Meningococcal B (MenB) vaccination programme: urgent time-limited response to recent outbreaks (WHC/2026/026)

Issue Date:

16th June 2026

Status:

Action

Category:

Public health

Title:

An urgent time-limited Meningococcal B (MenB) vaccination programme in response to recent outbreaks.

Date of expiry or review:

Not applicable

For action by:

• Chief Executives, Health Boards and Trusts
• Vaccination Operational Leads, Health Boards and Trusts
• Medical Directors, Health Boards and Trusts
• Directors of Primary Care, Health Boards and Trusts
• Nurse Executive Directors, Health Boards and Trusts
• Chief Pharmacists, Health Boards and Trusts
• Directors of Public Health, Health Boards and Trusts
• Directors of Therapies and Health Science Health Boards and Trusts
• National Director Health Protection and Screening Services and Executive Medical Director, Public Health Wales
• Nurse Director, Public Health Wales
• Head of Vaccine Preventable Disease Programme, Public Health Wales
• Director of Vaccine Delivery, Vaccination Programme Wales, NHS Wales Performance and Improvement 
• General Practitioner Committee, Wales
• General Practitioners
• Community Pharmacies
• Community Pharmacy Wales
• Digital Health Care Wales

Action required by: 

July 2026

Sender:

Dr Keith Reid, Deputy Chief Medical Officer (Public Health).

Health, Care and Prevention Welsh Government Contact(s):

Vaccination Division,
Welsh Government,
Cathays Park,
Cardiff.
CF10 3NQ.
Email: wg.vaccinationsprogrammeteam@gov.wales

Enclosures:

None

Following the unprecedented outbreak of Meningococcal Group B (MenB) in Kent in March, and more recent smaller outbreaks in Weymouth and Reading, I am writing to advise of an urgent MenB vaccination response as a precautionary measure to help protect the young people at highest immediate risk this year.  

Older teenagers and students aged less than 25 years of age who are entering higher and residential further educational settings for the first time are at higher risk of infection with meningococcus B. The offer of the MenB Bexsero® (4CMenB) vaccine will therefore be made to people currently in the Year 13 age group (born between 01/09/2007 and 31/08/2008) and anyone aged up to 25 years who will be attending higher education or residential further education for the first time in autumn 2026, including students from other UK nations and international students. 

This will be a time limited offer, beginning on 20 July 2026 this year. As two doses of the Bexsero® (4CMenB) vaccine are required at least 28 days apart for protection, it is important to start offering vaccination as soon as practicably possible after this date, with the aim of achieving protection of the above individuals before the start of the 2026 to 2027 academic year and the peak season for MenB in the autumn.

This letter is aimed at health professionals who will be responsible for delivering this targeted vaccination programme. I encourage you to share this information with all those who are involved in delivering the programmes in your area.

The MenB vaccination should be offered to:

• Cohort 1: all individuals born between 01/09/2007 and 31/08/2008 (17 to 18 years old)
• Cohort 2: individuals born on or after 21/07/2001 (turning 25 on or after 21/07/2026) and are due to start undergraduate higher education OR residential further education, for the first time in autumn 2026, including international students and those from the UK Devolved Administrations and Crown Dependencies.

The offer does not include:

• those born before 21/07/2001
• those aged less than 25 years continuing their studies (not first-time entrants) 
• those in school level residential settings, for example sixth form boarding schools, unless they are eligible due to their age 
• those who completed a 2 dose course of Bexsero^® within the last 5 years
• those who completed a 2 or 3 dose course of Trumenba^® within the last 5 years

Invitations will be issued by health boards for Cohort 1 (those born between 01/09/2007 and 31/08/2008), with self-referrals to health board vaccination clinics for Cohort 2 (those less than 25 years of age attending higher education or residential further education for the first time).

For individuals from Cohort 2 who are self-referring, health professionals should use the criteria listed below to verify eligibility and then facilitate vaccination:

• confirm the individual falls within the relevant age group by date of birth
• verify documentary evidence, including electronic confirmation, of an offer for the 2026 to 2027 academic year confirming the individual is due to attend higher education or residential further education (HERFE) for the first time

This should be an official email, letter or screenshot providing confirmation of their offer of a place at their chosen university or college from either the HE institution or the Universities and Colleges Admissions Service (UCAS). The relevant evidence should include the name of the university or college that they are due to attend, the course code or title of the course of study, and confirmation of the offer of a place (either conditional or unconditional).

A list of UK wide relevant universities and residential further education establishments is attached at Annex 2 as a guide, but this list is not absolute and subject to updates. Young people may be planning to study abroad, and so proof of an offer may be provided, which does not appear on this list. Consequently, health professionals should use their best judgement in deciding whether both the above criteria are met.

