What vaccines are recommended for a 16-year-old patient with a history of routine childhood vaccinations?

Vaccination Recommendations for 16-Year-Olds

A 16-year-old with routine childhood vaccinations needs a meningococcal ACWY booster dose and annual influenza vaccine, with meningococcal B vaccine available as an option based on shared clinical decision-making. 1

Required Vaccines at Age 16

Meningococcal ACWY Booster (MenACWY)

• The second dose of MenACWY is due at age 16 years for adolescents who received their first dose at ages 11-12 years (must be at least 8 weeks after the first dose). 1
• If the first MenACWY dose was given at ages 13-15 years, the booster should be administered at ages 16-18 years (at least 8 weeks or up to 5 years after the first dose). 1
• This booster is critical because it provides protection during the period of highest risk for meningococcal disease in late adolescence and young adulthood. 2
• Important caveat: If the first MenACWY dose was given at or after age 16, no booster is needed. 1

Annual Influenza Vaccine

• All adolescents aged 16 years should receive annual influenza vaccination, ideally before flu season begins. 1, 3
• This vaccine must be administered every year to maintain protection. 2

Optional Vaccine Based on Shared Clinical Decision-Making

Meningococcal B Vaccine (MenB)

• Adolescents aged 16-18 years may receive MenB vaccine to provide short-term protection against serogroup B meningococcal disease (Category B recommendation - may be administered based on individual clinical decision). 1, 4
• The preferred age range for this optional vaccination is 16-18 years. 4
• Two products are available: MenB-4C (Bexsero, 2 doses) or MenB-FHbp (Trumenba, 2-3 doses), but these products are not interchangeable once the series is started. 4
• MenB and MenACWY can be administered during the same visit using different injection sites. 4

Catch-Up Vaccinations to Verify

Tdap Booster

• Verify that the Tdap booster was administered at ages 11-12 years; if not completed, administer now. 1

HPV Vaccine Series

• If the HPV vaccine series was not started or completed, it should be initiated or completed now. 2
• The complete series consists of 2-3 doses depending on age at initiation. 2

Other Routine Childhood Vaccines

• Verify completion of all routine childhood vaccine series including MMR (2 doses), Varicella (2 doses), Hepatitis B (3 doses), Hepatitis A (2 doses), and Polio (4 doses). 2

High-Risk Populations Requiring MenB

MenB vaccine series is mandatory (not optional) for 16-year-olds with the following conditions:

• Persistent complement component deficiencies (C3, C5-9, properdin, factors D or H). 4, 1
• Patients taking complement inhibitors (such as eculizumab). 4
• Anatomical or functional asplenia. 1
• Microbiologists routinely exposed to Neisseria meningitidis. 1
• Those at increased risk due to a serogroup B meningococcal outbreak. 1

Common Pitfalls to Avoid

• Do not miss the MenACWY booster at age 16 - this is the most commonly missed adolescent vaccine and is critical for continued protection. 2
• Do not confuse MenACWY with MenB - these are different vaccines protecting against different serogroups of meningococcal disease. 4
• Remember that MenB products are not interchangeable - complete the series with the same product used for the first dose. 4
• Do not assume that because a patient received MenACWY at age 11-12, they are fully protected - the booster at age 16 is essential. 1