Meningococci are a type of bacteria that cause serious infections. The most common infection is meningitis, which is an inflammation of the thin tissue that surrounds the brain and spinal cord. Meningococci can also cause other problems, including a serious bloodstream infection called sepsis.

Meningococcal infections can spread from person to person. Risk factors include

• Age - it is more common in infants, teens, and young adults
• Living in close quarters, such as in college dorms or military settings
• Certain medical conditions, such as not having a spleen
• Travel to areas where meningococcal disease is common

In its early stages, you may have flu-like symptoms and a stiff neck. But the disease can progress quickly and can be fatal. Early diagnosis and treatment are extremely important. Lab tests on your blood and cerebrospinal fluid can tell if you have it. Treatment is with antibiotics. Since the infection spreads from person to person, family members may also need to be treated.

A vaccine can prevent meningococcal infections.

Certain people are at increased risk for meningococcal disease. Some risk factors include:

• Age. Doctors more commonly diagnose meningococcal disease in infants, teens, and young adults.
• Group settings. The risk for meningococcal disease in college students is slightly higher than the risk in other teens and young adults who are not attending college.
• Certain medical conditions. Certain medical conditions and medications put people at increased risk of meningococcal disease.
• Travel. Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal disease.

Anyone can get meningococcal disease, but rates of disease are highest in children younger than 1 year old, with a second peak in adolescence. Among teens and young adults, those 16 through 23 years old have the highest rates of meningococcal disease.

Infants

CDC recommends a meningococcal conjugate (MenACWY) vaccine for children as young as 2 months old if they

• Have certain medical conditions
• Are traveling to specific countries
• Are at risk because of an outbreak in their community

Teens and Young Adults

CDC recommends MenACWY vaccination for all 11 through 18 year olds. Preteens 11 to 12 years old should visit their clinicians to receive one dose and other preventive services. Since protection decreases over time, CDC recommends a booster dose at age 16. This allows teens to continue having protection during the ages when they are at highest risk.

Teens and young adults (16 through 23 year olds) may also be vaccinated with a serogroup B meningococcal (MenB) vaccine, preferably at 16 through 18 years old. Healthy teens and young adults who choose to get vaccinated need two doses of the same vaccine brand.

Recent data show that the risk for meningococcal disease in college students is slightly higher than the risk in other teens and young adults who are not attending college. College campuses have reported outbreaks of serogroup B meningococcal disease in recent years.

Many states require colleges to provide information on risks of meningococcal disease to incoming students or students residing on campus. Some states, colleges, and universities require meningococcal vaccination for certain students, unless the students provide a vaccination waiver. These requirements can include meningococcal conjugate (MenACWY) vaccines, serogroup B meningococcal (MenB) vaccines, or both.

CDC recommends MenACWY vaccination for first-year college students living in residence halls. If they received the vaccine before their 16th birthday, they need a booster shot for maximum protection before going to college.

CDC recommends MenB vaccination for people at increased risk during serogroup B meningococcal disease outbreaks. MenACWY vaccines do not include protection against serogroup B meningococcal disease. In an outbreak setting, CDC recommends a MenB booster shot for college students who previously received the vaccine series. Talk with your doctor about what is best for your specific situation.

Certain medical conditions and medications may weaken the immune system and increase risk of meningococcal disease. CDC recommends meningococcal vaccination for people with these conditions. Vaccine recommendations vary by age, vaccine type, and condition.

Persistent Complement Component Deficiencies

CDC recommends people with a persistent complement component deficiency receive two meningococcal vaccines, including booster shots throughout life:

• Meningococcal conjugate (MenACWY) vaccine
• Serogroup B meningococcal (MenB) vaccine

Complement component deficiencies refer to disorders of the ‘complement system,’ which helps the body fight off infections. Examples of complement component deficiencies include C3, C5-9, properdin, factor H, and factor D. These disorders are very rare and usually genetic.