The vaccination programme will be delivered by local immunisation teams via designated health board vaccination clinics.

Health boards will be responsible for issuing invitations to all individuals (Cohort 1) born between 01/09/2007 and 31/08/2008 (17 to 18 years old) to attend for a first dose vaccination appointment, with second letters sent for those who did not attend. Health boards are also required to offer a walk-in service to deliver vaccination to the self-referring group (Cohort 2).

Two doses are necessary for protection. Appointments should be made for individuals to attend for their second dose. This must be administered a minimum of 28 days after the first dose and individuals should be reminded of the importance of returning for this second dose.

Vaccinators should also consider opportunities to review the vaccination record of eligible individuals and offer any outstanding vaccinations at the same appointment. Given the eligible cohort, outstanding vaccinations are likely to include missed vaccinations for Meningococcal ACWY (MenACWY), Tetanus, Diphtheria and Polio (Td/IPV), Human papillomavirus (HPV) and Measles, Mumps & Rubella (MMR).

When checking an individual’s vaccination status, where a record is not held in CYPrIS, health board staff can access past immunisation history within the Welsh GP Record via Welsh Immunisation System. Each time an immunisation history is accessed in this way, it is essential the following statement is recorded in the consent model box: “Vaccination History Check in line with WHC(2026)026”.

Meningococcal vaccines can be given at the same time as any other vaccines required but should be given at a different site, and preferably into a different limb. Please refer to the Meningococcal chapter of Immunisation Against Infectious Disease (the Green Book) for more information.

There is a need for a coordinated, equity-focused approach to vaccination, which addresses barriers and the diverse needs of underserved communities. Equity needs to be built into the design and delivery of the programme, particularly in terms of accessibility, to ensure vaccination clinics are within easy reach of those eligible. In addition, there should be tailored interventions to understand and overcome the specific barriers faced by the different population groups within the eligible cohorts. The evidence tells us that with the right interventions and investment in services, underserved communities will accept the offer of vaccination, which points to accessibility rather than acceptability being the key barrier to inclusion and uptake.

As this programme will run concurrently across the UK, there may be a requirement for second doses to be facilitated in Wales for students from other UK nations and internationally. Vaccinators should ensure they provide individuals with their record card to enable them to receive their second dose in other parts of the UK if needed.

Understandably, eligible individuals, their parents or guardians may have questions about the programme delivery in each health board area. Contact details are attached as Annex 1. All queries regarding the programme should be directed here.

It should be stressed that the delivery of this programme is via local health board vaccination teams and not through general practitioners or pharmacies. Therefore, if queries are mistakenly directed to GPs or pharmacies about the programme, I would be grateful to staff there for signposting individual queries to their local health board, through the contact details in Annex 1.

The programme will run from 20 July 2026, with most of the vaccination activity to be completed by September 2026, ensuring completion of the two-dose course prior to the start of the 2026 to 2027 academic year. 

First doses must continue to be available until 31 December 2026 and second doses available until 31 March 2027, enabling late attendees or international students who arrive in the UK after the summer months, to accept the offer of two doses.

4CMenB (Bexsero) vaccine should be used to vaccinate in line with the guidance within the Green Book chapter for Meningococcal. This vaccine product is used routinely in the infant schedule and is delivered in packs of 10. Providers will need to source their own needles. Vaccine supplies are available to order online via the ImmForm website and need to be placed on the regular ordering day for the included sites, as out of schedule deliveries will not be possible. Care should be taken to ensure orders are placed against the correct product code for the infant MenB vaccination programme, which is separate from the gonorrhoea vaccination programme, to ensure appropriate stock allocation and data collection.

Vaccine supply ordered through wholesalers or any other means other than Immform will not be reimbursed.

In line with other vaccination programmes, health boards are responsible for delivery of vaccination services and will need to assure themselves on the delivery and uptake of the vaccination programme. Health boards are expected to report their local delivery plans to Vaccination Programme Wales.

The ‘National enhanced service specification for non-routine immunisations for adults and children at risk’ sets out arrangements for the vaccination of adults and children outside of the routine national immunisation programme due to their increased risk of disease. Whilst there are no plans for GPs to be involved in the delivery of this programme, the specification will be updated to provide cover if the situation arises where GP practices need to give Meningococcal vaccines to eligible persons included in this time-limited vaccination outbreak response. GP practices administrating vaccination will be able claim for an item of service (IOS) payment at the current applicable rate per dose.

