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Meningococcal disease is caused by the bacterium Neisseria meningitidis. At least 12 groups have been identified, including groups A, B, C, X, Y and W. The pattern of disease caused by each group varies by time and country or geographical areas. In New Zealand over 2014–2017, meningococcal group B caused around two-thirds of meningococcal disease each year, group C almost one-third and groups Y or W the remaining few cases. In 2022, group B was the prominent type causing 80% of group-identified cases, and group Y and group W made up the other cases. Meningococcal group A rarely causes disease in NZ.

Bexsero, a multicomponent recombinant vaccine against meningococcal group B disease only is available in New Zealand and now funded for children between 8 weeks and 12 months (catch up to 59 months until 31 August 2025); and 13 to 25 year-olds in specified close living situations (catch up lasts until 28 February 2024). See more in our quick facts.

Conjugated meningococcal vaccines that protect against either groups A, C, W and Y or group C disease only are also available in New Zealand. For best protection against all meningococcal disease in New Zealand, separate vaccinations against group B disease and groups A, C, Y and W disease are recommended.

Bexsero is broadly protective against meningococcal group B disease and is different to the MeNZB™ vaccine used in New Zealand between 2004 and 2011. The MeNZB vaccine was designed to target a specific type of meningococcal group B bacterium that only caused disease here in New Zealand. MeNZB was not meant for long term use. The vaccine was withdrawn once the rate of disease was significantly reduced. However, the active component of the MeNZB vaccine has contributed to the successful development of Bexsero.

Bexsero is also funded for individuals with a medical condition that increases their risk of invasive meningococcal disease AND listed on the Pharmaceutical Schedule. Bexsero is also available as a purchased vaccine through your family doctor.

For individuals with a medical condition that increases their risk of invasive meningococcal disease AND is listed on the Pharmaceutical Schedule, the meningococcal vaccines NeisVac-C and/or Menactra and/or MenQuadFi are available as funded vaccines. However, these vaccines do not provide protection against meningococcal group B disease.

Bexsero 7 rights of administration prompts

Find our A4 prompt card resource here

FInd our A6 prompt card resource here

Quick facts on Bexsero use

Find our quick facts here

Responses to vaccine

Bexsero (MenB)
Very common side effects
Common reponses
  • Fever over 38°C in children aged under 2 years
  • Redness, swelling and/or mild–moderate pain around injection site
  • Irritability, unusual crying
  • Decreased appetite, nausea
  • Headache, muscle and/or joint aches.
  • Malaise, drowsiness
Rare responses
  • Urticaria (allergic skin reaction)
  • Anaphylaxis (severe allergic reaction)

Other formulations and brands

Other vaccines:

Meningococcal group B only vaccine:

  • None

Meningococcal A, C, Y and W conjugate vaccine:

  • Menactra
  • MenQuadFi
  • Nimenrix

Meningococcal C only conjugate vaccine:

  • NeisVac-C

Bexsero is recommend and funded for:

  • Children between 3months-12months; catch up for 13 month to 59 month olds available until 31 August 2025 - including tamariki who were aged under 5 years on 1 March who have since turned 5 years old.
  • Young adults 13 to 25 year olds in specified close living situations (until 28 Feb 2024)
  • Catch up programmes for the above
  • Individuals who have previously had meningococcal disease of any group
  • Close contacts of a meningococcal disease case of any group
  • Individuals pre/post-splenectomy or with functional asplenia
  • HIV positive individuals
  • Individuals with a complement deficiency
  • Pre/post-solid organ transplantation
  • Following stem cell/bone marrow transplantation
  • Pre- and post-immunosuppression that will be/is for longer than 28 days

Bexsero is recommended but not funded for:

  • Travellers to high-risk countries and Hajj pilgrims
  • Laboratory workers regularly exposed to meningococcal cultures

If MeNZB has been used previously

Bexsero and MeNZB vaccines are not interchangeable in a course of vaccines to protect against meningococcal group B disease.

