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New Frontiers in Meningococcal Vaccination
Preventing the Worst: Evolving Strategies and New Frontiers in Meningococcal Vaccination

Released: October 23, 2025

Patti Wukovits
Patti Wukovits, BSN, RN, AMB-BC
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Key Takeaways
  • Vaccination is the only reliable protection against meningococcal disease, which remains rare but fast-moving and often fatal.
  • Pentavalent meningitis vaccines mark a major advancement, simplifying protection by combining coverage for all 5 major serogroups in a single shot.
  • Communication gaps hinder vaccination; many families remain unaware of MenB vaccines due to missed discussions under “shared clinical decision-making”.
  • Improving uptake requires action: vaccine checks at every visit, strong recommendations from healthcare professionals, reminders for series completion, and supportive policies like school-entry mandates

When I recently joined the expert forum “Preventing the Worst: Strategies to Optimize Meningococcal Vaccination,” with pediatric infectious disease experts Gary Marshall, MD and Jana Shaw, MD, MPH, MS, I felt both hopeful and determined. Having lived through the devastating consequences of meningococcal disease through the loss of my teenage daughter, the discussion about evolving vaccines, communication gaps, and prevention strategies struck a deeply personal chord. Kimberly died from Meningitis B 3 days before high school graduation and 2 days before prom. I buried her in the prom dress that she didn't get the chance to dance in. 

Unfortunately, there are many stories like Kimberly’s. Meningococcal disease remains 1 of the most heartbreaking infections in pediatrics—thankfully rare, yet terrifyingly fast and often fatal. I know how suddenly it can strike and how completely it can change a family’s life. Survivors often face lifelong challenges: limb loss, neurologic injury, or emotional trauma. The infection spreads easily through close contact, especially among adolescents whose social lives naturally include the kinds of interactions that raise risk: shared drinks, crowded dorms, or just being together.

Although overall incidence has dropped dramatically over the past few decades, outbreaks still occur, most often on college campuses and typically involving serogroup B. Since 2011, 100% of outbreaks of meningococcal disease on college campuses have been attributed to Meningitis B.  Several experts in our discussion described meningococcal disease as a “low-hanging fruit” of vaccine-preventable illness—uncommon but deadly, with enormous human and economic cost. Its unpredictability makes it especially dangerous: different serogroups shift over time, and the early symptoms can resemble a simple viral infection, delaying diagnosis until it’s too late for treatment. That’s why vaccination remains the only reliable form of protection.

Expanding Vaccine Options
I know firsthand the devastation of not having a MenB vaccine available to protect my child. When Kimberly died, the MenB vaccine was not yet available to protect her. Thankfully, today, healthcare professionals (HCPs) have 3 FDA-approved meningococcal vaccines: MenACWY, MenB, and new pentavalent (ABCWY) vaccines. The arrival of the pentavalent options marks a major milestone. By combining broad protection into a single shot, they simplify decisions for both HCPs and parents and make it easier for adolescents to receive complete protection.

Current ACIP recommendations include a MenACWY dose at 11-12 years of age with a booster at age 16, and MenB vaccination between ages 16 and 23, preferably at 16-18, under shared clinical decision-making. A second dose of the MenB vaccine is necessary 6 months after the first dose. Uptake for the MenB remains disappointing; only about a third of teens start the series and just 16% complete it. Too often, the “shared” part of decision-making never happens. Many families don’t even know the MenB vaccine exists because their HCP doesn’t bring it up. True shared decision-making should mean an informed conversation, not silence.

The pentavalent vaccines could help close that gap. By covering all 5 major serogroups in 1 dose, they offer a simpler, more comprehensive approach. In trials involving more than 7000 adolescents, they proved safe, effective, and well tolerated and performed as well or better than the separate MenACWY and MenB vaccines. They are now approved for use when both vaccines are needed at the same visit, with a follow-up MenB dose from the same manufacturer required 6 months later. A separate dose of MenACWY is also necessary at 11-12 years of age to kick off the series.

Coverage Gaps and Proposed Solutions
Despite progress, major coverage gaps persist. Approximately 87% of 13- to 17-year-olds receive MenACWY, but rates drop to 61% by age 17, and MenB coverage remains alarmingly low, even among high-risk groups. Only a small fraction of teens with asplenia or complement deficiencies—those who most need protection—are vaccinated. Disparities across racial and geographic lines persist, though states with school-entry mandates show what’s possible. North Dakota, for example, reports 70% MenB coverage, proof that stronger policy can drive real change.

When I shared my daughter Kimberly’s story—how she died of Meningitis B just weeks before her 18th birthday, before a vaccine was available—the emotion in the room was palpable. Stories like hers remind us why every conversation matters. Fear alone isn’t enough to motivate action; we have to focus on empowerment, helping parents and teens understand that vaccination is a way to protect themselves and their communities. Too many parents assume their child is fully protected after MenACWY, unaware that MenB requires a separate decision and series. Changing that begins with better communication—every HCP raising the topic, every parent understanding the facts, every teen having the chance to choose protection.

Our panel discussed practical ways to close the gap:

  1. Use every visit to check vaccine status
  2. Always bring up the MenB vaccine, even if the patient is not going to college
  3. Present MenB vaccination as critical, not optional
  4. Emphasize that 1 MenB dose isn’t enough
  5. Use reminders to ensure series completion
  6. Engage adolescents directly and highlight vaccination as an empowerment tool
  7. Support school mandates and equitable insurance coverage

Looking Ahead
Looking ahead, the future of meningococcal prevention is in the hands of those working with patients every day. Meningococcal disease may be rare, but every preventable death is 1 too many. With clearer, consistent communication, stronger advocacy, and the continuing evolution of vaccine science, we can ensure that no other family has to endure the heartbreak that mine did.

Your Thoughts
Have you faced challenges protecting teens and young adults from meningococcal disease, or struggled to navigate evolving vaccine recommendations? Are conversations about MenB and the new pentavalent vaccines happening in your practice, or are they being missed? Share your experiences, questions, or insights below. Together, we can close communication gaps, strengthen prevention, and ensure every adolescent gets the protection they deserve.

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