Meningococcal Vaccines ACWY and B Can Be Administered Simultaneously to College Students
Yes, college students can safely receive both the meningococcal ACWY and meningococcal B vaccines at the same time, using different injection sites. 1
Rationale for Simultaneous Administration
The Advisory Committee on Immunization Practices (ACIP) explicitly states that there is no contraindication to giving meningococcal B and quadrivalent meningococcal conjugate vaccines on the same day as long as different administration sites are used 1. This recommendation is reinforced in more recent guidelines that confirm MenACWY and MenB vaccines can be administered concomitantly but at different anatomical sites 2.
Recommendations for College Students
College students, particularly those living in residence halls, are at higher risk for meningococcal disease:
- College freshmen living in residence halls should receive at least 1 dose of MenACWY within 5 years before college entry 1
- The preferred timing of the most recent MenACWY dose is on or after their 16th birthday 1
- If only 1 dose of MenACWY was administered before the 16th birthday, a booster dose should be administered before enrollment 1
- MenB vaccination should be considered through shared clinical decision-making for adolescents and young adults aged 16-23 years, particularly for college students due to recent outbreaks of serogroup B meningococcal disease on college campuses 2
Vaccine Administration Details
When administering both vaccines at the same visit:
- Use different injection sites - This is critical when giving both vaccines simultaneously 1, 2
- Maintain vaccine specificity - The two MenB vaccines (MenB-4C/Bexsero and MenB-FHbp/Trumenba) are not interchangeable; the same product must be used for all doses in a series 1, 2
- Follow proper dosing schedules:
- MenACWY: Single dose for most college students (unless a booster is needed)
- MenB-FHbp (Trumenba): 2-dose series (0,6 months) for healthy individuals or 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
Safety Considerations
- Common adverse events include pain at injection site, fever, headache, fatigue, and muscle pain 2
- All healthcare personnel administering vaccinations should be aware of the potential for syncope after vaccination, especially among adolescents 1
- Providers should consider observing patients for 15 minutes after vaccination 1
- Vaccination is contraindicated in persons with a history of severe allergic reaction to any component of the vaccine 1, 2
Special Considerations
- For persons who previously completed a MenB primary series who remain at increased risk for meningococcal disease, booster vaccination should be administered according to the recommended schedule 1
- Vaccination should be deferred for persons with moderate or severe acute illness until the person's condition improves 1
Recent Developments
A pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya]) that covers serogroups A, B, C, W, and Y was approved in October 2023 for persons aged 10-25 years 3. This may simplify vaccination for college students in the future, but it's still too new to be included in most institutional requirements.