Independent report

JCVI statement on meningococcal B vaccination in older children and young adults, 16 July 2026

Updated 17 July 2026

Background

The Joint Committee on Vaccination and Immunisation (JCVI) is an expert scientific advisory committee which advises the UK government on vaccination and immunisation matters.

Following the outbreak of capsular group B meningococcal disease (MenB) in Kent in March 2026, JCVI received a request from the Secretary of State for Health and Social Care on 19 March 2026 to provide an assessment of the clinical effectiveness of MenB vaccination in older children and young adults (hereafter referred to as ‘adolescents’) and to separately provide a recommendation on routine MenB vaccination in this group, subject to a demonstration of cost-effectiveness.

JCVI provided an assessment on the clinical effectiveness of MenB vaccination in adolescents to the Secretary of State for Health and Social Care on 25 March 2026 (available as an annex to the minutes of the ‘Extraordinary JCVI meeting on MenB’ held on 24 March 2026). A one-off, time-limited MenB vaccination programme was subsequently announced by the Secretary of State for Health and Social Care on 12 June 2026.

This statement sets out the JCVI recommendation and additional considerations to the second part of the request regarding a routine offer of MenB vaccination in adolescents.

Invasive meningococcal disease (IMD) is a rare but very serious illness, which can have a devastating impact on the lives of those affected. JCVI approached key charity stakeholders during this review and would like to thank all those who responded, including those responding on behalf of adolescents who sadly died or had life-changing sequelae (long-term complications) following IMD. These stories were carefully reviewed, and our thoughts are with those affected by this disease.

There are 2 MenB vaccines available for use in the UK:

• 4CMenB vaccine
• MenB-fHbp vaccine

JCVI has kept MenB vaccination under review since recommending a programme for infants in 2014. Prior to the current review, a MenB vaccination programme in adolescents had been considered highly unlikely to be cost-effective. Important factors influencing those assessments included the: 

• lower incidence of meningococcal disease in adolescence compared with levels observed in infants
• lack of impact from MenB vaccination on carriage of meningococci in adolescents

Newly available data on a) the use of a single dose of 4CMenB vaccine in adolescents who received 4CMenB vaccine in infancy and b) the protection from MenB vaccination against gonococcal disease (gonorrhoea), has allowed JCVI to meaningfully reassess this position.

Recommendation

JCVI recommends a routine offer of 4CMenB vaccination at around 15 years of age in those adolescents eligible for 4CMenB vaccination in infancy (individuals born on or after 1 May 2015, also referred to as ‘primed adolescents’).

The aim of this vaccination programme is to protect adolescents from IMD caused by MenB during the time they are at the highest risk.

Cost-effectiveness analysis considered by the committee indicates that vaccination at around 15 years of age is likely to be cost-effective using a single dose of the 4CMenB vaccine, assuming that one dose of vaccine administered to primed adolescents would provide the same protection against MenB IMD as 2 doses of vaccine in adolescents who had not received the 4CMenB vaccine in infancy.

Adolescents born on or after 1 May 2015 who did not receive the 4CMenB vaccine in infancy should be offered 2 doses of MenB vaccine.

Additional considerations

While there is uncertainty around the cost-effectiveness of MenB vaccination of adolescents born on or before 30 April 2015 who did not receive 4CMenB vaccination in infancy, an offer of vaccination to these groups is considered by JCVI to be highly important on the grounds of equity. Ministers may wish to take into further account other societal benefits related to the prevention of meningitis in these individuals when coming to a policy position.

Unprimed adolescents

Adolescents born on or before 30 April 2015 (referred to as ‘unprimed adolescents’) will not have been offered MenB vaccination in infancy. JCVI strongly supports an offer of MenB vaccination in a 2-dose schedule to these individuals. The second dose of vaccine should be offered around 15 years of age. This will maximise coverage and protection of adolescents against MenB disease over the period of highest risk in young adulthood.

The second dose can be given at any interval above 4 weeks after the first dose, including intervals of one or more years, to allow for operational flexibility and co-administration with other routine adolescent vaccinations. Two doses are required to protect against MenB disease.

