What should be done for a patient who received an expired meningococcal B vaccine (MenB), specifically Bexsero (multicomponent meningococcal B vaccine) or Trumenba (meningococcal group B vaccine), that was 6 days past its expiration date?

Management of Expired Meningococcal B Vaccine Administration

The expired MenB vaccine dose administered 6 days past expiration should be repeated with a valid (non-expired) dose, maintaining a minimum 4-week interval from the invalid dose.

Immediate Actions Required

Document the vaccine administration error in the patient's medical record, noting the specific vaccine product (Bexsero or Trumenba), lot number, expiration date, and date administered 1.

• Notify the patient or guardian about the administration of an expired vaccine dose 1
• Report the incident according to your facility's vaccine error reporting protocols 1
• The expired dose should be considered invalid and does not count toward completion of the MenB series 1

Revaccination Strategy

Administer a replacement dose using the same MenB vaccine product (either MenB-FHbp/Trumenba or MenB-4C/Bexsero) that was originally given, as these vaccines are not interchangeable 1.

Timing of Repeat Dose

• Wait a minimum of 4 weeks from the invalid expired dose before administering the replacement dose 1
• This 4-week minimum interval applies to any situation where MenB doses must be repeated 1

Series Completion Based on Product

For MenB-FHbp (Trumenba):

• If patient is at increased risk (complement deficiency, asplenia, complement inhibitor use): Complete a 3-dose series at 0,1-2, and 6 months from the valid first dose 1
• If patient is a healthy adolescent (ages 16-23) receiving vaccine via shared clinical decision-making: Complete a 2-dose series at 0 and 6 months from the valid first dose 1, 2

For MenB-4C (Bexsero):

• If patient is at increased risk: Complete a 3-dose series at 0,1-2, and 6 months from the valid first dose 2
• If patient is a healthy adolescent (ages 16-23): Complete a 2-dose series at 0 and 6 months from the valid first dose 2

Critical Considerations

Do not attempt to "continue" the series from where it left off – restart the appropriate schedule from the first valid dose 1.

• The expired vaccine provides no assurance of immunogenicity or protection, as vaccine potency cannot be guaranteed beyond the expiration date 1
• If the vaccine product used for the expired dose is unknown or unavailable, you must restart the entire series with either MenB product, as mixing products results in inadequate protection 1

Patient Communication Points

• Explain that vaccine expiration dates are established based on stability data and that expired vaccines may have reduced potency 1
• Reassure the patient that receiving an expired vaccine is not harmful, but it cannot be counted as a valid dose 1
• Emphasize the importance of completing the replacement series to ensure adequate protection against meningococcal serogroup B disease 1

Quality Improvement

Implement storage and handling protocols to prevent future expired vaccine administration, including regular expiration date checks and first-expired-first-out (FEFO) inventory management 1.