Use of the Pfizer Pentavalent Meningococcal Vaccine Among Persons Aged ≥10 Years: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023

Abstract

Meningococcal disease is a life-threatening invasive infection caused by Neisseria meningitidis. Two quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccines (MenACWY) (MenACWY-CRM [Menveo, GSK] and MenACWY-TT [MenQuadfi, Sanofi Pasteur]) and two serogroup B meningococcal vaccines (MenB) (MenB-4C [Bexsero, GSK] and MenB-FHbp [Trumenba, Pfizer Inc.]), are licensed and available in the United States and have been recommended by CDC's Advisory Committee on Immunization Practices (ACIP). On October 20, 2023, the Food and Drug Administration approved the use of a pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer Inc.]) for prevention of invasive disease caused by N. meningitidis serogroups A, B, C, W, and Y among persons aged 10-25 years. On October 25, 2023, ACIP recommended that MenACWY-TT/MenB-FHbp may be used when both MenACWY and MenB are indicated at the same visit for the following groups: 1) healthy persons aged 16-23 years (routine schedule) when shared clinical decision-making favors administration of MenB vaccine, and 2) persons aged ≥10 years who are at increased risk for meningococcal disease (e.g., because of persistent complement deficiencies, complement inhibitor use, or functional or anatomic asplenia). Different manufacturers' serogroup B-containing vaccines are not interchangeable; therefore, when MenACWY-TT/MenB-FHbp is used, subsequent doses of MenB should be from the same manufacturer (Pfizer Inc.). This report summarizes evidence considered for these recommendations and provides clinical guidance for the use of MenACWY-TT/MenB-FHbp.

FIGURE

Recommended meningococcal vaccines for persons at increased risk for meningococcal disease due to serogroups A, B, C, W, or Y and who are due for both meningococcal A, C, W, and Y vaccine and meningococcal B vaccine^,,, — United States, 2023 Abbreviations: MenACWY = quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccine; MenACWY-TT/MenB-FHbp = Penbraya (Pfizer Inc.) pentavalent (serogroups A, B, C, W, and Y) meningococcal vaccine; MenB-FHbp = Trumenba (Pfizer Inc.) serogroup B meningococcal vaccine; MenB-4C = Bexsero (GSK) serogroup B meningococcal vaccine. * MenACWY products are interchangeable; the same vaccine product is recommended, but not required, for all doses. ^† Different manufacturers’ MenB vaccines are not interchangeable. ^§ To determine whether MenACWY and MenB are indicated based on a person’s risk factors and timing of any previous meningococcal vaccines, clinicians should see previously published recommendations. https://pubmed.ncbi.nlm.nih.gov/33417592/ ^¶ If MenB was received previously but the vaccine manufacturer is not known, the series must be restarted with any licensed product to ensure completion of the series using products from a single manufacturer. For additional guidance, clinicians should see previously published recommendations. https://pubmed.ncbi.nlm.nih.gov/33417592/ ** If MenB-FHbp was received previously, MenACWY-TT/MenB-FHbp may be used provided the person has not received MenACWY-TT/MenB-FHbp previously or ≥6 months have passed since the previous dose of MenACWY-TT/MenB-FHbp.