The recommended dose schedule for Bexsero does not change for individuals with a history of immunisation with MeNZB vaccines. Bexsero utilises four antigen components to induce broad protection against meningococcal group B disease and is significantly different to MeNZB that utilised only one of these antigen components.

Storage and preparation

  • Bexsero is provided as a 0.5mL suspension in a pre-filled syringe in a single-dose pack.
  • During storage, a fine off-white deposit may form in the syringe. Shake the vaccine well before use to ensure the ingredients are evenly distributed within the vaccine.
  • Store the vaccine as per the cold chain between 2°C to 8°C. Protect from light.


Bexsero is administered by deep intramuscular injection into the vastus lateralis in infants or deltoid in older children, adolescents and adults.

Bexsero can be administered at the same visit as other vaccines in separate syringes and at separate injection sites. When giving two intramuscular (IM) injections in the same limb in infants, the vastus lateralis is preferred because of its greater muscle mass. The injection sites should be on the long axis of the thigh and separated by at least 2 cm so that localised reactions will not overlap.

Bexsero is approved for use from 8 weeks of age, however, infants eligible to funded meningococcal vaccination and high risk of meningococcal disease can receive Bexsero from 6 weeks of age. The recommended number of Bexsero doses is determined by the age of the individual when they receive their first Bexsero vaccination. The recommended Bexsero vaccination schedules are shown in table 1.

Bexsero vaccination schedules
Age when Bexsero first dose given Number and timing of doses
Infants >6 weeks to <11 months – 2 doses separated by 8 weeks plus
– Booster dose aged ≥12 months or a minimum of 6
months after second dose, whichever is later.
Infants ≥12 to ≤23 months (for first dose) – 2 doses separated by 8 weeks plus
– Booster dose given 12-24 months after second dose
Children ≥24 months (for first dose) and adults¥ – 2 doses separated by 8 weeks
– Booster doses are funded for high-risk groups.

¥Interval between Bexsero doses for children aged ≥2 years to ≤10 years

The recommended minimum interval between doses in this age group is 8 weeks (however, a 4 week interval can be accepted if clinically indicated). After an 8 week interval between doses 91–100% of children were expected to be protected from meningococcal group B disease compared with 69–100% of children after a 4 week interval. The safety and efficacy in individuals aged 50 years or over has not been established but there are no safety concerns expected.

Vaccine Safety

Bexsero has an excellent safety record. The most common vaccine responses include fever and discomfort or pain around the injection site. Infants and children may also be irritable, have unusual crying or a decreased appetite, whilst adolescents and adults may experience headache, muscle or joint aches, malaise or nausea. Very rarely, a severe allergic reaction (anaphylaxis) to a component in the vaccine occurs.

Fever and local vaccine responses

Fever is part of a robust immune system response to Bexsero, usually peaking around 6 hours after vaccination and settling over 24–48 hours. A fever over 38°C is more likely to occur in infants and children aged under 2 years after vaccination with Bexsero compared with other routinely used infant vaccines. When Bexsero is administered at the same visit as other Immunisation Schedule vaccines, a fever over 38°C or 39°C is almost twice as likely as when the Immunisation Schedule vaccines are given alone.

Similarly, redness, swelling and/or mild–moderate pain around the injection site are also common expected immune responses to Bexsero, peaking on the day of vaccination followed by a significant decrease, and settling from around 24 hours after vaccination.

Recommendation for use of prophylactic paracetamol

The advice for the use of prophylactic paracetamol (using 120mg/5ml solution) for children aged under 2 years (see below) only applies to immunisation events when Bexsero is administered, either as the only vaccine or with other vaccines. This is because of the evidence of a robust immune response to Bexsero in young children and that the use of prophylactic paracetamol around fever over 39°C, and injection site pain. Some infants will still develop a fever and/or injection site pain even though they have received paracetamol doses.

Ibuprofen may be given as an alternative to paracetamol.

Other strategies that can also be used to help manage fever and injection site discomfort or pain are described below.

