What vaccines are recommended for college students?

Meningococcal Vaccine for College Students

College freshmen, particularly those living in dormitories, should receive the quadrivalent meningococcal conjugate vaccine (MenACWY) covering serogroups A, C, W, and Y, with meningococcal B (MenB) vaccination offered based on shared clinical decision-making for students aged 16-23 years.

Primary Recommendation: MenACWY Vaccine

Healthcare providers should inform incoming and current college freshmen—especially those living in dormitories or residence halls—about meningococcal disease and the benefits of vaccination during routine medical care. 1

Key Points for MenACWY:

• College freshmen living in dormitories face modestly increased risk for meningococcal disease compared to other persons their age 1
• The quadrivalent meningococcal polysaccharide vaccine (now replaced by conjugate vaccines) covers serogroups C, Y, W-135, and A, though efficacy is <100% 1
• College freshmen who want to reduce their risk should be administered the vaccine or directed to where it is available 1
• Non-freshmen college students have risk similar to the general population but can receive vaccination if they want to reduce their risk 1

Timing and Revaccination:

• Antibody levels decline rapidly over 2-3 years after vaccination 1
• Revaccination may be considered for freshmen who were vaccinated more than 3-5 years earlier 1
• Routine revaccination of college students who were vaccinated as freshmen is not indicated 1
• A booster dose at age 16 years is recommended, which provides protection throughout the college years 2

Secondary Recommendation: MenB Vaccine

MenB vaccination may be administered to adolescents and young adults aged 16-23 years based on shared clinical decision-making. 3

Rationale for MenB Consideration:

• Serogroup B accounts for 62% of invasive meningococcal disease cases in persons 16-23 years of age in the United States 4
• College campuses, particularly dormitories, are settings where serogroup B outbreaks occur due to crowding 5
• Two MenB vaccines are available: MenB-4C (Bexsero) and MenB-FHbp (Trumenba), administered as 2-dose series 3
• The same vaccine product must be used for all doses; vaccines are not interchangeable 3

Shared Decision-Making Factors:

• The decision should consider the serious nature of meningococcal infections, the low absolute number of serogroup B cases, and the increased risk among college students 3
• Most institutions with MenB policies recommend rather than require vaccination (96% vs 4%) 6
• Routine MenB vaccination would prevent an estimated 15-29 cases and 2-5 deaths per year nationally if all eligible persons were immunized 3

High-Risk Students Requiring MenB Vaccination:

The following college students should definitively receive MenB vaccination (not optional):

• Students with persistent complement component deficiencies or receiving complement inhibitor therapy 3
• Students with anatomic or functional asplenia, including sickle cell disease 3
• Microbiology students routinely exposed to isolates of Neisseria meningitidis 3
• Students at risk during meningococcal B disease outbreaks 3
• Students traveling to countries where N. meningitidis is hyperendemic or epidemic (meningitis belt of sub-Saharan Africa) 1

Important Caveats:

• Neither vaccine eliminates risk completely: MenACWY does not protect against serogroup B disease, and MenB vaccines do not protect against serogroups A, C, W, or Y 1
• Colleges should inform students about meningococcal disease and vaccine availability 1
• The absolute risk of meningococcal disease among college students remains low, though higher than age-matched peers not in college 1
• Most institutions have meningococcal vaccination policies, but there is substantial diversity in these policies 6