What vaccinations are recommended for a 16-year-old?

Vaccination Schedule for 16-Year-Olds

A 16-year-old should receive a meningococcal conjugate vaccine (MenACWY) booster dose if their first dose was given before age 16, and may receive meningococcal B (MenB) vaccine for short-term protection against serogroup B disease. 1

Meningococcal Vaccination

MenACWY (Quadrivalent Conjugate Vaccine)

Booster Dose Requirement:

• Adolescents who received their first MenACWY dose at ages 11-12 years should receive a booster at age 16 years (at least 8 weeks after the first dose). 1
• Adolescents who received their first dose at ages 13-15 years should receive a booster at ages 16-18 years (at least 8 weeks or up to 5 years after their first dose). 1
• If the first dose is given at or after age 16, no booster is needed. 1

Rationale for Booster: The booster recommendation stems from evidence showing waning antibody protection within 5 years after initial vaccination. 1, 2 Research demonstrates vaccine effectiveness of 79% in the first year declining to 61% at 3-8 years post-vaccination, supporting the need for a booster during the high-risk adolescent period. 2 Studies show that 4 years after a booster dose, 89.9-98.2% of participants maintain protective antibody titers. 3

MenB (Serogroup B Vaccine)

Permissive Recommendation:

• Adolescents aged 16-18 years (preferred age range 16-18) may receive MenB vaccine to provide short-term protection against serogroup B meningococcal disease. 1
• This is a Category B recommendation (may be administered based on individual clinical decision), not a routine recommendation. 1
• Either a 2-dose series of MenB-4C or a 3-dose series of MenB-FHbp can be used. 1

Mandatory MenB Vaccination: MenB vaccine series is required (not optional) for adolescents aged ≥10 years with:

• Persistent complement component deficiencies 1
• Anatomical or functional asplenia 1
• Microbiologists routinely exposed to Neisseria meningitidis 1
• Those at increased risk due to a serogroup B outbreak 1

HPV Vaccination

At age 16, assess HPV vaccination status:

• The HPV vaccine series (9vHPV, 4vHPV for males; 9vHPV, 4vHPV, or 2vHPV for females) should be completed if not already done. 1, 4
• HPV vaccination is routinely recommended through age 26 years. 4
• If the series was started but not completed, it should be finished at this visit. 4

Other Routine Vaccinations

Annual influenza vaccine should be administered. 1

Tdap/Td booster should be verified as completed (if not given at ages 11-12, it should be administered now). 1

Special Populations at Age 16

High-risk conditions requiring modified schedules:

• Adolescents with persistent complement deficiencies or functional/anatomic asplenia should have received a 2-dose primary MenACWY series and require boosters every 5 years. 1
• HIV-infected adolescents should receive a 2-dose primary MenACWY series. 1

Clinical Pitfalls

Common errors to avoid:

• Failing to give the MenACWY booster at age 16 when the first dose was given at ages 11-12 leaves adolescents vulnerable during peak risk years due to waning immunity. 1, 2
• Assuming that a single MenACWY dose at age 16 provides adequate protection—if given as a first dose at age 16, no booster is needed, but if given earlier, the booster is essential. 1
• Not distinguishing between MenACWY (routine booster required) and MenB (permissive recommendation for healthy adolescents, mandatory for high-risk). 1