The GSK Pentavalent Meningococcal Vaccine: ACIP's 2025 Recommendations

This page describes recommendations adopted by the Advisory Committee on Immunization Practices in April 2025. Check current CDC schedules before acting on them.

Meningococcal disease is a serious bacterial infection caused by Neisseria meningitidis. In the United States, most cases are caused by serogroups B, C, W and Y, and different vaccines target different serogroups.

The vaccines

Penmenvy combines the components of two existing GSK vaccines, Menveo and Bexsero, and is licensed for people aged 10–25 — the same indication as Penbraya.

Who is already recommended to be vaccinated

• MenACWY: one dose at age 11–12 with a booster at 16, routinely; a multi-dose series with regular boosters for people 2 months and older at increased risk.
• MenB: a 2-dose series for healthy 16–23-year-olds based on shared clinical decision-making (given its short protection, about 1–2 years, and high cost per quality-adjusted life year gained), and for people 10 and older at increased risk.

Increased risk includes asplenia (no spleen or a spleen that doesn't work), persistent complement component deficiencies, use of complement inhibitors such as eculizumab or ravulizumab, HIV infection, exposure to tobacco smoke, recent upper respiratory infection, crowded living such as college residence halls, and close contact with a case. These indications have not changed since 2020.

The recommendation

On April 16, 2025, ACIP recommended that MenACWY-CRM/MenB-4C may be used when both MenACWY and MenB are due at the same visit for:

1. healthy people aged 16–23 on the routine schedule, when shared clinical decision-making favors MenB; and
2. people aged 10 and older at increased risk of meningococcal disease.

Because MenB vaccines from different makers aren't interchangeable, this gives people already using GSK's MenB vaccine a pentavalent option.

The evidence

ACIP weighed seven multi-country randomized trials in healthy people aged 10–25, rating the evidence with the GRADE approach. There were no data on actual disease prevention or on interference with other vaccines.

• Short-term immunity: one month after a dose, the pentavalent and MenACWY-CRM groups were similarly likely to be protected against serogroups A, C, W and Y. After two doses 6 months apart, the pentavalent and MenB-4C groups were similar for three of four serogroup B antigens, but the pentavalent group was less likely to be protected against the fourth, PorA, thought to give broad protection across B strains; what this means clinically is unknown.
• Lasting immunity: no studies looked at A, C, W and Y beyond a year; at two years, protection against all four serogroup B antigens was similar between groups.
• Serious adverse events possibly related to vaccination were rare and similar: three among 3,925 pentavalent recipients and three among 3,922 controls.
• Non-serious side effects (such as injection-site pain, fever or fatigue) were similar to MenB-containing controls but more common than after a single MenACWY-CRM dose.

During the review, the recommended interval between MenB-4C doses for healthy 16–23-year-olds was lengthened from at least 1 month to at least 6 months, based on better immune response with the longer gap.

Design of the trials in the evidence review. CDC figure.

Cost: a CDC model found the pentavalent vaccine cost-saving when it replaces MenACWY and MenB given together — the most favorable of the options studied. Replacing MenACWY alone would cost $11.3 million per quality-adjusted life year gained; replacing MenB alone ranged from cost-saving to $4.5 million. A GSK model reached similar conclusions.

How to use it

• Stick with one maker for MenB. MenACWY products are interchangeable, but MenB products aren't: every serogroup B dose, including boosters, should come from the same manufacturer. If doses from different makers were given, complete a full series of one maker's product; if the brand of earlier doses can't be found, restart the series. Always check the package label.
• Dosing: healthy 16–23-year-olds who get the pentavalent dose should get MenB-4C 6 months later to complete the series. People at increased risk who need more MenACWY and MenB doses less than 6 months after a pentavalent dose should get separate vaccines at the recommended intervals. The pentavalent vaccine can be used for boosters when both are due at once.
• Given by mistake? If it's given when only MenACWY or only MenB was due, the dose counts if it would otherwise have been valid.

Contraindications and precautions:

• Don't give it to anyone with a severe allergic reaction, such as anaphylaxis, to any component or to a diphtheria toxoid-containing vaccine.
• There are no high-quality data on use in pregnancy or breastfeeding. MenB should generally wait until after pregnancy unless risk is increased and a provider judges benefits outweigh risks; when MenACWY is needed during pregnancy or breastfeeding, MenACWY-CRM or MenACWY-TT may be used.
• Usually defer vaccination during moderate or severe acute illness.

Report any adverse event after vaccination to the Vaccine Adverse Event Reporting System (VAERS), online or at 800-822-7967, even if it's unclear whether the vaccine caused it.

Sources

• Amin AB, Collins JP, Dong X, et al. "Use of the GSK MenACWY-CRM/MenB-4C Pentavalent Meningococcal Vaccine Among Persons Aged ≥10 Years: Recommendations of the Advisory Committee on Immunization Practices — United States, 2025." Morbidity and Mortality Weekly Report 75(1), Centers for Disease Control and Prevention.
• A typing error in the source ("Indavertent") is corrected here.