Complement inhibitor medications

People who receive complement inhibitors such as eculizumab (Soliris®) and ravulizumab (Ultomiris™) are also at increased risk for meningococcal disease. Doctors most commonly prescribe complement inhibitors for four rare medical conditions:

• Atypical hemolytic uremic syndrome (aHUS), a blood disorder
• Paroxysmal nocturnal hemoglobinuria (PNH), a blood disorder
• Generalized myasthenia gravis (MG), a disorder that leads to muscle weakness
• Neuromyelitis optica spectrum disorder (NMOSD), a disorder of the brain and spinal cord

Functional or Anatomic Asplenia

CDC recommends people with functional or anatomic asplenia receive two meningococcal vaccines, including booster shots throughout life:

• MenACWY
• MenB

Someone with anatomic asplenia does not have a spleen (for instance, if it was surgically removed). Someone with functional asplenia has a spleen but it doesn’t work the way that it should. People with sickle cell anemia have functional asplenia. The spleen is an important organ for fighting meningococcal infections because it helps produce antibodies and filter bacteria.

HIV Infection

CDC recommends people living with HIV receive a meningococcal conjugate vaccine, including booster shots throughout life. These vaccines provide protection against meningococcal disease caused by serogroups A, C, W, and Y. For people living with HIV who get meningococcal disease, 4 in 5 cases (80%) are due to serogroups C, W, and Y. A low CD4 count or high viral load increases risk of meningococcal disease for people living with HIV.

CDC recommends meningococcal conjugate (MenACWY) vaccination for people traveling to or living in the meningitis belt in sub-Saharan Africa. CDC will issue advisories for travelers to other countries as needed. CDC does not routinely recommend serogroup B meningococcal vaccination before international travel.

The meningitis belt has much higher rates of meningococcal disease than the United States and outbreaks are common. The disease is most common in these countries during the dry season (December through June). Travelers who spend a lot of time with local populations, especially during outbreaks, have the highest risk of getting sick. Vaccinated travelers who continue to be at increased risk should receive booster shots.

Ask your doctor which meningococcal vaccines you or your child should get.

Saudi Arabia requires participants in the annual Hajj and Umrah pilgrimage show proof of MenACWY vaccination. No other countries require meningococcal vaccination prior to travel.

Bacteria called Neisseria meningitidis cause meningococcal disease. About 1 in 10 people have these bacteria in the back of their nose and throat without being ill. This is called being ‘a carrier.’ Sometimes the bacteria invade the body and cause certain illnesses, which are known as meningococcal disease.

Six serogroups (types) of Neisseria meningitidis — A, B, C, W, X, and Y —cause most disease worldwide. Three of these serogroups (B, C, and Y) cause most of the illness seen in the United States.

People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (for example, coughing or kissing) or lengthy contact to spread these bacteria. Fortunately, they are not as contagious as germs that cause the common cold or the flu. People do not catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been.

Sometimes the bacteria spread to people who have had close or lengthy contact with a patient with meningococcal disease. Those at increased risk of getting sick include:

• People in the same household
• Roommates
• Anyone with direct contact with the patient’s oral secretions, such as a boyfriend or girlfriend

Close contacts of someone with meningococcal disease should receive antibiotics to help prevent them from getting the disease. Experts call this prophylaxis (pro-fuh-lak-sis). This does not mean that the contacts have the disease; it is to prevent it. Health departments investigate each case of meningococcal disease to identify all close contacts and make sure they receive prophylaxis. People who are not a close contact of a patient with meningococcal disease do not need prophylaxis.

Seek medical attention immediately if you or your child develops symptoms of meningococcal disease. Symptoms of meningococcal disease can first appear as a flu-like illness and rapidly worsen.

The two most common types of meningococcal infections are meningitis and septicemia. Both of these types of infections are very serious and can be deadly in a matter of hours.

Doctors call meningitis caused by the bacteria Neisseria meningitidis meningococcal meningitis. When someone has meningococcal meningitis, the bacteria infect the lining of the brain and spinal cord and cause swelling.

The most common symptoms include:

• Fever
• Headache
• Stiff neck

There are often additional symptoms, such as

• Nausea
• Vomiting
• Photophobia (eyes being more sensitive to light)
• Altered mental status (confusion)

Newborns and babies may not have or it may be difficult to notice the classic symptoms listed above. Instead, babies may be slow or inactive, irritable, vomiting, feeding poorly, or have a bulging in the soft spot of the skull (anterior fontanelle). In young children, doctors may also look at the child’s reflexes for signs of meningitis.

If you or your child has any of these symptoms, call the doctor right away.

