Meningitis Vaccination for an 11-Year-Old
Yes, meningococcal vaccination is routinely indicated for an 11-year-old patient—specifically, one dose of MenACWY (quadrivalent meningococcal conjugate vaccine covering serogroups A, C, W, and Y) should be administered at age 11-12 years. 1
Primary Vaccination Schedule
The Advisory Committee on Immunization Practices (ACIP) recommends the following for routine meningococcal vaccination in adolescents:
Administer one dose of MenACWY vaccine at age 11-12 years as part of the routine adolescent vaccination platform. 1, 2
A booster dose is required at age 16 years if the first dose was administered before the 16th birthday, as vaccine effectiveness wanes over time. 1
The minimum interval between doses is 8 weeks, though the standard schedule calls for the booster at age 16. 1
Rationale for Vaccination at This Age
Adolescents aged 16-23 years have the highest incidence of invasive meningococcal disease (IMD) among age groups routinely vaccinated, with rates of 0.10 per 100,000 in 2018. 3
Nasopharyngeal carriage rates peak in adolescents and young adults, making them key reservoirs for meningococcal transmission. 1
Vaccine effectiveness wanes significantly over time: VE drops from 79% at <1 year post-vaccination to 61% at 3-8 years, necessitating the age 16 booster to maintain protection through the highest-risk period. 4
Meningococcal disease carries serious consequences, including a 14.5% case fatality rate, with survivors experiencing neurologic sequelae, limb amputation, and other permanent disabilities. 1, 5
Available Vaccine Products
All MenACWY vaccines are interchangeable for the adolescent schedule: 1
- MenACWY-D (Menactra)
- MenACWY-CRM (Menveo)
- MenACWY-TT (MenQuadfi)
Serogroup B Considerations
MenB vaccination is NOT routinely recommended at age 11, but rather at ages 16-23 years based on shared clinical decision-making (preferred age 16-18 years). 1
Serogroup B accounts for the majority of IMD cases in adolescents (62% in ages 16-23), but the recommendation differs from MenACWY due to different epidemiology and policy considerations. 3
MenB requires a separate 2-dose series and should be discussed at the age 16 visit. 1
Critical Implementation Points
Strong, unambiguous provider recommendation is the single most important factor in vaccine acceptance—lack of provider recommendation is a major reason for non-receipt of adolescent vaccines. 2
MenACWY can and should be co-administered with other adolescent vaccines (Tdap and HPV) at the same visit. 2
National coverage for MenACWY reached 81% for at least one dose in 2015, but booster coverage at age 16 remains lower at 61%, highlighting the importance of emphasizing both doses. 2, 5
Common Pitfalls to Avoid
Do not delay vaccination waiting for the "optimal" age—any visit between ages 11-12 years is appropriate for the first dose. 1
Do not assume one dose provides lifelong protection—counsel families at the initial visit that a booster at age 16 will be necessary. 1, 4
Do not confuse MenACWY with MenB—they are separate vaccines with different schedules and recommendations. 1
Eliminating the age 11-12 dose would result in 1,062 additional IMD cases and 154 additional deaths over 11 years, even with increased uptake of a single dose at age 16—maintaining the current two-dose schedule is critical. 5
Special Populations Requiring Modified Schedules
If the 11-year-old has any of the following conditions, a 2-dose primary series (not just one dose) is indicated: 1
- Persistent complement component deficiencies
- Complement inhibitor use (e.g., eculizumab)
- Anatomic or functional asplenia
- HIV infection
These patients also require booster doses every 3-5 years while the risk persists. 1