What meningococcal vaccine(s) are recommended for a healthy 16‑year‑old adolescent?

Meningococcal Vaccination for a Healthy 16-Year-Old

A healthy 16-year-old should receive a MenACWY (quadrivalent meningococcal conjugate) booster dose if their first dose was given before age 16, and may optionally receive a MenB vaccine series based on shared clinical decision-making. 1

MenACWY Booster at Age 16

The MenACWY booster at 16 years is critical because antibody levels decline significantly 3–5 years after the initial dose given at age 11–12 years. 1, 2

• If the adolescent received their first MenACWY dose at age 11–15 years, they must receive a booster at age 16 years (can be given anytime from 16–18 years). 1
• The minimum interval between the first dose and booster is 8 weeks, though longer intervals are preferred for optimal immune response. 1, 2
• If the first dose was given at or after age 16, no booster is needed unless the person develops a high-risk condition. 1
• Vaccine effectiveness data show protection drops from 79% in the first year to 69% at 1–3 years and 61% at 3–8 years after a single dose, justifying the booster recommendation. 2, 3

Available MenACWY Products (All Interchangeable)

• MenACWY-D (Menactra), MenACWY-CRM (Menveo), or MenACWY-TT (MenQuadfi) can be used interchangeably for the booster dose. 1, 4
• The same product is preferred but not required for all doses. 1

MenB Vaccination (Optional via Shared Clinical Decision-Making)

MenB vaccination is NOT routinely required but may be administered to adolescents aged 16–23 years (preferred age 16–18 years) based on shared clinical decision-making between the provider and patient/family. 1

Two MenB Products Available (NOT Interchangeable)

• MenB-FHbp (Trumenba): 2 doses at 0 and 6 months 1, 5
• MenB-4C (Bexsero): 2 doses at least 1 month apart 1
• Critical caveat: MenB vaccines are not interchangeable—the same product must be used for all doses in the series. 1

Factors for Shared Clinical Decision-Making

The decision to give MenB should weigh: 1

• Serious nature of meningococcal disease with high mortality and permanent sequelae
• Low incidence (average 34 serogroup B cases annually among 16–23 year-olds in the U.S.)
• Increased risk for college students, especially freshmen in residence halls or those in fraternities/sororities
• Short duration of protection (antibody waning within 1–2 years)
• No herd immunity (MenB vaccines do not reduce carriage)

Pentavalent Vaccine Option (Combines MenACWY + MenB)

If both MenACWY booster and MenB are indicated at the same visit, a pentavalent vaccine may be used instead of separate injections. 6, 7

• MenACWY-TT/MenB-FHbp (Penbraya) or MenACWY-CRM/MenB-4C (Penmenvy) can be given as a single injection. 6, 7
• If pentavalent vaccine is used, subsequent MenB doses must be from the same manufacturer (not interchangeable). 6, 7

Special Considerations for College-Bound Students

College freshmen living in residence halls should receive at least one MenACWY dose within 5 years before college entry, preferably on or after their 16th birthday. 1

• If only one dose was given before age 16, a booster should be administered before enrollment. 1
• Many colleges and universities have mandatory vaccination policies as a condition of enrollment. 1

Common Pitfalls to Avoid

• Do not assume a 16-year-old who received MenACWY at age 11–12 is fully protected—they need the booster. 1, 2
• Do not mix MenB vaccine products—if you start with one brand, complete the series with the same brand. 1
• Do not routinely recommend MenB boosters for healthy adolescents—boosters are only for those at increased risk. 1
• Do not confuse the routine MenACWY booster (required) with the optional MenB series (shared decision-making). 1