• Meningitis and bloodstream infections are the most common types of infections caused by the Neisseria (N.) meningitidis
• Symptoms of meningococcal disease can first appear as a flu-like illness and rapidly worsens.

Meningitis is the most common presentation of invasive disease. Symptoms may include:

• Sudden onset of fever
• Headache
• Stiff neck
• Nausea or vomiting
• Sensitivity to light
• Altered mental status (examples: confusion, sleepiness)

Meningococcal bloodstream infection has symptoms that may include:

• Fever
• Chills
• Fatigue
• Vomiting
• Severe aches and pains
• Rapid breathing
• A petechial (red/purple dots on skin) or dark purple rash

If you think you may have these symptoms, seek medical attention immediately.

The best way to have protection against meningococcal disease is to receive the meningococcal vaccines.

There are 3 types of meningococcal vaccines used in the United States:

• Meningococcal conjugate or MenACWY vaccines
• Serogroup B meningococcal or MenB vaccines
• Pentavalent or MenABCWY vaccine

For more information about meningococcal vaccines and situations when meningococcal vaccines are recommended for children and adults, visit this CDC webpage on meningococcal vaccination.

There are many places to get the meningococcal vaccine. If you have insurance, talk to your doctor or check with your local pharmacy to see what vaccines are offered. Most health insurances cover the cost of all recommended vaccines for children and adults.

If you are uninsured or underinsured, there are programs available to help cover the cost of vaccines. Children who are 18 years of age or younger are eligible to receive vaccines at no cost through the Vaccines for Children (VFC) Program if they are:

• Eligible for or are enrolled in Medi-Cal
• American Indian or Alaskan Native
• Uninsured (do not have health insurance)
• Underinsured (private health insurance does not cover the full cost of vaccines)

Click to see if your child is eligible to receive VFC vaccines: English | Spanish

Uninsured or underinsured adults can access free or low cost vaccines at select clinics enrolled in the Vaccines for Adults (VFA) program. For more information on who is eligible, read VFA Eligibility Based on Insurance Status. You can use the following resources for more information on locating clinics:

• A list of free and low-cost clinics in Los Angeles County.
• Interactive county map to locate free and low-cost vaccine clinics.
• LACDPH Vaccines website for patients and their families to get more information on vaccines.

You can also dial 2-1-1 for a list of free or low cost vaccine clinics. This includes Vaccines for Children (VFC) provider locations that serve Medi-Cal eligible children and uninsured or underinsured adults. Learn more about specific vaccine information for different age groups:

• Vaccines for Infants and Children (LACDPH)
• Vaccines for Adolescents and Teens (LACDPH)
• Vaccines for Adults (LACDPH)

• Vaccine (Shot) for Meningococcal Disease (CDC): English | Spanish
• Meningococcal Vaccines for Preteens and Teens (CDC): English | Spanish
• Vaccines for your Preteen (CDPH): English | Spanish | Chinese | Tagalog
• Protect Your Preteen/Teen with Vaccines (CDPH): English | Spanish | Chinese | Tagalog
• Infographic: CDC-recommended Vaccines for Adolescents (UNITY 4 Teen Vax): English | Spanish
• Protect and Connect with your Teen (UNITY 4 Teen Vax)
• Off to College? What You Should Know about Meningococcal Disease (CDPH)
• Vaccines by Age (CDC): English | Spanish
• Vaccines for Adolescents and Teens (LACDPH)
• Recommended Vaccinations for Children 7 to 18 Years Old (CDC): English | Spanish
• Child and Teen Vaccine Preventable Diseases E-book (Vaccinate Your Family)

Meningococcal disease usually presents as fever, headache, stiff neck, rash and myalgias. Patients can have meningitis or bacteremia. For more information, please see Invasive Meningococcal Disease

About 10 to 15 in 100 people with meningococcal disease will die. Up to 1 in 5 survivors will have long-term disabilities, such as:

• Loss of limb(s)
• Deafness
• Nervous system problems
• Brain damage

MenACWY Vaccine

Two quadrivalent meningococcal conjugate (MenACWY) vaccines are currently licensed and available in the United States: Menveo® or MenQuadfi®

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Routine MenACWY Vaccination of Adolescents

CDC recommends routine vaccination with a single dose of MenACWY (Menveo or MenQuadfi) for pre-teens aged 11 –12 years. Since protection wanes, a booster dose is recommended at 16 years of age. The booster dose provides protection during the ages when adolescents are at highest risk of meningococcal disease.

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MenACWY Vaccination of Young Children and Adults at Increased Risk

CDC recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease, including:

• Persons with certain medical conditions:
  • Persistent complement deficiencies
  • Functional or anatomical asplenia (including sickle cell disease)
  • HIV
• Persons taking specific medications:
  • Complement inhibitor (e.g., Soliris® or Ultomiris®)
• Persons working in specific professions or living in specific settings:
  • Microbiologists routinely exposed to isolates of Neisseria meningitidis
  • Military recruits
  • First-year college freshmen living in residence halls
• Persons at risk during an meningococcal outbreak (e.g., community or organizational settings, and among men who have sex with men [MSM]).
• All MSM, regardless of HIV status, should receive at least one dose of meningococcal conjugate vaccine.
• Consider a booster dose for MSM who received MenACWY vaccine ≥5 years ago.
• Persons traveling to or residents of countries where meningococcal disease is hyperendemic or epidemic.