Funding will be reimbursed to health boards for vaccine supply and delivery costs associated with the programme. This will be included in the finance letters for health board finance directors, which are due to be issued shortly.

Clinical guidance is contained in the Meningococcal chapter of the Green Book. Further clinical information will also be available from the UKHSA document: Meningococcal B: vaccine information for healthcare professionals - GOV.UK, which is due to be updated to reflect this time-limited offer. A summary of this information can be found in Annex 3.

Healthcare practitioner information and guidance on this time limited meningococcal group B (MenB) vaccination programme, including a webinar and training slide set are being developed. Resources to support this programme will be available here:

• MenB vaccine information - Public Health Wales
• Brechlyn MenB ar gyfer pobl ifanc - Iechyd Cyhoeddus Cymru

Resources on protection against meningitis and sepsis will be available to order from:

• Health Information Resources - Public Health Wales
• Brechiadau i fyfyrwyr - Iechyd Cyhoeddus Cymru

A Vaccination Record Card is also available to order from the above links. These are recommended for individuals to track doses, particularly where vaccinations may be received across different countries.

Public information on meningitis and meningococcal disease, the MenB vaccine and information on vaccination for young people and students is available here: 

• MenB vaccine for young people - Public Health Wales
• Brechlyn MenB ar gyfer pobl ifanc - Iechyd Cyhoeddus Cymru
• Vaccination for students - Public Health Wales
• Brechiadau i fyfyrwyr - Iechyd Cyhoeddus Cymru

UKHSA has PGD templates available for MenB as a reference resource for health boards to develop and authorise for use locally. Templates can be found on the Welsh Medicines Advice Service's page for Patient Group Directions (PGD): Patient Group Directions (PGD) - Welsh Medicines Advice Service

Invitations for first dose vaccination appointment must be sent by health boards to all individuals born between 01/09/2007 and 31/08/2008 (17 to 18 years old). Public Health Wales will provide a template letter. 

The communications approach will need to be robust. Cohort 2 will not receive an invitation letter, and it is therefore vital they are aware of the need to contact their local health board by phone or via their website and not contact GPs or pharmacies. 

Public Health Wales will update their communication materials to create public awareness of this time limited vaccination offer amongst those eligible. Resources are being updated for healthcare professionals (see above) and public facing web content will be updated, targeted at the eligible groups and shared with relevant stakeholders to publicise. 

Vaccination activity will be recorded in the Welsh Immunisation System (WIS) and this information will write back to the Welsh GP record where the patient is registered in Wales. Public Health Wales will compile a report detailing how much vaccination activity has been undertaken during the time limited programme for the 17 to 18 year old cohort, which should be used to assist health board plans in the event of future MenB outbreaks. 

NHS oversight and assurance of vaccination programme planning and delivery is through Vaccination Programme Wales. The Vaccination Programme Wales team will work with health boards on implementing the programme outlined in this circular.

Any planning or operational queries should be directed to: VPW.Enquiries@wales.nhs.uk. 

For clinical queries or queries about programme resources, please email: phw.vaccines@wales.nhs.uk.

I would like to take this opportunity to thank everyone involved in the national vaccination programmes in Wales. The introduction of this time limited programme provides us with an opportunity to protect those at highest risk against infection and severity of illness from this serious disease. I am extremely grateful for the work and commitment shown in planning and delivering the programme.

Yours sincerely,

Dr Keith Reid

Deputy Chief Medical Officer (Public Health)

Welsh Health Board contacts

Aneurin Bevan University Health Board

Website: Home - Aneurin Bevan University Health Board (nhs.wales)
Telephone: 0300 303 1373
Email: ABB.vsbc@wales.nhs.uk

Betsi Cadwaladr University Health Board

Website: Home - Betsi Cadwaladr University Health Board (nhs.wales)
Phone number: 03000 840004
Email: bcu.info@wales.nhs.uk

Cardiff and Vale University Health Board

Website: Home - Cardiff and Vale University Health Board (nhs.wales)
Phone number: 02921 841234
Email:
immunisations.co-ordinators.cavuhb@wales.nhs.uk 
cvuhb.massimms@wales.nhs.uk 
news@wales.nhs.uk

Cwm Taf Morgannwg University Health Board

Website: Home - Cwm Taf Morgannwg University Health Board (nhs.wales)
Phone number: 01685 726464
Email: CTM_ImmunisationService@wales.nhs.uk

Hywel Dda University Health Board

Website: Home - Hywel Dda University Health Board (nhs.wales)
Phone number: 0300 303 8322
Email: ask.hdd@wales.nhs.uk

Powys Teaching Health Board

Website: Home - Powys Teaching Health Board (nhs.wales)
Phone number: 01874 442510
Email: Powys.immunisations@wales.nhs.uk

Swansea Bay University Health Board

Website: Home - Swansea Bay University Health Board (nhs.wales)
Phone number: 01792 200492.
Email: sbu.imms@wales.nhs.uk 

A list of higher education and residential further education establishments across
Wales is below.

