TABLE 4. Recommended vaccination schedule and intervals for persons with persistent complement deficiencies* (including patients using a complement inhibitor)† — Advisory Committee on Immunization Practices, United States, 2020.
| Age group | Serogroups A, C, W, and Y meningococcal conjugate vaccines MenACWY-D (Menactra, Sanofi Pasteur)§ or MenACWY-CRM (Menveo, GlaxoSmithKline)¶ or MenACWY-TT (MenQuadfi, Sanofi Pasteur)** | Serogroup B meningococcal vaccines MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero, GlaxoSmithKline) |
|---|---|---|
| 2–23 mos |
Primary vaccination: MenACWY-D (aged ≥9 mos): 2 doses ≥12 wks apart
or MenACWY-CRM if first dose at age
• 2 mos: 4 doses at 2, 4, 6, and 12 mos
• 3–6 mos: See catch-up schedule§§
• 7–23 mos: 2 doses (second dose ≥12 wks after the first dose and after the 1st birthday) |
No recommendations for use of MenB vaccines in this population†† |
| 2–9 yrs |
Primary vaccination¶¶: MenACWY-D***
or MenACWY-CRM
or MenACWY-TT: 2 doses ≥8 wks apart
Boosters (if person remains at increased risk)†††:
• Aged <7 yrs: Single dose at 3 yrs after primary vaccination and every 5 yrs thereafter
• Aged ≥7 yrs: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter |
No recommendations for use of MenB vaccines in this population†† |
| ≥10 yrs | Primary vaccination††: MenACWY-D or MenACWY-CRM or MenACWY-TT: 2 doses ≥8 wks apart Boosters (if person remains at increased risk)†††: Single dose at 5 yrs after primary vaccination and every 5 yrs thereafter | Primary vaccination††: MenB-FHbp: 3 doses at 0, 1–2, and 6 mos or MenB-4C: 2 doses ≥1 mo apart Boosters (if person remains at increased risk)§§§: Single dose at 1 yr after completion of primary vaccination and every 2–3 yrs thereafter Note: MenB-FHbp and MenB-4C are not interchangeable |
Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; MenACWY-CRM = meningococcal groups A, C, W, and Y oligosaccharide diphtheria CRM197 conjugate vaccine; MenACWY-D = meningococcal groups A, C, W, and Y polysaccharide diphtheria toxoid conjugate vaccine; MenACWY-TT = meningococcal groups A, C, W, and Y polysaccharide tetanus toxoid conjugate vaccine; MenB-4C = four-component meningococcal group B vaccine; MenB-FHbp = meningococcal group B factor H binding protein vaccine.
* Persistent complement deficiencies include C3, C5–C9, properdin, factor H, or factor D.
† Includes eculizumab (Soliris) and ravulizumab (Ultomiris). Meningococcal vaccines should be administered at least 2 weeks before the first dose of complement inhibitor, unless the risk for delaying complement therapy outweighs the risk for developing meningococcal disease.
§ Licensed in the United States only for persons aged 9 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
¶ Licensed in the United States only for persons aged 2 months–55 years. Vaccination of persons aged ≥56 years is considered off-label.
** Licensed in the United States only for persons aged ≥2 years.
†† Licensed in the United States only for persons aged 10–25 years. Vaccination of persons aged ≥26 years is considered off-label.
§§ If MenACWY-CRM is initiated at ages 3–6 months, catch-up vaccination includes doses at intervals of 8 weeks until the infant is aged ≥7 months, at which time an additional dose is administered at age ≥7 months, followed by a dose at least 12 weeks later and after the 1st birthday.
¶¶ Primary vaccination licensed as a single dose in persons aged 2–55 years for MenACWY-D and MenACWY-CRM or ≥2 years for MenACWY-TT. Two-dose primary series is considered off-label.
*** MenACWY-D should be given either before or at the same time as DTaP to avoid interference with the immune response to meningococcal vaccine in children.
††† Licensed in the United States only for a single booster dose for persons aged 15–55 years for MenACWY-D and MenACWY-CRM or aged ≥15 years for MenACWY-TT. Booster doses administered outside of these ages or administration of >1 booster dose are considered off-label.
§§§ Licensed in the United States only for a primary series. Administration of booster doses is considered off-label.