At what age is the Men B (Meningococcal B) vaccine typically administered?

MenB Vaccine Administration Timing

MenB vaccine is licensed for use starting at age 10 years, with routine vaccination recommended for healthy adolescents aged 16-23 years (preferably 16-18 years) based on shared clinical decision-making, while high-risk individuals should begin vaccination at age 10 years or older when risk factors are identified. 1

Routine Vaccination in Healthy Adolescents

For healthy adolescents without increased risk factors, MenB vaccination is administered between ages 16-23 years, with the preferred window being 16-18 years. 1 This is not a universal recommendation but requires a shared clinical decision-making discussion between the provider and patient/family. 1

Dosing Schedules for Healthy Adolescents

Two MenB vaccines are available, and they are NOT interchangeable - the same product must be used for all doses: 1

• MenB-FHbp (Trumenba): 2 doses at 0 and 6 months 2
• MenB-4C (Bexsero): 2 doses at 0 and 6 months (updated October 2024) 3

The dosing interval for MenB-4C was recently extended from ≥1 month to 6 months to align with MenB-FHbp recommendations and improve immunogenicity. 3

High-Risk Populations (Age ≥10 Years)

For individuals at increased risk for meningococcal disease, MenB vaccination should begin at age 10 years or older as soon as the risk factor is identified. 1 High-risk groups include:

• Persons with persistent complement deficiencies (C3, C5-C9, properdin, factor H, or factor D) 2
• Persons using complement inhibitors (eculizumab/Soliris, ravulizumab/Ultomiris) 2
• Persons with anatomical or functional asplenia, including sickle cell disease 2
• Microbiologists routinely exposed to Neisseria meningitidis 1
• Persons at risk during serogroup B meningococcal disease outbreaks 1

Dosing Schedules for High-Risk Individuals (Age ≥10 Years)

A 3-dose schedule is recommended for all high-risk individuals to provide earlier protection and maximize short-term immunogenicity: 2

• MenB-FHbp: 3 doses at 0,1-2, and 6 months 2
• MenB-4C: 3 doses at 0,1-2, and 6 months 2, 3

Booster doses are recommended for high-risk individuals who remain at increased risk: a single dose at 1 year after completion of primary vaccination, then every 2-3 years thereafter. 2

Special Timing Consideration for Complement Inhibitor Users

MenB vaccines should be administered at least 2 weeks before the first dose of complement inhibitor therapy, unless the risk of delaying complement therapy outweighs the risk of developing meningococcal disease. 2

Age Restrictions and Licensing

MenB vaccines are licensed in the United States only for persons aged 10-25 years. 2, 1 There are no recommendations for use in children under age 10 years. 1 Vaccination of persons aged ≥26 years is considered off-label but may be considered for those at increased risk. 1

Critical Pitfalls to Avoid

• Never interchange the two MenB vaccine products - the same brand must be used for all doses in the series 1
• Do not administer MenB vaccines to children under age 10 years - they are not licensed for this age group 1
• Do not use the 2-dose schedule for high-risk individuals - they require the 3-dose schedule for adequate protection 2
• Remember that MenB vaccination in healthy adolescents requires shared clinical decision-making - it is not a routine universal recommendation like MenACWY 1