4CMenB (Bexsero) Dosing Schedule per NHS UK Guidelines
The NHS UK recommends a reduced two-dose infant priming schedule of 4CMenB at 8 weeks and 16 weeks of age, followed by a booster dose at 12 months of age. 1, 2
Standard Infant Schedule
The UK national immunisation programme uses the following dosing schedule for 4CMenB:
- First dose: 8 weeks (2 months) of age 1, 2
- Second dose: 16 weeks (4 months) of age 1, 2
- Booster dose: 12 months (1 year) of age 1, 2
This represents a reduced schedule compared to the three-dose priming schedules used in other countries, with the UK being the first nation to implement this approach in a publicly funded national programme. 1
Vaccine Uptake and Coverage
The NHS programme has achieved consistently high uptake rates:
- 92.5% of children complete the two-dose primary series by their first birthday 2
- 87.9% receive all three doses (including the booster) by 2 years of age 2
- 95.5% receive at least one dose and 88.6% receive both primary doses by 6 months of age 1
Effectiveness of the UK Schedule
The reduced two-dose priming schedule has proven highly effective in real-world implementation:
- Two-dose vaccine effectiveness: 82.9% (95% CI 24.1-95.2) against all MenB cases 1
- Three-dose effectiveness (with booster): 59.1% (95% CI -31.1 to 87.2) 2
- Overall impact: 75% reduction in meningococcal group B disease incidence in vaccine-eligible cohorts over the first 3 years 2
- Cases prevented: An estimated 277 cases (95% CI 236-323) were prevented over the 3-year period 2
Important Clinical Considerations
Coadministration with routine vaccines: 4CMenB can be administered concomitantly with other routine infant vaccines at the same visit but at different anatomic sites. 3 However, be aware that coadministration is associated with increased rates of fever compared to routine vaccines given alone. 4, 5
Common adverse reactions: The most frequently reported adverse reactions include:
- Injection site pain (≥85% of recipients) 3
- Fever (40% of Yellow Card reports) 5
- Local reactions (41% of Yellow Card reports) 5
- Persistent nodules at injection sites have been reported but are usually benign 5
Safety profile: Prospective surveillance of approximately 3 million doses administered to 1.29 million UK children found no significant safety concerns, with no increased risk of seizures, Kawasaki disease, or sudden infant death syndrome. 5
Special Populations
Household contacts after second case: If two or more cases of serogroup B disease occur within the same household, 4CMenB should be offered to all household contacts in addition to chemoprophylaxis, even if the interval between cases exceeds 30 days or the strains differ. 6
Catch-up vaccination: The UK programme initially offered an opportunistic catch-up for infants aged 3-4 months at programme launch. 1