Meningococcal Vaccination Guidance for Adults Over 55
For adults aged 55 and older, meningococcal vaccination is not a routine recommendation but is advised for those with certain health conditions or exposures that increase their risk. The Advisory Committee on Immunization Practices (ACIP) provides guidance to the CDC, and has specific recommendations for this population. Factors that can increase an older adult's risk of contracting meningococcal disease include:
- Certain medical conditions: Functional or anatomic asplenia and persistent complement component deficiencies.
- Immunocompromised status: Conditions like HIV infection.
- Specific medications: Taking complement inhibitor medications.
- Travel and outbreaks: Traveling to or living in areas with endemic disease or during outbreaks.
- Occupational exposure: Microbiologists with routine exposure to Neisseria meningitidis.
Types of Meningitis Vaccines for Older Adults
Historically, the Meningococcal Polysaccharide Vaccine (MPSV4) was licensed for individuals over 55. However, newer vaccines, particularly MenACWY conjugate vaccines, are now often used.
- MenACWY Vaccines: These protect against serogroups A, C, W, and Y. ACIP recommends MenACWY for at-risk people over 55 who have a history of MenACWY vaccination and need a booster, or who are in a high-risk group needing one dose. Brands include MenQuadfi.
- MenB Vaccines: Not routinely recommended for older adults but indicated for those aged 10 and older with certain high-risk conditions or during a serogroup B outbreak. Brands include Bexsero and Trumenba.
- Combination Vaccines: Pentavalent vaccines like Penbraya, protecting against A, B, C, W, and Y, are approved for ages 10 to 25.
Comparing Meningococcal Vaccines for Older Adults
| Vaccine Type | Protected Serogroups | Recommended For Adults Over 55? | Key Differences | Duration of Protection |
|---|---|---|---|---|
| MPSV4 (Menomune) | A, C, W, Y | Yes, historically. Distribution discontinued in the US as of 2017. | Polysaccharide vaccine with shorter immunity and no herd immunity effect. | Short (<3 years in some cases). |
| MenACWY (MenQuadfi, Menveo) | A, C, W, Y | Yes, for individuals at increased risk. | Conjugate vaccine with more robust, longer-lasting immunity and herd immunity. | Boosters recommended every 5 years for continued risk. |
| MenB (Bexsero, Trumenba) | B | Yes, for individuals at high risk for serogroup B disease or during an outbreak. | Recombinant protein vaccine; protects against serogroup B only. | Boosters recommended for persistent risk. |
Considerations for Vaccination
Choosing the right vaccine involves a careful discussion with a healthcare provider, considering the individual's health profile and risk exposure. For older adults, the priority is typically on protecting against the serogroups they are most likely to encounter based on their underlying conditions or environment. For those with certain chronic conditions, a combination of MenACWY and MenB vaccines might be necessary. If an older adult received MPSV4, revaccination with MenACWY may be advised depending on current risk factors and time since the last dose. Conjugate vaccines offer more durable protection.
Important Note: It is vital to consult with a doctor to review individual risk factors, past vaccination history, and current CDC and ACIP recommendations to determine the most appropriate meningococcal vaccination plan. An authoritative resource for vaccination information is the Immunize.org website.
Conclusion
The meningococcal vaccine strategy for adults aged 55 and older is not universal but is recommended for those with specific health conditions, occupational exposures, or travel plans that increase their risk. While the older MPSV4 vaccine is no longer used, modern MenACWY conjugate vaccines are available for at-risk seniors. A personalized medical consultation is essential to determine the best course of action based on the latest guidelines and individual risk assessment.
