9 questions and answers about the MenB vaccine

Bacterial meningitis or meningococcal disease can be caused by a number of different bacteria, which are categorized into different groups, called serogroups. While they are not the only bacteria that can cause bacterial meningitis, serogroups A, B, C, W, X, and Y cause nearly all of cases of meningococcal disease worldwide. In the United States, most cases of meningococcal disease are caused by serogroups B, C, and Y.

There are vaccines that protect against bacterial infections from the most common of these serogroups. As the name implies, the meningococcal ACWY (MenACWY) vaccine protects against infections from bacteria in the serogroups A, C, W, and Y.

There is also a meningococcal B (MenB) vaccine that protects against serogroup B bacteria.

Here, we will look at some common questions and answers about the MenB vaccine.

Why is MenB a separate vaccine?

The short answer is that the MenB vaccine took a much longer time to develop. The first vaccines for serogroups A, C, W, and Y have been around since the 1970s and 1980s, and the MenACWY vaccines currently in use were approved in 2005 and 2010. In contrast, the first FDA approval for a MenB vaccine occurred in 2014.

Is the MenB vaccine part of routine vaccinations?

While the MenACWY vaccine is part of routine vaccinations in the United States—meaning the vaccine is recommended for nearly every person—the MenB vaccine is recommended for people over the age of 10 who are at an increased risk of contracting meningococcal B.

Who is at increased risk of MenB?

According to the Centers for Disease Control and Prevention (CDC), people at an increased risk of contracting MenB include:

• Those exposed to MenB due to an outbreak—for example, students on a college campus where there has been an outbreak.
• People who have a damaged spleen or have had their spleen removed. This includes people with sickle cell anemia, a red blood cell disorder that can damage the spleen.
• People who have complement component deficiency, a rare genetic disorder that causes immunodeficiency.
• People who are taking a medication called a complement inhibitor, a drug that suppresses immune activity and is used to treat rare disorders.

Also, microbiologists who work closely with serogroup B bacteria should be vaccinated.

What if you are not at an increased risk—can you get the vaccine anyway?

Yes. People between the ages of 16 and 23 years who are at normal risk can get the MenB vaccine. The preferred age for vaccination is 16 to 18. Parents and teens should talk to their family’s healthcare provider about getting vaccinated, including the risks, benefits, and costs (because the MenB vaccine is not part of routine vaccinations, it may not be covered by insurance).

Are there different options for the MenB vaccine?

Yes. There are two MenB vaccines approved by the FDA. Both require an initial dose and at least one booster dose to provide the most protection. Because dosing schedules can vary depending on a patient’s age, risk, and the vaccine being used, it is important to have a clear understanding of the dosing schedule when talking to your family’s healthcare provider.

Why do some colleges require students to have a MenB vaccine?

There have been several outbreaks of MenB on college campuses in the past decade and infections can spread when people are living in close proximity to one another. As a precaution against potential outbreaks, some colleges recommend students get a MenB vaccination (and a few require it). Many colleges also mandate that students have the MenACWY vaccine.

Do the MenB vaccines contain live bacteria?

No. MenB vaccines do not contain live bacteria. Instead, the vaccines contain proteins found on the outer capsules of bacteria. While these proteins cannot cause an infection, they do trigger a response by the immune system, which begins making antibodies that protect against serogroup B bacteria.

How common is MenB?

MenB is very rare, with roughly 200 cases in the United States in a given year. Up to half of those cases are children younger than five years old. People between the ages of 11 and 23 also make up a significant percentage of cases. Meningococcal disease in general is very rare in the U.S., and rates have been steadily declining since the late 1990s.

How serious is MenB?

Regardless of serogroup, all types of meningococcal disease are very serious. Meningococcal disease causes inflammation in the meninges, the membranes that form a protective layer over the brain and spinal cord. Infection can also spread to the blood, where it can damage blood vessels and cause internal bleeding. Between 10 and 15 percent of cases are fatal (and that number is as high as 50 percent when infections are untreated). Initial symptoms can be mistaken for a cold or flu, but progression can be rapid—many people who die from meningococcal disease die within 24 to 48 hours. Roughly 20 percent of people who survive infection experience permanent disability, such as brain damage, nerve damage, kidney damage, or loss of limbs.