Doctors call septicemia (a bloodstream infection) caused by Neisseria meningitidis meningococcal septicemia or meningococcemia. When someone has meningococcal septicemia, the bacteria enter the bloodstream and multiply, damaging the walls of the blood vessels. This causes bleeding into the skin and organs.

Symptoms may include:

• Fever and chills
• Fatigue (feeling tired)
• Vomiting
• Cold hands and feet
• Severe aches or pain in the muscles, joints, chest, or abdomen (belly)
• Rapid breathing
• Diarrhea
• In the later stages, a dark purple rash

If you or your child has any of these symptoms, call the doctor right away.

Meningococcal disease can be difficult to diagnose because the signs and symptoms are often similar to those of other illnesses. If a doctor suspects meningococcal disease, they will collect samples of blood or cerebrospinal fluid (fluid near the spinal cord). Doctors then send the samples to a laboratory for testing. If Neisseria meningitidis bacteria are in the samples, laboratorians can grow (culture) the bacteria. Growing the bacteria in the laboratory allows doctors to know the specific type of bacteria that is causing the infection. Knowing this helps doctors decide which antibiotic will work best. Other tests can sometimes detect and identify the bacteria if the cultures do not.

Doctors treat meningococcal disease with a number of antibiotics. It is important that treatment start as soon as possible. If a doctor suspects meningococcal disease, they will give the patient antibiotics right away. Antibiotics help reduce the risk of dying.

Depending on how serious the infection is, people with meningococcal disease may need other treatments, including:

• Breathing support
• Medications to treat low blood pressure
• Surgery to remove dead tissue
• Wound care for parts of the body with damaged skin

Even with antibiotic treatment, 10 to 15 in 100 people infected with meningococcal disease will die. Up to 1 in 5 survivors will have long-term disabilities, such as loss of limb(s), deafness, nervous system problems, or brain damage.

Keeping up to date with recommended vaccines is the best defense against meningococcal disease. Maintaining healthy habits, like getting plenty of rest and not having close contact with people who are sick, also helps.

Vaccination

There are two types of meningococcal vaccines licensed in the United States:

• Meningococcal conjugate (MenACWY) vaccines
• Serogroup B meningococcal (MenB) vaccines

These vaccines help protect against all three serogroups (B, C, and Y) of Neisseria meningitidis bacteria most commonly seen in the United States. Like with any vaccine, meningococcal vaccines are not 100% effective. This means there is still a chance someone can develop meningococcal disease after vaccination. People should know the symptoms of meningococcal disease since early recognition and quick medical attention are extremely important.

Antibiotics

Close contacts of a person with meningococcal disease should receive antibiotics to prevent them from getting sick. Experts call this prophylaxis (pro-fuh-lak-sis). Examples of close contacts include:

• People in the same household
• Roommates
• Anyone with direct contact with a patient’s oral secretions (saliva or spit), such as a boyfriend or girlfriend

Doctors or local health departments recommend who should get prophylaxis.

Re-Infection

Although rare, people can get meningococcal disease more than once. A previous infection will not offer lifelong protection from future infections. Therefore, CDC recommends meningococcal vaccines for all preteens and teens. In certain situations, children and adults should also get meningococcal vaccines.

If you get meningococcal disease twice, your doctor should check to see if you have an underlying immune deficiency.

Key Facts

There are 2 types of meningococcal vaccines used in the United States:

• Meningococcal conjugate or MenACWY vaccines
• Serogroup B meningococcal or MenB vaccines

Who Should Get Meningococcal Vaccines?

CDC recommends vaccination with meningococcal conjugate vaccine for all preteens and teens. In certain situations, other children and adults could be recommended to get meningococcal vaccines. Below is more information about which meningococcal vaccines are recommended for people by age, as well as information on who should not get meningococcal vaccines.

Talk to your or your child’s healthcare professional about what is best for your specific situation.

Preteens and Teens

All 11 to 12 year olds should get a MenACWY vaccine, with a booster shot at 16 years old. Teens may also get a MenB vaccine, preferably at 16 through 18 years old.

While any teen may choose to get a MenB vaccine, certain preteens and teens should get it if they:

• Have a rare type of immune disorder called complement component deficiency
• Are taking a type of medicine called a complement inhibitor (for example, Soliris^® or Ultomiris^®)
• Have a damaged spleen or sickle cell disease, or their spleen has been removed
• Are part of a population identified to be at increased risk because of a serogroup B meningococcal disease outbreak

Talk to your child’s doctor to find out if, and when, they will need MenACWY or MenB booster shots.

