Meningococcal Serogroup B Vaccination for College Dormitory Students
Current guidelines do not routinely recommend serogroup B meningococcal (MenB) vaccination for all college students living in dormitories, but recommend it be considered through shared clinical decision-making. 1, 2
Current Recommendations for College Students
MenACWY vs. MenB Recommendations
- MenACWY (quadrivalent meningococcal conjugate vaccine): Routinely recommended for first-year college students living in residence halls 1, 2
- MenB (serogroup B meningococcal vaccine): Not routinely recommended for all college students living in dormitories 1
Key Points About MenB Vaccination for College Students
- College students have a lower risk of serogroup B meningococcal disease than the general population of similar age 1
- However, college students are at 3.54 times higher risk for MenB disease compared to non-college students of the same age 3
- Freshmen living in dormitories have the highest incidence rate of meningococcal disease at 5.1 per 100,000 4
- MenB vaccination is recommended based on shared clinical decision-making for adolescents and young adults aged 16-23 years 2
Risk Assessment and Decision-Making
Factors Supporting MenB Vaccination for Dormitory Students
- Increased risk during outbreaks: College campuses have experienced 200-1400-fold increases in risk during outbreaks 1, 2
- Six serogroup B outbreaks were identified on college campuses between 2014-2016 3
- Freshmen living in dormitories have 3.6 times higher risk of meningococcal disease compared to other college students 4
Factors Against Routine MenB Vaccination
- Low overall incidence: Only 50-60 cases of serogroup B meningococcal disease occur annually in adolescents and young adults 11-24 years 1, 2
- Limited cost-effectiveness: Routine MenB vaccination of college students is estimated to prevent only 10 cases and 1 death per year 1
- Limited data on long-term protection: Studies regarding antibody persistence are limited 1
Vaccination Protocols When Administered
If MenB vaccination is chosen, it should be administered according to the following schedules:
MenB-FHbp (Trumenba):
- 2-dose series (0,6 months) for healthy individuals
- 3-dose series (0,1-2, and 6 months) for high-risk individuals
MenB-4C (Bexsero):
- 2-dose series (≥1 month apart) for all groups 2
Special Considerations
Outbreak Response
- During confirmed outbreaks of serogroup B meningococcal disease on college campuses, mass vaccination campaigns are recommended 5, 6
- Proactive, routine immunization of incoming students may be more efficient than emergency response to outbreaks 5
Documentation of Decision
- If the clinician and family discuss the MenB vaccine and the vaccine is not administered, the discussion and decision should be documented in the patient's health record 1
Common Pitfalls and Caveats
- Don't confuse MenACWY and MenB recommendations: While MenACWY is routinely recommended for first-year college students in dormitories, MenB is not 1
- Recognize limitations of protection: MenB vaccines may not protect against all strains of serogroup B meningococcal disease 1, 7
- Consider timing: If vaccination is chosen, the preferred age range is 16-18 years 1, 2
- Be aware of adverse effects: Common adverse events of MenB vaccine include severe pain at injection site, fever, severe headache, fatigue, and muscle pain 2
In summary, while MenB vaccination is not routinely recommended for all college dormitory students, it should be considered through shared clinical decision-making, particularly for freshmen living in dormitories who face the highest risk of meningococcal disease.