What is the difference between Bexsero (meningococcal B vaccine) and Menveo (meningococcal conjugate vaccine)?

Differences Between Bexsero and Menveo Meningococcal Vaccines

Bexsero and Menveo target different meningococcal serogroups - Bexsero protects against serogroup B while Menveo protects against serogroups A, C, W, and Y. 1

Key Differences

Target Serogroups

• Bexsero (MenB-4C) is specifically designed to protect against meningococcal serogroup B disease 1
• Menveo (MenACWY-CRM) provides protection against meningococcal serogroups A, C, W, and Y 1

Vaccine Composition

• Bexsero contains multiple components:
  • Factor H binding protein (FHbp) from subfamily B (nonlipidated form) 2
  • Neisserial Heparin Binding Antigen 3
  • Neisserial adhesin A 3
  • Outer membrane vesicles 3, 4
• Menveo is a polysaccharide-protein conjugate vaccine using CRM197 as the carrier protein 1, 5

Dosing Schedule

• Bexsero is administered as a 2-dose series with doses given 1 month apart for all indicated populations 1
• Menveo's schedule varies by age but is typically given as a single dose with potential boosters depending on risk factors 1

Indications

• Both vaccines are licensed for use in persons 10 through 25 years of age 1
• Bexsero is indicated for protection against meningococcal serogroup B disease 1
• Menveo is indicated for protection against meningococcal serogroups A, C, W, and Y 5

Clinical Importance

Epidemiology

• With widespread use of MenACWY vaccines, serogroup B now causes approximately 40% of all meningococcal disease cases in adolescents and young adults in the US 1
• Approximately 50 cases of serogroup B meningococcal disease occur annually among 11-23 year-olds in the US 1
• About one-third of serogroup B cases among 18-23 year-olds occur in college students 1

Recommendations for Use

• Both vaccines are recommended for persons at increased risk for meningococcal disease, including:
  • Individuals with persistent complement component deficiencies 1
  • Persons with anatomic or functional asplenia 1
  • Microbiologists who routinely work with N. meningitidis 1
  • Persons in outbreak settings 1
• Only Menveo is recommended for:
  • Travelers to areas with hyperendemic or epidemic meningococcal disease 1
  • First-year college students living in residence halls 1
  • Military recruits 1

Clinical Efficacy

• Bexsero has demonstrated effectiveness in outbreak settings, including university outbreaks in the US prior to licensure 3
• Menveo has established efficacy against serogroups A, C, W, and Y 1
• Neither vaccine provides cross-protection against the serogroups covered by the other 5

Important Clinical Considerations

When to Use Which Vaccine

• For complete protection against all major disease-causing meningococcal serogroups (A, B, C, W, Y), both vaccines would be needed 1
• For specific outbreak situations, select the appropriate vaccine based on the identified serogroup causing the outbreak 1
• For high-risk individuals, both vaccines are typically recommended to provide comprehensive protection 1

Potential Pitfalls

• The vaccines are not interchangeable - if starting a series with one product, the same product must be used to complete the series 1
• Bexsero does not protect against serogroups A, C, W, or Y 1
• Menveo does not protect against serogroup B 5
• Protection against serogroup B is particularly important for college students due to the higher risk of outbreaks in this population 1

Recent Developments

• A pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp) that protects against all five major serogroups (A, B, C, W, Y) was approved in 2023 and may be an alternative to receiving separate vaccines 6

Remember that for comprehensive protection against all major disease-causing meningococcal serogroups, both vaccines or the new pentavalent vaccine would be needed, as neither Bexsero nor Menveo alone provides complete coverage.