Continuing Bexsero After International Relocation
Yes, it is safe and appropriate to continue the local vaccination schedule for Bexsero (4CMenB) after relocating, as different meningococcal conjugate vaccine products can be used interchangeably when the original product is unavailable. 1
Key Principle: Vaccine Interchangeability
Limited data suggest that different conjugate vaccine products can be used interchangeably, and if the same vaccine product used for the first dose is not available or if it is not known which vaccine product was used previously, administration of the vaccine should not be deferred if indicated. 1
Any licensed age-appropriate conjugate vaccine can be administered to complete the series. 1
Important Context for Bexsero (4CMenB)
However, it's critical to understand that Bexsero is a meningococcal group B vaccine, which is distinct from the meningococcal ACWY vaccines discussed in most interchangeability guidelines. The evidence provided primarily addresses ACWY vaccines (MenACWY-D, MenACWY-CRM, MenACWY-TT), not MenB vaccines like Bexsero.
Bexsero-Specific Considerations:
The UK uses a reduced 2-dose primary schedule at 2 and 4 months with a booster at 12 months for Bexsero. 2, 3
Uptake data from England showed 92.5% of children completed primary immunizations by their first birthday and 87.9% received all three doses by 2 years, demonstrating the feasibility of this schedule. 3
The vaccine demonstrated 59.1% effectiveness with a two-dose priming schedule plus a booster at 1 year, with protection sustained for at least 2 years. 3
Practical Recommendation for Your Situation
Continue with the local NHS schedule where you are now residing. The general principle of vaccine interchangeability applies, though you should:
Ensure the receiving location uses the same Bexsero (4CMenB) vaccine product, as this is the only broadly licensed MenB vaccine in most countries. 2, 4
Follow the local schedule timing for subsequent doses (typically at 4 months and 12 months if the first dose was given at 2 months). 2, 3
Be aware that prophylactic paracetamol (three doses) should be given with each primary vaccination dose due to high rates of fever post-vaccination. 2
Critical Timing Considerations
Timely vaccination is critical because of the high incidence of MenB disease in early childhood. 5
A study found that 46.5% of infants who developed MenB disease had missed opportunities for vaccination with two doses prior to illness. 5
Do not delay subsequent doses - maintaining the schedule is more important than waiting to return to the original location. 5, 3
Common Pitfall to Avoid
Do not assume you must return to the original vaccination location to complete the series. This delay could leave your infant vulnerable during the highest-risk period for meningococcal disease, which occurs in early infancy. 5, 3