MenB: Why Vaccinate?

A recent survey found that family practitioners and pediatricians are not discussing the meningitis B (MenB) vaccine with their patients, despite current guidelines recommending MenB vaccination among individuals aged 16 to 23 years.

To clear the air around MenB vaccination, we spoke with Sarah Mbaeyi, MD, MPH, who is a Medical Epidemiologist in the Division of Bacterial Diseases at the Centers for Disease Control and Prevention (CDC). She specifically works on surveillance, epidemiology, and vaccine policy related to meningococcal disease.

Infectious Diseases Consultant: What is meningitis B, and why is it important that persons aged 10 to 25 years are vaccinated against it?

Sarah Mbaeyi: Meningococcal disease can refer to any illness, including meningitis, caused by Neisseria meningitidis bacteria. If serogroup B bacteria cause someone’s illness, then it is called serogroup B meningococcal disease. Three serogroups—B, C, and Y—cause most of the meningococcal disease reported in the United States. All can cause severe illness and be deadly.

Two different meningococcal vaccines are available to protect against meningococcal disease. One protects against serogroup B (called serogroup B meningococcal or MenB vaccine). The other protects against serogroups A, C, W, and Y (meningococcal conjugate or MenACWY vaccine).

CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that all adolescents get a MenACWY vaccine at age 11 or 12 years and again at 16 years. Individuals aged 2 months or older who have certain medical conditions or who are part of a population identified to be at increased risk because of an outbreak should also get a MenACWY vaccine.

ACIP also recommends that individuals aged 10 years or older who have certain medical conditions or who are part of a population identified to be at increased risk because of an outbreak get a MenB vaccine. Any teen or young adult (age 16 years through 23 years) may also get a MenB vaccine, preferably at 16 years through 18 years. Giving the vaccine series later in adolescence maximizes the likelihood that vaccinated adolescents will have protection during the years when they are at highest risk of meningococcal disease.

NEXT: How can ID specialists better serve their patients?

ID CON: Recently, a study was published that concluded that most doctors aren’t discussing the MenB vaccine with their patients. What do physicians and infectious disease specialists need to know about the vaccine to better educate their patients?

SM: Clinicians can help patients (and their parents/guardians) understand the risks and benefits of vaccination. When clinicians talk to patients about MenB vaccines, they can discuss how serious the disease is, how uncommon it is in the United States, the safety and potential side effects of the vaccine, and how long protection might last. Clinicians can find more about these points at https://www.cdc.gov/vaccines/vpd/mening/hcp/adolescent-vaccine.html. Together, clinicians and patients can decide whether or not to vaccinate with MenB vaccines.

ID CON: Where do you think is the confusion? Can you help clear it up for our readers?

SM: ACIP recommends individual clinical decision making for MenB vaccine in adolescents. Clinicians may choose to administer MenB vaccine to patients aged 16 years through 23 years, preferably at age 16 years through 18 years.

This is different from CDC’s recommendation for MenACWY vaccine, which specifically states that clinicians should administer that vaccine to adolescents at age 11 or 12 years and again at age 16 years. Since the MenB vaccine recommendation is not a routine recommendation for all adolescents, many clinicians may be choosing not to recommend the vaccine to those aged 16 years through 23 years who are not at increased risk for serogroup B meningococcal disease. In that case, those clinicians may not be educating their patients about the vaccine.

ID CON: What are the adverse effects (AEs) associated with the MenB vaccine? Do you think the AEs are a deciding factor for patients/guardians?

SM: Available data suggest that MenB vaccines are safe. Side effects like pain at the injection site, fever, and headache are common but resolve on their own within 3 to 7 days after vaccination. There have been no unusual patterns of serious reactions associated with MenB vaccines.

ID CON: What is the next step in developing a more effective vaccine—with fewer AEs?

SM: Future meningococcal vaccines may combine protection against 5 serogroups—A, B, C, W, and Y. The goal would be for these vaccines to be at least as safe and effective as currently available meningococcal vaccines. In the meantime, CDC will continue to monitor the safety, effectiveness, and duration of protection as a step to help inform future vaccine development.

For more information about meningococcal vaccination, visit the CDC’s website at https://www.cdc.gov/vaccines/vpd/mening/index.html.