Why adolescence is a critical window for meningococcal disease prevention
Meningococcal disease can affect people at any age, but adolescence is a pivotal period for prevention. Recent expert discussions highlight that while infants and younger children are traditionally prioritized, the risk rises again during adolescence due to behavioural and environmental factors. In the United States, MenB remains a leading cause among young people aged roughly 11–23, and in Europe, outbreaks among adolescents have underscored the vulnerability of this group. Because Neisseria meningitidis carriage peaks during adolescence, this is the stage where vaccination can blunt transmission and protect individuals from severe outcomes.
Adolescents at risk: transmission, carriage, and behavior
Carriage of meningococcal bacteria in the nasopharynx reaches notable levels in teens and early young adults. A peak carriage rate around 23.7% in adolescence has been observed, making this group a potential reservoir for spread within communities such as schools, summer camps, and shared housing. Tobacco exposure, including passive smoking, has been linked to increased risk by enhancing nasopharyngeal colonisation. These factors together amplify both the individual risk and the likelihood of transmission during adolescence.
Sequelae are real: the lasting impact of IMD
Even when survivors recover, invasive meningococcal disease (IMD) can leave lasting scars. Long-term sequelae affect one in five survivors, with potential hearing loss, vision and cognitive impairments, seizures, and physical disabilities. The burden is not only medical but also social and educational, as adolescence is a formative period for memory, attention, and psychosocial development. Early recognition and prompt treatment improve outcomes, but delays—common in adolescents due to non-specific symptoms—can worsen prognosis and necessitate longer hospital stays.
Vaccines exist, but uptake is uneven
There are effective vaccines against several leading IMD serogroups. Conjugate vaccines for MenACWY protect against major disease-causing serogroups, and MenB vaccines specifically target the most prevalent MenB disease in teens and young adults. While some countries have integrated these vaccines into adolescent programs, coverage and completion remain suboptimal, particularly for MenB. Co-administration strategies—for example, delivering MenACWY and MenB in the same visit—have the potential to strengthen protection across serogroups and simplify scheduling for families.
Boosters and catching up: optimising schedules
Experts emphasise that adolescence is an opportunity to reinforce immunity for those primed as infants and to vaccinate those who are still naive. Booster doses, when appropriate, can reinforce protection as teenagers transition into late adolescence and early adulthood. Scheduling is country-specific and can be tailored to local epidemiology, school calendars, and healthcare access patterns. In some systems, catch-up vaccination is offered into early adulthood, while others focus on pre-adolescent or early adolescent windows to pre-empt the second peak in risk.
Role of healthcare professionals: education, access, and surveillance
Healthcare professionals (HCPs) play a crucial part in closing the knowledge gap among adolescents and families. Clear conversations that engage teens in decision-making—and the use of non-judgmental, age-appropriate dialogue—are essential. Education should cover the disease, the value of vaccination, and what to expect from vaccine schedules. Practical steps include integrating vaccination into existing visits (e.g., routine adolescent check-ups) and organizing vaccine drives in schools or community settings to improve access.
Using surveillance to guide action
Local epidemiology and robust surveillance data help tailor vaccination strategies. By tracking disease distribution, serogroup prevalence, and vaccine failures, health systems can adapt schedules and outreach to the age groups most at risk. Routine, active surveillance offers timely information that supports decisive, evidence-based interventions. The ultimate aim is to prevent IMD before it can take hold, rather than reacting after onset.
What families and teens can do now
For adolescents and their caregivers, the key steps are early and proactive discussions with paediatricians or primary care providers, understanding the risks and benefits of available vaccines, and planning vaccination around school breaks or transitions to higher-risk environments. Parents, educators, and healthcare teams should work together to create easy, clear pathways to vaccination—whether through school-based programs, pharmacies, or community health events.
Conclusion: vaccination as a shared responsibility
The consensus among researchers and clinicians is clear: timely vaccination during adolescence reduces the incidence and severity of invasive meningococcal disease, protects future adults, and lessens the burden of long-term sequelae. The only non-optimal age to consider vaccination is after disease onset. By leveraging evidence-based schedules, reinforced education, and accessible vaccination opportunities, we can shield adolescents from IMD and preserve their health into adulthood.
