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Meningococcal vaccination recommendations for children age 2 through 23 months who are at increased risk of meningococcal disease in the United States^[1,2]

Targeted group by risk factor and current age	Primary dose(s) of MenACWY	Future booster dose(s) of MenACWY if increased risk persists
*Children with anatomic or functional asplenia (including sickle cell disease) or HIV infection**
Age 2 through 6 months	Initiate series with MenACWY-CRM as soon as possible: 3 doses, ≥8 weeks apart 4^th dose at age 12 months	Primary series completed at age <7 years: 3 years after completion of primary series and every 5 years thereafter Primary series completed at age ≥7 years: every 5 years
Age 7 through 23 months	2 doses of MenACWY-CRM^¶, ≥12 weeks apart
Children with complement component deficiency* (eg, C3, C5-C9, properdin, factor H, factor D) or using complement inhibitors (eg, eculizumab, ravulizumab)*
Age 2 through 6 months	Initiate series with MenACWY-CRM as soon as possible: 3 doses, ≥8 weeks apart 4^th dose at age 12 months	Primary series completed at age <7 years: 3 years after completion of primary series and every 5 years thereafter Primary series complete at age ≥7 years: every 5 years
Age 7 through 23 months	2 doses of MenACWY-CRM^¶, ≥12 weeks apart
Children who travel to or are residents of countries where meningococcal disease is hyperendemic or epidemic^Δ
Age 2 through 6 months	Initiate series with MenACWY-CRM as soon as possible: 3 doses, ≥8 weeks apart 4^th dose at age 12 months	Not applicable
Age 7 through 23 months	2 doses of MenACWY-CRM^¶, 12 weeks apart^◊	Not applicable

This table is meant for use with UpToDate content on meningococcal vaccination. Refer to UpToDate content for additional details, including information about immunizations during meningococcal outbreaks. For children ≥9 months of age, if available, the same MenACWY product should be used for all doses of the primary series. Some of the recommendations are considered off-label (eg, administration of a 2-dose primary series, repeated booster doses).

MenACWY: meningococcal groups A, C, W, and Y conjugate vaccine; MenACWY-CRM (Menveo); CDC: United States Centers for Disease Control and Prevention.

* Children with these conditions should also receive serogroup B meningococcal vaccine at age ≥10 years.

¶ For children age 7 through 23 months, the second dose of MenACWY-CRM should be given at age ≥12 months.

Δ Vaccination is recommended for international travelers visiting the parts of sub-Saharan Africa known as the meningitis belt during the dry season (December to June). The CDC issues advisories for other countries during epidemics of vaccine-preventable serogroups. Additional traveler's health information is available from the CDC.

◊ The interval may be shortened to ≥2 months if the travel is scheduled in <3 months.

References:

Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020; 69:1.
Immunization Action Coalition. Meningococcal ACWY vaccine recommendations by age and risk factor. https://www.immunize.org/catg.d/p2018.pdf (Accessed on October 26, 2020).

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Meningococcal vaccination recommendations for children age 2 through 23 months who are at increased risk of meningococcal disease in the United States[1,2]

Meningococcal vaccination recommendations for children age 2 through 23 months who are at increased risk of meningococcal disease in the United States^[1,2]