National and regional differences in meningococcal vaccine recommendations for individuals at an increased risk of meningococcal disease

Figures & data

Table 1. Available Meningococcal Conjugate and Protein-Based Vaccines.

Quadrivalent Serogroup A, C, W, and Y Vaccine (Brand)	Serogroup(s) Targeted	Carrier Protein	Manufacturer
MenACWY-DT (Menactra®) [8]	A, C, W, Y	DT	Sanofi Pasteur
MenACWY-CRM (Menveo®) [9]	A, C, W, Y	CRM	GSK
MenACWY-TT (Nimenrix®) [10]	A, C, W, Y	TT	Pfizer
MenACYW-TT (MenQuadfi®) [11]	A, C, W, Y	TT	Sanofi Pasteur
Monovalent Serogroup A or C Vaccine (Brand)	Serogroup Targeted	Carrier Protein	Manufacturer
PsA-TT (MenAfriVac) [12]	A	TT	Serum Institute of India
MenC-CRM (Menjugate®) [13]	C	CRM	GSK
MenC-TT (NeisVac-C®) [14]	C	TT	Pfizer
MenC-TT/Hib-TT (Menitorix®) [15]	C	TT	GSK
Serogroup B Vaccine (Brand)	Recombinant Protein Targets	Other Major Antigenic Components	Manufacturer
MenB-FHbp (Trumenba®) [16]	FHbp subfamily A and B	–	Pfizer
MenB-4C (Bexsero®) [17]	NadA, NHBA, FHbp subfamily B	PorA (present in OMV)	GSK

Note: CRM, cross-reacting material 197 protein; DT, diphtheria toxoid; FHbp, factor H binding protein; HiB, Haemophilus influenzae type b; NadA, neisserial adhesin A; NHBA, neisserial heparin-binding antigen; OMV, outer membrane vesicle; PorA, outer membrane porin protein (serosubtype P1.4); TT, tetanus toxoid.

Table 2. Current Meningococcal Vaccine Recommendations for At-Risk and Increased-Risk Groups in Different Countries*.

	Underlying Medical Conditions^†	College/University Students	Indigenous People	Laboratory Workers	Military Personnel	Travelers to Areas With Hyperendemic Meningococcal Disease
Australia [40,41]	MenACWY, MenB	MenACWY, MenB	MenB	MenACWY, MenB	MenACWY, MenB	MenACWY
Brazil [42]	MenC, MenACWY			MenC, MenACWY
France [43,44]	MenACWY, MenB, MenC			MenACWY, MenB		MenACWY
Germany [45,46]	MenACWY, MenB	MenACWY, MenB^‡		MenACWY, MenB	MenACWY	MenACWY
Ireland [47–49]	MenACWY, MenB	MenACWY		MenACWY, MenB		MenACWY
Israel [50]	MenACWY, MenB			MenACWY, MenB	MenACWY	MenACWY
Italy^§ [51,52]	MenACWY, MenB
Netherlands [53]	MenACWY					MenACWY
New Zealand [54,55]	MenACWY or MenC^¶, MenB	MenACWY, MenB		MenACWY, MenB	MenACWY, MenB	MenACWY, MenB
Portugal [56]	MenACWY, MenB
Spain [46,57]	MenACWY, MenB				MenACWY	MenACWY
Turkey [58–61]	MenACWY			MenACWY	MenACWY	MenACWY
United Kingdom [46,62–67]	MenACWY, MenB	MenACWY		MenACWY	MenACWY, MenB**	MenACWY
United States[1,68–70]	MenACWY, MenB	MenACWY, MenB^††		MenACWY, MenB	MenACWY, MenB^††	MenACWY

Note: MenACWY, quadrivalent meningococcal vaccine for serogroups A, C, W, and Y; MenB, meningococcal serogroup B vaccine; MenC, meningococcal serogroup C vaccine.

*Vaccine recommendations included here are those in addition to age-based recommendations.

^†Underlying medical conditions include, but are not limited to, cellular immune deficiencies, combined immune deficiencies, complement deficiencies, those for patients who underwent transplantation, those for patients with cancer, hereditary immune deficiencies, and HIV. Recommendations may not apply to all medical conditions; the original source should be referred to for information on specific conditions.

^‡Vaccination of students is recommended only before long-term stays in countries with recommended general vaccination for adolescents or selective vaccination for pupils/students. The type of vaccination given is according to the recommendations of the destination countries.

^§Note that the indicated vaccines are for individuals who are asplenic or hyposplenic; the specific meningococcal vaccine that is recommended in individuals with other underlying medical conditions is not specified.

^¶In high-risk infants aged <9 months, a specific MenACWY vaccine is recommended (but not funded) instead of MenC vaccine.

**Vaccination requirements depend on the military organization, role, and previous vaccination history.

^††Whilst not a recommended vaccine, MenB is available to adolescents and young adults 16–23 years old based on shared clinical decision-making; the individual is not required to be at increased risk of meningococcal disease.

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