Additional catch-up

On 12 June 2026, in response to outbreaks of IMD earlier in the year, a one-off, time-limited offer of MenB vaccination (2 doses of vaccine) was announced for eligible young people. Consequently, there would potentially be a cohort of adolescents who would be either too young to be offered MenB vaccination as part of the 2026 one-off offer, or too old to be offered MenB vaccination as part of a routine MenB programme.  

JCVI strongly supports an offer of MenB vaccination in a 2-dose schedule to these individuals as part of a one-off catch up programme.

Vaccine type

Given the importance of timely vaccination ahead of the period of highest risk from MenB IMD, the number of cohorts requiring vaccination simultaneously within a programme, and possible constraints arising on vaccine supply, a 2-dose schedule of 4CMenB or MenB-fHbp vaccine (not interchangeable from first to second vaccine doses) is considered appropriate for these additional programmes.

Considerations

JCVI has reviewed updated evidence on:

• vaccine effectiveness and duration of protection against IMD following 2 doses of MenB vaccine
• vaccine immune responses and safety data from one dose of 4CMenB vaccine following priming in infancy
• potential protection against gonococcal infection following 4CMenB vaccination
• current epidemiology of IMD and uncertainties with regard to future disease levels, recent meningococcal outbreaks, and cost-effectiveness analyses

In March 2014, JCVI recommended a routine MenB vaccination programme in infants in a 3-dose schedule. At the time, JCVI considered that the cost-effectiveness of an adolescent MenB vaccination programme was uncertain due to a lack of data around how long protection from disease lasted following vaccination, and whether MenB vaccines were able to prevent meningococcal carriage in adolescents. Since then, JCVI and the meningococcal sub-committee have continued to review the relevant evidence on meningococcal disease and vaccination.

Duration of protection

The introduction of the routine MenB vaccination programme in 2015 has allowed the generation of real-world evidence on vaccine effectiveness and duration of protection of MenB vaccination. Data indicates that 4CMenB vaccine effectiveness is high, around 82.9% against all MenB strains^{[footnote 1]}, and the latest data presented by the UK Health Security Agency (UKHSA) meningococcal surveillance team indicates that reductions in numbers of cases are seen for at least 6 years after vaccination in infancy, after which time case numbers were too low to evaluate longer-term protection. Published data from South Australia, where adolescents have routinely been offered 2 doses of 4CMenB since 2018, also shows effective protection for at least 5 years against MenB disease.^{[footnote 2]} 

Evidence on carriage

Meningococcal bacteria are typically ‘carried’ by individuals in their noses and throats without causing disease, with the highest carriage rates in adolescents. Evidence from a large study in Australia^{[footnote 3]} indicates that MenB vaccines do not prevent carriage of meningococci in adolescents. This means that MenB bacteria would continue to be transmitted between individuals irrespective of vaccination status and may then cause serious disease in unvaccinated individuals. MenB vaccination in adolescents would therefore only confer direct protection to vaccinated individuals. There would be no indirect or ‘herd’ protection in the population from vaccination.

Epidemiology and recent outbreaks

Since the introduction of the infant MenB vaccination programme in 2015, case numbers of IMD associated with meningococcal serogroup B have continued to decline. In recent years there have been 300 to 400 cases of IMD annually in England. MenB currently accounts for over 85% of cases (with a fatality rate of approximately 6%). Due to the success of the infant MenC programme in 1999 and the adolescent MenACWY vaccination programme in 2015, case numbers of IMD caused by meningococcal A, C, W and Y serogroups have fallen significantly.

Figure 1: invasive MenB infections laboratory reports in England by age group and epidemiological year, from 2010 to 2011 up to 2024 to 2025

Figure 1 shows invasive MenB infections laboratory reports in England by age group and epidemiological year, from 2010 to 2011 up to 2024 to 2025. Cases have decreased since 2014 across all age groups. In the epidemiological year 2024 to 2025, the highest incidence of MenB cases was seen in infants aged under 4 years and adolescents and young adults aged 15 to 19 years. 

Young adults in their first year of university have been identified to be at significantly higher risk of IMD than their peers not attending higher education. The highest period of meningococcal activity is usually between September and January.