Persons who remain at increased risk will need regular booster doses.

• Children age <7 years, should receive a booster dose 3 years after completion of the primary series and every 5 years thereafter.
• Children ≥ 7 years old and adults, should receive a booster dose 5 years after completion of the primary series and every 5 years thereafter.

See Meningococcal Vaccines- High-Risk Populations for more details.

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MenB Vaccine

CDC recommends vaccination of healthy adolescents or young adults aged 16-23 years (preferred age is 16-18 years) with a MenB series with shared clinical decision-making.  Administering MenB vaccine at the preferred age range maximizes the likelihood that vaccinated adolescents will have protection during the time when they are at highest risk.

Certain children (>10 years old)  and adults should receive this vaccine if they:

• Have certain medical conditions (complement deficiency, functional or anatomic asplenia)
• Are taking a complement inhibitor (Soliris® or Ultomiris®).
• Are part of a population identified to be at increased risk because of a serogroup B meningococcal disease outbreak.
• Work as microbiologist who is routine exposed to meningitidis

Persons who remain at increased risk need regular booster doses.

• Administer a booster dose of MenB vaccine 1 year after completion of the series and then every 2 – 3 years thereafter.
• Persons at increased risk due to an outbreak who previously received the MenB series, should receive a booster dose if a year or more has passed since the primary series.

Both MenB vaccine products require more than 1 dose for maximum protection and may require additional boosters if individuals remain at increased risk. Use the same brand of MenB vaccine for each dose in the series.

• Bexsero®(MenB-4C):2 doses. Administer the second dose at least 1 month after the first dose.

• Trumenba®(MenB-FHbp): 2 or 3 doses.
• A two – dose series is recommended for persons who are not at risk for meningococcal disease.
• A three – dose series is recommended for persons at increased risk, including during outbreaks of serogroup B disease.

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Pentavalent Meningococcal Vaccine (MenACWY – MenB)

CDC recommends pentavalent meningococcal vaccine (MenABCWY Penbraya™) as an option for patients aged 10 – 25 years receiving MenACWY and MenB vaccines (Trumenba) at the same visit. This includes:

• Healthy persons aged 16 – 23 years (routine schedule) when shared clinical decision-making favors MenB vaccine, and
• Persons aged ≥10 years who are at increased risk of meningococcal disease.

If a MenACWY-MenB is not available, administer MenACWY and MenB vaccines as two separate vaccinations.  If Penbraya is given, additional doses of Men B vaccine should be Trumenba (when MenACWY is not indicated) or Penbrava (when MenACWY is indicated).

• Example of suggested routine dosing if using MenACWY-MenB:
  • Dose 1 (11-12 years)= Menveo (MenACWY-CRM) or MenQuadfi (MenACWY-TT)
  • Dose 2 (16-18 years) = Penbraya (MenACWY/MenB)
  • Dose 3 (16-18 years, ≥6 months after dose 2) = Trumenba (MenB)

All meningococcal vaccines can be administered with other vaccines, including HPV and Tdap which are usually administered during the preteen and adolescent visits.

For routine meningococcal vaccine guidance, view the Meningococcal Vaccines for Adolescents and Young Adults: Routine Risk job-aid.  Guidance for high- risk populations can be found here.

• Store all meningococcal vaccines in the refrigerator at 2°C to 8°C (36°F to 46°F) in the original carton. Do not freeze. Discard if frozen.
• Check the package inserts for additional storage and handling instructions.
• Proper vaccine storage and handling practices play an important role. For general recommendations and guidance access the Vaccine Storage and Handling Toolkit.

Vaccine AE reporting

Report any adverse events to the Vaccine Adverse Event Reporting System at 1-800-822-7967 or online at https://vaers.hhs.gov/.

• CDC Health Alert Network (HAN) - Meningococcal Disease Cases Linked to Travel to the Kingdom of Saudi Arabia (KSA): Ensure Pilgrims are Current on Meningococcal Vaccination
• CDC Health Alert Network (HAN) - Increase in Invasive Serogroup Y Meningococcal Disease in the United States
• Meningococcal Disease – Clinical Information (CDC)
• Meningococcal ACIP Vaccine Recommendations (CDC)
• ACIP/CDC Meningococcal B Recommendations (CDC)
• Meningococcal Vaccination: Information for Healthcare Professionals (CDC)
• Meningococcal Vaccines for Adolescents & Young Adults (CDPH)
• Meningococcal Vaccines High – Risk Populations (CDPH)
• MenACWY – Give 2 Doses Campaign (Immunize.org)
• VIS: Meningococcal ACWY Vaccine (8/06/2021) (CDC)
• VIS: Meningococcal B Vaccine (CDC)
• MenB Vaccine Shared Clinical Decision-Making (CDC)
• Package Insert - PENBRAYA™ (Meningococcal Groups A, B, C, W, and Y) (FDA)
• Package Insert - MENVEO® (Meningococcal Groups A, C, Y and W-135) (FDA)
• Package Insert - MENQUADFI® (Meningococcal Groups A, C, Y, W) (FDA)
• Package Insert - BEXSERO® (Meningococcal Group B Vaccine) (FDA)
• Package Insert - TRUMENBA® (Meningococcal Group B Vaccine) (FDA)
• Menveo New Ready – to – Use Single Vial Presentation (CDC)