At what age is the first dose of meningococcal conjugate vaccine (MCV) administered?

Meningococcal Conjugate Vaccine First Dose Timing

For routine vaccination, adolescents receive their first dose of meningococcal conjugate vaccine (MenACWY) at age 11-12 years. 1 However, for high-risk infants and children, vaccination begins much earlier depending on specific risk factors.

Routine Vaccination Schedule

Healthy adolescents should receive their first MenACWY dose at 11-12 years of age, followed by a booster at 16-18 years. 1 This two-dose schedule provides optimal protection through the high-risk period of late adolescence and early adulthood. 2

• Adolescents who receive their first dose at age 13-15 years still need a booster at 16-18 years, administered at least 8 weeks after the first dose. 1
• Those receiving their first dose at or after age 16 do not require a booster dose. 1

High-Risk Populations Requiring Early Vaccination

Infants with Persistent Complement Deficiencies or Asplenia

For infants at highest risk (complement deficiencies, anatomic or functional asplenia including sickle cell disease), vaccination begins as early as 2 months of age. 1

• MenACWY-CRM (Menveo) is the preferred vaccine for this age group, administered as a 4-dose series at 2,4,6, and 12 months. 1
• If vaccination starts at 7-23 months, a 2-dose series is given with the second dose at least 12 weeks after the first and after the first birthday. 1
• MenACWY-D (Menactra) can be used starting at 9 months as a 2-dose series at least 12 weeks apart, but must be given at least 4 weeks after completing all pneumococcal conjugate vaccine (PCV) doses to avoid immune interference. 1

Children 2-10 Years with High-Risk Conditions

For children aged 2-10 years with persistent risk factors, a 2-dose primary series is administered 8-12 weeks apart. 1

• Any of the three MenACWY vaccines (MenACWY-D, MenACWY-CRM, or MenACWY-TT) can be used. 1
• MenACWY-D must be given at least 4 weeks after completing the PCV13 series in children with asplenia or HIV to prevent immune interference. 1

Travelers to Endemic Areas

Infants as young as 2 months traveling to meningitis-endemic regions should receive age-appropriate MenACWY vaccination. 1

• MenACWY-CRM can be initiated at 2 months with a 4-dose series. 1
• MenACWY-D can be used starting at 9 months as a 2-dose series at least 8 weeks apart (may be given as early as 8 weeks apart for travelers). 1

Outbreak Situations

During community outbreaks, vaccination age depends on the affected population, with infants as young as 2 months receiving MenACWY-CRM. 1

• The specific schedule mirrors that for high-risk infants, with 4 doses at 2,4,6, and 12 months if starting at 2 months. 1

Important Clinical Caveats

Timing relative to other vaccines matters significantly for certain populations. MenACWY-D should be given either before or simultaneously with DTaP in children to avoid interference with the meningococcal immune response. 1 For children with asplenia or HIV, MenACWY-D must not be administered until at least 4 weeks after completing all PCV doses. 1

Healthy children aged 2 months to 10 years without risk factors do not receive routine meningococcal vaccination. 1, 3 The vaccine is reserved for those with specific risk factors or exposure circumstances.

Booster dose timing varies by age at primary vaccination. Children vaccinated before age 7 years need their first booster 3 years later, then every 5 years if risk persists. 1 Those vaccinated at age 7 or older need boosters every 5 years if risk continues. 1