Vaccines That Protect Against Meningitis
Multiple vaccines protect against bacterial meningitis, with meningococcal vaccines covering serogroups A, B, C, W, and Y, pneumococcal vaccines preventing Streptococcus pneumoniae meningitis, and Haemophilus influenzae type b (Hib) vaccine preventing H. influenzae meningitis.
Meningococcal Vaccines
Quadrivalent Meningococcal Conjugate Vaccines (MenACWY)
These vaccines protect against meningococcal serogroups A, C, W, and Y 1:
- MenACWY-D (Menactra) - approved for persons aged 2-55 years 1
- MenACWY-CRM (Menveo) - licensed for use in multiple age groups 1
- MenACWY-TT (MenQuadfi) - newer conjugate vaccine option 1, 2
MenACWY vaccines are preferred over the older polysaccharide vaccine (MPSV4) for adults aged ≤55 years 1. MPSV4 (Menomune) is a quadrivalent polysaccharide vaccine licensed in 1981 that may be used for adults aged ≥56 years requiring only a single dose 1.
Serogroup B Meningococcal Vaccines (MenB)
Two vaccines specifically target serogroup B meningococcus 1:
- MenB-FHbp (Trumenba) - administered as either a 2-dose series (0 and 6 months) for healthy adolescents or a 3-dose series (0,1-2, and 6 months) for persons at increased risk 1, 2
- MenB-4C (Bexsero) - administered as a 2-dose series at least 1 month apart 1, 2
These MenB vaccines are not interchangeable; the same product must be used for all doses in a series 1.
Pentavalent Meningococcal Vaccine
MenACWY-TT/MenB-FHbp (Penbraya) - approved in 2023 for persons aged 10-25 years, this vaccine protects against all five major disease-causing serogroups (A, B, C, W, and Y) in a single formulation 3. It may be used when both MenACWY and MenB vaccines are indicated at the same visit 3.
Pneumococcal Vaccines
While the evidence provided focuses primarily on meningococcal vaccines, pneumococcal vaccines (PCV13 and PPSV23) are critical for preventing Streptococcus pneumoniae meningitis 1. These vaccines protect against the most common bacterial cause of meningitis in adults and children.
Haemophilus influenzae Type b (Hib) Vaccine
The Hib vaccine prevents meningitis caused by Haemophilus influenzae type b 1. A combination vaccine, Hib-MenCY-TT (MenHibrix), provides protection against both Hib and meningococcal serogroups C and Y 1.
Key Clinical Considerations
Routine Vaccination Schedule
- Age 11-12 years: One dose of MenACWY 2
- Age 16 years: Booster dose of MenACWY 2
- Ages 16-23 years (preferably 16-18): MenB vaccination based on shared clinical decision-making 1, 2
High-Risk Populations Requiring Enhanced Protection
Persons with the following conditions require a 2-dose primary series of MenACWY and MenB vaccination 1, 2:
- Persistent complement component deficiencies (C3, C5-C9, properdin, factor H, or factor D) 1
- Complement inhibitor use (eculizumab or ravulizumab) 1
- Anatomic or functional asplenia (including sickle cell disease) 1
- HIV infection 1
- Microbiologists routinely exposed to Neisseria meningitidis 1
Booster Recommendations
Revaccination with MenACWY every 5 years is recommended for persons who remain at increased risk 1. For MenB vaccines, boosters are recommended 1 year after primary vaccination and every 2-3 years thereafter for high-risk individuals 1.
Important Safety Precautions
Patients should be observed seated or lying down for 15 minutes after vaccination to prevent injury from syncope, which is particularly common in adolescents 2.