Babies and Children

CDC recommends MenACWY vaccination for children who are between 2 months and 10 years old if they:

• Have a rare type of immune disorder called complement component deficiency
• Are taking a type of medicine called a complement inhibitor (for example, Soliris^® or Ultomiris^®)
• Have a damaged spleen or sickle cell disease, or their spleen has been removed
• Have HIV
• Are traveling to or residing in countries in which serogroup A, C, W, or Y meningococcal disease is common
• Are part of a population identified to be at increased risk because of a serogroup A, C, W, or Y meningococcal disease outbreak

CDC recommends MenB vaccination for children 10 years or older if they:

• Have a rare type of immune disorder called complement component deficiency
• Are taking a type of medicine called a complement inhibitor (for example, Soliris^® or Ultomiris^®)
• Have a damaged spleen or sickle cell disease, or their spleen has been removed
• Are part of a population identified to be at increased risk because of a serogroup B meningococcal disease outbreak

Talk to your child’s doctor to find out if, and when, they will need MenACWY or MenB booster shots.

Adults

CDC recommends MenACWY vaccination for adults if they:

• Have a rare type of immune disorder called complement component deficiency
• Are taking a type of medicine called a complement inhibitor (for example, Soliris^® or Ultomiris^®)
• Have a damaged spleen or sickle cell disease, or their spleen has been removed
• Have HIV
• Are a microbiologist who is routinely exposed to Neisseria meningitidis
• Are traveling to or residing in countries in which serogroup A, C, W, or Y meningococcal disease is common
• Are part of a population identified to be at increased risk because of a serogroup A, C, W, or Y meningococcal disease outbreak
• Are not up to date with this vaccine and are a first-year college student living in a residence hall
• Are a military recruit

CDC recommends MenB vaccination for adults if they:

• Have a rare type of immune disorder called complement component deficiency
• Are taking a type of medicine called a complement inhibitor (for example, Soliris^® or Ultomiris^®)
• Have a damaged spleen or sickle cell disease, or their spleen has been removed
• Are a microbiologist who is routinely exposed to Neisseria meningitidis
• Are part of a population identified to be at increased risk because of a serogroup B meningococcal disease outbreak

Talk to your doctor to find out if, and when, you will need MenACWY or MenB booster shots.

Who Might Not Be Able to Get These Vaccines?

Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below and ask your or your child’s doctor for more information.

Tell the person who is giving you or your child a meningococcal vaccine if:

You or your child have had a life-threatening allergic reaction or have a severe allergy.

• Do not get a meningococcal vaccine if
  • You have ever had a life-threatening allergic reaction after a previous dose of that meningococcal vaccine.
  • You have a severe allergy to any part of that vaccine. Your or your child’s doctor can tell you about the vaccine’s ingredients.

You are pregnant or breastfeeding.

• Pregnant women who are at increased risk for serogroup A, C, W, or Y meningococcal disease may get MenACWY vaccines.
• Pregnant or breastfeeding women who are at increased risk for serogroup B meningococcal disease may get MenB vaccines. However, they should talk with a doctor to decide if the benefits of getting the vaccine outweigh the risks.

You or your child are not feeling well.

• People who have a mild illness, such as a cold, can probably get these vaccines. People who have a moderate or severe illness should probably wait until they recover. Your or your child’s doctor can advise you.

What Types of Meningococcal Vaccines Are There?

There are 2 types of meningococcal vaccines available in the United States:

• MenACWY (conjugate) vaccines (Menactra^®, Menveo^®, and MenQuadfi^®)
• MenB (recombinant protein) vaccines (Bexsero^® and Trumenba^®)

MenACWY Vaccines

• Menactra^®, Menveo^®, and MenQuadfi^®: Vaccine providers give 2 doses to preteens and teens. Vaccine providers also give it to certain people at increased risk of meningococcal disease. It helps protect against 4 types of the bacteria that cause meningococcal disease (serogroups A, C, W, and Y).