Levels of IMD fell significantly during the COVID-19 pandemic. However, case numbers have now returned to pre-pandemic levels, or higher, for serogroup B. Due to the reduction in MenACWY case numbers, the majority of IMD cases in adolescents are now caused by serogroup B.

Meningococcal disease epidemiology is stochastic (unpredictable), with cyclical peaks and troughs in incidence which can be difficult to predict. The outbreak in Kent was the largest meningococcal outbreak seen in the UK in recent years. To date, there have been 2 further clusters of meningococcal serogroup B disease in England (in Weymouth and Reading) in 2026.

These outbreaks have been caused by different sub-strains of meningococcal serogroup B and do not suggest the emergence of a single, hypervirulent strain. Post-outbreak studies in Kent found very low rates of MenB carriage among university students, consistent with declining rates of MenB carriage when compared with previous national studies, performed in England between 1999 to 2001 and 2014 to 2015.

These declining carriage rates are consistent with the declining incidence of MenB disease in the UK observed since the early 2000s. This would suggest that the UK population is currently much less exposed to MenB compared to previously, possibly leading to population immunity overall being low against MenB disease. It is possible that the recent outbreaks may signal the start of a new endemic period of meningococcal serogroup B disease in the UK, which would be consistent with previous similar cycles over the past century.

Vaccine effectiveness evidence

At the June 2026 JCVI meeting, the committee considered new evidence, received from vaccine manufacturers, on the effectiveness of one dose of 4CMenB vaccine in individuals who had received 4CMenB vaccination in infancy. The data was considered by the committee to support the likelihood that a single dose of the 4CMenB vaccine in primed individuals would provide levels of protection against MenB IMD that are similar to 2 doses of 4CMenB vaccine given to individuals who have not previously received 4CMenB vaccination. Timely publication of this evidence is strongly encouraged by JCVI.

JCVI encourages further studies on MenB vaccine efficacy, particularly regarding the interchangeability of different MenB vaccines, both during primary course in infancy and additional vaccination in primed adolescents.

Gonococcal protection

Evidence indicates that the 4CMenB vaccine also provides some protection against gonococcal infection. Observational studies have been carried out in adolescents and young adults in Canada, Australia and the USA, where the 4CMenB vaccine has been offered and a lower incidence of gonococcal disease (gonorrhoea) identified in vaccinated individuals compared with unvaccinated individuals.

In South Australia, a study based on their adolescent 4CMenB vaccination programme reported a 2-dose vaccine effectiveness of 41.8% against gonorrhoea. This protection lasted out to 5 years, with vaccine waning evident.^{[footnote 2]} In the USA, a study using sexually transmitted infection (STI) surveillance data from New York City and Philadelphia estimated a 4CMenB 2-dose vaccine effectiveness of 40% against gonorrhoea, with a vaccine effectiveness of 26% for one dose.^{[footnote 4]} 

A recently published randomised controlled trial conducted in Australia^{[footnote 5]} concluded that 4CMenB vaccination in men who have sex with men (MSM) who were at high risk for gonorrhoea did not result in a lower level of gonococcal infection compared with those who had not received the vaccine. The trial population had very high rates of prior gonococcal infection and did not include women. JCVI considers that the trial population is unlikely to be reflective of the target population for a national adolescent MenB vaccination programme, who would largely have not had previous exposure to gonorrhoea.

Gonorrhoea diagnoses in England reached record highs in 2023, with over 85,000 cases reported. Diagnoses have since fallen: there were approximately 63,000 diagnoses in 2025. High gonorrhoea diagnosis rates are seen in adolescents. Left untreated, gonorrhoea can cause complications such as pelvic inflammatory disease (PID), chronic pelvic pain (CPP), ectopic pregnancy, infertility and systemic infections, including disseminated gonococcal infection.^{[footnote 6]} Gonococcal infections can also increase the risk of acquiring other sexually transmitted infections, including HIV.^{[footnote 7]}

Stakeholder engagement

JCVI carried out an engagement process with key meningococcal disease stakeholders, including charities and societies. Contributions received from stakeholders included stories from bereaved families and information on the wider impacts of meningococcal disease, most outside of the scope of JCVI cost-effectiveness methodology. JCVI noted these contributions and the devastating impact of meningococcal disease on individuals and their families and considered these alongside other evidence in their decision-making.

