Shared Clinical Decision-Making

Adolescents not at increased risk age 16-23 years (preferred age 16-18 years) based on shared clinical decision-making:

• Bexsero: 2-dose series at least 1 month apart.
• Trumenba: 2-dose series at least 6 months apart; if dose 2 is administered earlier than 6 months, administer a 3rd dose at least 4 months after dose 2.

Special Situations

Anatomic or functional asplenia (including sickle cell disease), persistent complement component deficiency, complement inhibitor (e.g., eculizumab, ravulizumab) use, and microbiologists routinely exposed to Neisseria meningitidis:

• Bexsero: 2-dose series at least 1 month apart.
• Trumenba: 3-dose series at 0, 1-2, 6 months (if dose 2 was administered at least 6 months after dose 1, dose 3 not needed; if dose 3 is administered earlier than 4 months after dose 2, a 4th dose should be administered at least 4 months after dose 3).

MenB-4C and MenB-FHbp are not interchangeable  (use same product  for  all  doses  in  series);  1  dose  MenB booster 1 year after primary series and revaccinate every 2-3 years if risk remains.

Pregnancy: Delay MenB until after pregnancy unless at increased  risk  and  vaccination  benefits  outweigh potential risk.