Pondering the New Meningococcal B Vaccine: Do B or Do Not Do B?

April 13, 2015

To give the meningococcal B vaccine or not to give it?

“To be or not to be?” Hamlet asked himself this question as he contemplated suicide in Shakespeare’s eponymous drama. Parents will soon be asking themselves a similar question, “To give the meningococcal B vaccine or not to give, etc . . .”

The FDA in January 2015 approved a second vaccine against the B serogroup of meninogoccus, Bexsero, made by Novartis. The first meningococcal B vaccine, Trumemba (Pfizer), was approved in October 2014. Bexsero has been in use in Europe since January 2013 and was the meningococcal B vaccine granted emergency use in the Princeton University meningitis outbreak last year (9 students stricken, 1 death) before a vaccine against this strain had been approved for use in the United States. This begs the question: why was Trumemba approved before Bexsero?

Perhaps the simplest answer is that Pfizer submitted its application to the FDA for Trumemba before Novartis submitted the one for Bexseso. A cynic might suggest that the FDA wanted to introduce a little competition to Bexsero in an attempt to keep the price of the vaccines down, since the federal government buys a lot of vaccines every year.

The current quadravalent meningococcal vaccines (against strains A, C, Y, and W-135) are recommended for universal use in children aged 11 to 12 years, with a booster at age 16. The Advisory Committee on Immunization Practices (ACIP) voted its recommendations for menigococcal B vaccine use. Let’s see how you do on a little quiz. Here is a hint (or not): serogroup B is responsible for close to 40% of disease in college-aged adolescents.

The ACIP voted to recommend use of the two new meningococcal B vaccines for which of the following groups (among others)?