MenB Vaccines

• Bexsero^®: Vaccine providers give a 2-dose series to people 16 through 23 years old who are not at increased risk of meningococcal disease. Vaccine providers also give a 2-dose series to people 10 years or older at increased risk of meningococcal disease. Bexsero^® helps protect against serogroup B meningococcal disease.
• Trumenba^®: Vaccine providers give a 2-dose series to people 16 through 23 years old who are not at increased risk of meningococcal disease. Vaccine providers give a 3-dose series to people 10 years or older at increased risk of meningococcal disease. Trumenba^® helps protect against serogroup B meningococcal disease.

Helpful Terms

• Conjugate: A type of vaccine that joins a protein to an antigen in order to improve the protection the vaccine provides
• Recombinant protein: A type of vaccine that contains protein antigens

How Well Do These Vaccines Work?

Summary

Vaccines that help protect against meningococcal disease work well but cannot prevent all cases.

As part of the licensure process, MenACWY and MenB vaccines showed that they produce an immune response. This immune response suggests the vaccines provide protection, but data are limited on how well they work. Since meningococcal disease is uncommon, many people need to get these vaccines in order to measure their effectiveness.

Available data suggest that protection from MenACWY vaccines decreases in many teens within 5 years. Getting the 16-year-old MenACWY booster dose is critical so teens have protection when they are most at risk for meningococcal disease. Available data on MenB vaccines suggest that protective antibodies also decrease quickly (within 1 to 2 years) after vaccination.

In Depth

Rates of meningococcal disease have declined in the United States since the 1990s and remain low today. Much of the decline occurred before the routine use of MenACWY vaccines. In addition, serogroup B meningococcal disease declined even though MenB vaccines were not available until the end of 2014.

CDC first recommended preteens and teens get a MenACWY vaccine in 2005. Since then, rates of meningococcal disease in teens caused by serogroups C, Y, and W have decreased by over 90% (note: serogroup A meningococcal disease continues to be very rare in the United States). Other age groups that CDC does not recommend routine MenACWY vaccination for did not see this large of a percent decline. These data suggest MenACWY vaccines have provided protection to those vaccinated, but probably not to the larger, unvaccinated community (population or herd immunity). Experts also believe MenB vaccines do not provide protection to unvaccinated people through population immunity.

What Are the Possible Side Effects of Meningococcal Vaccines?

Most people who get a meningococcal vaccine do not have any serious problems with it. With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own within a few days, but serious reactions are possible.

Mild Problems

MenACWY Vaccines

Mild problems following MenACWY vaccination can include:

• Reactions where the shot was given
  • Redness
  • Soreness
• Muscle pain
• Headache
• Feeling tired

If these problems occur, they usually last for 1 or 2 days.

MenB Vaccines

Mild problems following a MenB vaccination can include:

• Reactions where the shot was given
  • Soreness
  • Redness
  • Swelling
• Feeling tired
• Headache
• Muscle or joint pain
• Fever or chills
• Nausea or diarrhea

If these problems occur, they can last up to 3 to 5 days.

Problems that Could Happen After Getting Any Injected Vaccine

• People sometimes faint after medical procedures, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell the provider if you or your child feel dizzy, have vision changes, or have ringing in the ears.
• As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

Where Can I Find These Vaccines?

Your doctor is usually the best place to receive recommended vaccines for you or your child. These vaccines are part of the routine childhood immunization schedule. Therefore, vaccines for children and teens are regularly available at

• Pediatric and family practice offices
• Community health clinics
• Public health departments

If your doctor does not have these vaccines for adults, ask for a referral.

Vaccines may also be available at

• Pharmacies
• Workplaces
• Community health clinics
• Health departments
• Other community locations, such as schools and religious centers

You can also contact your state health department to learn more about where to get vaccines in your community.

When receiving any vaccine, ask the provider to record the vaccine in the state or local vaccine registry, if available. This helps providers at future visits know what vaccines you or your child have already received.

How Can I Get Help Paying for These Vaccines?

People can pay for meningococcal vaccines in several ways:

Private Health Insurance

Most private health insurance plans cover these vaccines. Check with your insurance provider for details on whether there is any cost to you. Ask your insurance provider for a list of in-network vaccine providers.

Vaccines for Children Program

Most health insurance plans cover routine vaccinations. The Vaccines for Children (VFC) program also provides vaccines for children 18 years and younger who are uninsured, underinsured, Medicaid-eligible, American Indian, or Alaska Native.