Abstract
Meningococcal disease is a serious bacterial infection caused by Neisseria meningitidis. Serogroups B, C, W, and Y cause the majority of cases of this disease in the United States. These serogroups are targeted by different meningococcal vaccines available in the United States. 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]) are licensed for use in the United States and recommended by CDC's Advisory Committee on Immunization Practices (ACIP). Indications for MenACWY and MenB vaccination have not changed since indications for their use were published in 2020. A pentavalent (serogroups A, B, C, W, and Y) meningococcal vaccine (MenABCWY) (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer]) has been licensed and recommended for use since October 2023. On February 14, 2025, the Food and Drug Administration licensed a second pentavalent MenABCWY vaccine (MenACWY-CRM/MenB-4C [Penmenvy, GSK]) for prevention of invasive disease caused by N. meningitidis serogroups A, B, C, W, and Y in persons aged 10-25 years, the same indication for which MenACWY-TT/MenB-FHbp is licensed. On April 16, 2025, ACIP recommended that MenACWY-CRM/MenB-4C may be used when both MenACWY and MenB are indicated at the same visit for 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-targeting vaccines are not interchangeable; therefore, when MenACWY-CRM/MenB-4C is used, MenB-4C should be used for the other MenB doses. This report summarizes evidence considered for these recommendations and provides clinical guidance for the use of MenACWY-CRM/MenB-4C.