Evidence supporting the Advisory Committee on Immunization Practices (ACIP) decision in April to recommend the pentavalent meningococcal vaccine, Penmenvy (GSK), as the second licensed pentavalent to serve as an alternative to administering separate quadrivalent (ACWY) and serogroup B meninococcal (MenB) vacccines has been recently described and qualified, and provided with clinical guidance in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR).1
The Penmenvy (GSK) pentavalent (serogroups ACWY and MenB) meningococcal vaccine was licensed in February 2025; with an earlier licensed pentavalent, Penbraya (Pfizer) having been recommended as an alternative to the quadrivalent and MenB vaccines in October 2023. Either vaccine is now a recommended alternative when both MenACWY and MenB are indicated at the same visit for: i) healthy persons aged 16-23 ("when shared clinical decision-making favors MenB administration") and ii) persons aged ≥10years who are at increased risk for meningococcal disease. As the manufacturers' serogroup B-targeting vaccines are not interchangeable, however, the same manufacturer should be used for the MenB series.
Supporting evidence for the April recommendation was drawn from seven multisite randomized controlled trials (RCTs) which assessed immungenicity and safety among healthy participants aged 10-25 years. The report points out that evidence is lacking for two outcomes: disease caused by serogroups A,B,C,W, and Y; and interference with other recommended vaccines administered concurrently.
Lead author Anika Amin, PhD, MSHP, epidemic intelligence service (EIS) officer, CDC, and colleagues relate that one month after receipt of 2 doses of serogroup B-targeting vaccine administered 6 months apart, participants in the pentavalent group (MenACWY-jCRM/MenB-4C) and control group (only MenB-4C, with no concomitant administration of MenACWY-CRM) were similarly likely to have seroprotective antibody titers against three of four serogroup B antigens (fHbP, NadA, and NHBA).They note, however, that those in the pentavalent group were less likely than controls to have seroprotective antibody titers against the fourth antigen, PorA.
What You Need to Know
Penmenvy (GSK), newly licensed in February 2025, joins Penbraya (Pfizer) as a recommended alternative to giving separate MenACWY and MenB vaccines when both are indicated at the same visit, based on moderate evidence in healthy adolescents and young adults.
Clinical trials showed similar short-term and 2-year seroprotection for most serogroup B antigens, though the pentavalent vaccine produced lower antibody responses to PorA, a potentially important antigen—an effect whose clinical significance remains unclear.
Data are lacking on real-world disease prevention, long-term immunity to ACWY serogroups, and coadministration with other vaccines; however, safety profiles were comparable to separate vaccines, with serious adverse events being rare.
Although PorA is likely responsible for broad cross-protection against various serogroup B strains, Amin and colleagues indicate that the clinical implications of the reduced PorA response are unknown "as differences in titer assay choices and circulating strains make comparing data across studies complex".
"In addition," they note, "whether the reduced response might result from immune interference could not be assessed because of limited data comparing titers after 2 doses given 2 months apart, rather than 6 months apart.The overall level of certainty for the evidence regarding short-term immunity was moderate for healthy persons and low for persons at increased risk for meningococcal disease."
Amin and colleagues found no studies evaluating the persistence (>1 year post vaccination) of immunity against serogroups A,C,W, and Y. Both the pentavalent and control group, however, were similarly likely to have seroprotective antibody titers against all four serogroup B antigens two years after vaccination.
"The overall level of certainty for the evidence regarding persistent immunity was low for healthy persons and very low for persons at increased risk for meningococcal disease," they concluded.
The safety reports were comparable, with serious adverse events related to any vaccine dose being rare and as likely to occur with the pentavalent vaccine as the combination used in the control group.
In the clinical guidance, the use of same manufacturer for the MenB series is emphasized.If doses from multiple manufactures have been used, an additional complete series with one manufacturer should be provided.
"Providers should always check the packaging label to be certain they are administering the intended vaccine product to the recipient," Amin and colleagues advise.
Reference
1. 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. MMWR Morb Mortal Wkly Rep. 2026; 75:7-14.