Box 1: Use of prophylactic paracetamol in children aged under 2 years to help manage post-Bexsero fever

Note: This advice only applies to immunisation events when Bexsero is administered, either as the only vaccine or with other vaccines.

Prophylactic paracetamol use (using 120mg/5ml solution) is recommended with every dose of Bexsero in children aged under 2 years:

  • Three doses of paracetamol (15mg/kg) are recommended with 6 hours between each dose, whether the child has a fever or not:
    • The first dose can be administered 30 minutes prior to Bexsero or at time of vaccination
  • The second paracetamol dose is given 6 hours after the first dose, the third dose is given a further 6 hours later.
  • If the infant or child is sleeping when the second or third paracetamol dose is due:
    • It is not necessary to wake the child
    • The dose can be given when the child wakes up as long as it is at least 6 hours since the previous dose was given
  • Ensure parents:
    • Have the 120mg/5mL paracetamol strength formulation
      • The doctor can provide a prescription for them to fill at the pharmacy
    • Measure the paracetamol dose using a measuring spoon or syringe
  • If the child is miserable or distressed because of a fever or injection site pain 6 hours after the third dose of paracetamol and is otherwise well:
    • The parent can continue to administer the paracetamol doses with a minimum of 6 hours between doses until the discomfort resolves or 48 hours after vaccination, whichever occurs first
      • No more than four doses of paracetamol can be given in a 24-hour period
  • A child who is miserable or distressed because of a fever or injection site pain 48 hours or more after vaccination is advised to be seen by their doctor 
  • Box 2: Non-pharmaceutical strategies to help manage fever or injection site discomfort or pain

    If the child has a fever

    • Give lots of breastfeeds or fluids
    • Undress them to a single layer
    • Make sure the room is not too hot or too cold
    • Give lots of cuddles

    If the child has injection site discomfort or pain

    • Do not rub the injection site
    • Hold a cool damp cloth or an ice pack well wrapped in a dry cloth on the injection site
    • Give lots of cuddles

    Bexsero should not be given to:

    • Anyone with severe allergy (anaphylaxis) to a previous dose of the vaccine or any component of the vaccine
    • Administration of Bexsero should be postponed in individuals suffering from a fever over 38°C.  The presence of a minor infection is not a reason to delay immunisation.

    Specialist advice should be sought for the following groups:

    • Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions.

    Vaccine Effectiveness

    Immunisation generates circulating antibodies. Over time, the antibody levels decrease. The number and quality of antibodies and how long they last depend on what type of vaccine is used, the meningococcal group(s) covered by the vaccine, and the age of the person receiving the vaccine.

    During clinical trials, as there are generally low numbers of meningococcal disease cases in countries such as Australia, England, Germany, New Zealand and the United States, it is not possible to determine exactly how many cases of disease are prevented by vaccination or how long protection after vaccination lasts. Instead, the immune system response and antibody levels are used as an alternative measure of how well and how long meningococcal vaccines can protect from disease.

    The impact on the number of cases can indicate how well a vaccine programme performs. In the UK, the first country to introduce Bexsero to its infant immunisation programme, a 75% decline in group B disease was reported during the first three years of the programme in the vaccine-eligible age groups. Similar reductions in cases were reported Australia and Canada in vaccinated infants and adolescents.

    Bexsero is expected to provide protection against disease caused by a broad range of group B meningococcal bacterium types, including the New Zealand specific type of meningococcal group B. On average in New Zealand, meningococcal group B causes more than three-quarters of meningococcal disease each year.

    Table 2 shows the expected protection against group B meningococcal disease after completion of an age appropriate course of Bexsero.

    Table 2:  Expected protection against meningococcal disease after vaccination with Bexsero

    Expected protection against meningococcal disease after vaccination with Bexsero
    Age group Expected protection
    Under 2 years 63-100%
    2 - 3 years 97-100%
    4 - 10 years 72-100%
    Adolescents 99-100%
    Adults 91-100%


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    Last updated:
    Feb 2023