2. Delaying vaccination: Given the rapid progression of meningococcal disease, vaccination should occur before or immediately upon dormitory move-in
3. Missing booster doses: Protection wanes over time, so following the recommended adolescent vaccination schedule (initial dose at 11-12 years with a booster at 16 years) is important

While the absolute risk remains relatively low, the potentially devastating consequences of meningococcal disease (including death) and the demonstrated effectiveness of vaccination make this an important preventive measure for college students living in dormitories.