Bexsero (Meningococcal B) Vaccine Dosing Schedule in Australian Children
The recommended Bexsero (meningococcal B) vaccine dosing schedule in Australia varies by age group, with infants requiring more doses than older children, and common side effects include injection site pain, fever, irritability, and rash.
Age-Specific Dosing Schedule
Infants 2-5 months
- Primary vaccination: 3 doses administered at 2,4, and 6 months of age 1
- Booster dose: 1 dose at 12 months of age 1
Infants 6-11 months
- Primary vaccination: 2 doses administered at least 8 weeks apart 1, 2
- Booster dose: 1 dose in the second year of life, at least 8 weeks after completion of primary series 1, 2
Children 12-23 months
- Primary vaccination: 2 doses administered at least 8 weeks apart 1, 2
- No booster dose required unless child remains at high risk 1
Children 2-10 years
- Primary vaccination: 2 doses administered at least 8 weeks apart 1
- Booster doses only for high-risk children (see below) 1
Adolescents and young adults 11-23 years
- Primary vaccination: 2 doses administered at least 8 weeks apart 1
- No booster required unless at high risk 1, 3
Special Considerations for High-Risk Groups
Children with complement deficiencies, asplenia, or during outbreaks
- More frequent booster doses are recommended 1
- For children 2 months to 6 years of age: booster dose 3 years after primary series and every 5 years thereafter 1, 3
- For children 7 years and older: booster dose every 5 years 1, 3
Common Side Effects
Local reactions
Systemic reactions
- Fever (common, reported in 11% of adverse event notifications in South Australia) 4
- Irritability in infants and young children 5
- Fatigue (≥40% of recipients) 1, 5
- Headache (≥35% of recipients) 1, 5
- Muscle pain/myalgia (≥30% of recipients) 1, 5
- Chills (≥15% of recipients) 1
- Nausea/vomiting/diarrhea (reported in 11% of adverse event notifications) 4
- Rash (reported in 14% of adverse event notifications) 4
Serious adverse events (rare)
- Hypotonic-hyporesponsive episodes 4
- High fever >40°C 4
- Anaphylaxis or anaphylactoid reactions (very rare) 4
- Febrile convulsions (very rare) 4
Important Clinical Considerations
Fever management
- Prophylactic acetaminophen (paracetamol) is recommended, particularly for infants and young children 6, 4
- Prophylactic paracetamol significantly decreases the occurrence of fever and other solicited reactions without clinically relevant negative effects on vaccine immunogenicity 6
- In South Australia, 83% of children under two years with reported adverse events had been administered prophylactic acetaminophen 4
Coadministration with other vaccines
- Bexsero can be administered concomitantly with routine childhood vaccines but at a different anatomic site 1
- Higher rates of fever may occur when coadministered with routine vaccines 6, 5
Persistence of immunity
- Antibody levels decline significantly by 12 months after infant vaccination 2
- By 24 months after infant vaccination, protective antibody levels have waned considerably for most vaccine antigens 2
- Booster doses at 12 months of age produce robust immune responses in previously vaccinated infants 5, 2
Common Pitfalls to Avoid
- Failing to administer prophylactic paracetamol, especially in infants, which can lead to higher rates of post-vaccination fever 6, 4
- Not completing the full series of doses, which is essential for optimal protection 5, 2
- Missing the 12-month booster dose for infants who received the primary series, as antibody levels wane significantly by this age 2
- Overlooking the need for more frequent booster doses in high-risk children with complement deficiencies or asplenia 1, 3
- Using different meningococcal B vaccine products interchangeably within a series, which is not recommended 1