Cost-effectiveness modelling analysis

Modelling and cost-effectiveness analyses were provided by the University of Bristol, and UKHSA and Imperial College London (pending publication). These analyses focused on potential vaccination of adolescents and young adults aged 13 to 17 years.

A medium incidence of meningococcal serogroup B disease was assumed in both models, based on historical epidemiological data and reflecting the uncertainty of meningococcal epidemiology. Vaccine uptake was assumed to be similar to other adolescent vaccination programmes, such as human papillomavirus (HPV). JCVI considered that, given evidence of public concern both in parents and young adults around meningitis and septicaemia (both associated with meningococcal disease), and the rapid onset and progression of meningococcal disease symptoms, it was appropriate in this instance to include ‘peace of mind’ as a benefit provided from vaccination.

Updated cost estimates from the MenB outbreak in Kent were also included in cost-effectiveness models. As in previous MenB vaccination models, litigation costs to the NHS were included in the health economics component of the models.^{[footnote 8]}

Sensitivity analyses were conducted, including (but not limited to) differing considerations on:

• the number of large (Kent-like) MenB outbreaks projected to occur every year
• prevalence and severity assumptions of long-term sequelae from gonorrhoea
• vaccine effectiveness of MenB vaccination against gonorrhoea

Different vaccination scenarios and strategies were also modelled, including age at which vaccine was administered and dosing schedule.

Wider societal benefits

UKHSA and modelling teams provided assessments of the impact on meningococcal disease in wider society. While JCVI noted this data, in accordance with the JCVI Code of Practice, these societal impacts were not taken into account for the assessment of cost-effectiveness. JCVI recognises that there are likely to be additional societal benefits from MenB vaccination in adolescents, including on school attendance and educational attainment. JCVI supports the consideration of these assessments by the Department of Health and Social Care (DHSC) and by ministers when developing policy based on the JCVI statement and recommendations regarding MenB vaccination. These assessments have been provided to DHSC alongside this statement, and JCVI supports their publication by UKHSA and the respective modelling teams in a timely manner.

References

1. Parikh SR, Andrews NJ, Beebeejaun K, Campbell H, Ribeiro S, Ward C, White JM, Borrow R, Ramsay ME and Ladhani SN. ‘Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study’. The Lancet (2016): volume 388, number 10061, pages 2775 to 2782. ↩

2. Wang B, Giles L, Andraweera P and others. ‘4CMenB sustained vaccine effectiveness against invasive meningococcal B disease and gonorrhoea at three years post program implementation’. Journal of Infection (2023): volume 87, issue 2, pages 95 to 102. ↩ ↩²

3. Marshall HS, McMillan M, Koehler AP, Lawrence A, Sullivan TR, MacLennan JM, Maiden MCJ and others. ‘Meningococcal B vaccine and meningococcal carriage in adolescents in Australia’. New England Journal of Medicine (2020): volume 382, number 4, pages 318 to 327. ↩

4. Abara WE, Bernstein KT, Lewis FMT and others. ‘Effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhoea: a retrospective observational study’. Lancet Infectious Diseases (2022): volume 22, issue 7, pages 1021 to 1029. ↩

5. Seib KL, Donovan B, Jin F, Thng C, Yeung B, Comninos N, Bopage RI, Ray A, Mahony A, Chow EP, Chen MY. ‘Meningococcal B Vaccine to Prevent Neisseria gonorrhoeae Infection’. New England Journal of Medicine (2026). ↩

6. Fifer H, Saunders J, Soni S, Sadiq ST, FitzGerald M. ‘2018 UK national guideline for the management of infection with Neisseria gonorrhoeae’. International Journal of STD & AIDS (2020): volume 31, issue 1, pages 4 to 15. ↩

7. Unemo M, Seifert HS, Hook EW 3rd, Hawkes S, Ndowa F, Dillon JR. ‘Gonorrhoea’. Nature Reviews Disease Primers (2019): number 5, page 79. ↩

8. Christensen H, Trotter CL, Hickman M and Edmunds WJ. ‘Re-evaluating cost effectiveness of universal meningitis vaccination (Bexsero) in England: modelling study’. British Medical Journal (2014): issue 349. ↩