List of Higher Education establishments in Wales:

• Aberystwyth University
• Bangor University
• Cardiff University
• Cardiff Metropolitan University
• Swansea University
• University of South Wales (Cardiff, Newport and Pontypridd)
• University of Wales Trinity Saint David (Lampeter, Swansea, and Carmarthen)
• Wrexham University

List of further education establishments with residential provision in Wales:

• Atlantic College (Vale of Glamorgan)
• Beechwood College (Vale of Glamorgan)
• Bevan College (Bridgend)
• Cambian Pengwern College (Rhuddlan, Denbighshire)
• Coleg Cambria (Llysfasi campus Wrexham)
• Coleg Elidyr (near Llandovery, Carmarthenshire)
• Coleg Plas Dwbl (Clynderwen, Pembrokeshire)
• Gower College (Swansea)
• Grŵp Llandrillo Menai (Glynllifon campus)

A list of relevant UK wide education institutions is being produced, and the latest version can be found here: Older children and young adult vaccinations | GOV.WALES

Recommendations for the administration of MenB vaccination

Administration

1. Bexsero® is administered intramuscularly into the deltoid muscle of the upper arm. Further information about immunisation procedures, including injection technique can be found in Chapter 4 of the Green Book.

Co-administration

2. Meningococcal vaccines can be given at the same time as any other vaccines required but should be given at a different site, and preferably into a different limb. Please refer to the Meningococcal chapter of Immunisation Against Infectious Disease (the Green Book) for more information.

Dosage

3. Bexsero® vaccine is supplied as a white opalescent liquid suspension (0.5mL) in a pre-filled syringe (10-dose pack) for injection. One dose (0.5mL) contains 50 micrograms each of NHBA, NadA and fHbp and 25 micrograms of OMV. Further information can be found in the Summary of Product Characteristics (SPC).

Contraindications

4. There are very few individuals who cannot receive meningococcal vaccine. The vaccines should not be given to those who have had:

• a confirmed anaphylactic reaction to a previous dose of the vaccine 
• a confirmed anaphylactic reaction to any component or residue from the manufacturing process

Please see chapter 22 of the Green Book and SPC for more information.

Vaccination of individuals with unknown or incomplete vaccination status

5. Vaccination courses delivered to young people as part of the Canterbury, Weymouth and Reading MenB responses, or as part of the gonorrhoea vaccination programme, may mean that some individuals present to clinics having already received at least one dose of MenB (Bexsero®) vaccination. It is also likely that a proportion of the eligible cohort will have taken up at least one dose via the private market and international students may have received a dose or course of vaccination outside of the UK.

6. Proof of receipt of prior vaccination will be assessed based on:

• relevant entries in the GP record
• presentation of a MenB vaccination record card
• presentation of a written or virtual (for example, app) record of dose(s) delivered via a private provider

7. The below summarises recommendations regarding administration of vaccination to individuals with incomplete vaccination status, depending on the number of prior doses received, and of which specific vaccine product. Further detail on the whether the course is considered complete with respect to dosing intervals is set out in the Information for Healthcare Practitioners document for MenB vaccination.

Bexsero®: 1 prior dose

If an individual has received 1 dose of Bexsero® (regardless of when it was given), they should receive 1 dose of Bexsero® now.

This dose should be given at least 28 days after the first dose to complete the 2-dose course.

Bexsero®: 2 doses within the last 5 years

If an individual has completed a 2-dose course of Bexsero® within the last 5 years, no further doses are required.

Bexsero®: 2 doses 5 or more years ago

If an individual has completed a 2-dose course of Bexsero® 5 or more years ago, they should receive 1 dose of Bexsero® now.

Trumenba®: partial course

If an individual has had a partial course of Trumenba® (1 dose, or 2 doses given less than 6 months apart), they can:

• complete the Trumenba® schedule (outside the national programme), or
• start a 2-dose course of Bexsero® now

Trumenba®: completed course 5 or more years ago

If an individual has completed a 2- or 3-dose course of Trumenba® 5 or more years ago, they should restart vaccination with a full 2-dose course of Bexsero®, starting now.

Trumenba® and Bexsero® vaccines are not interchangeable. An interval of at least 4 weeks between vaccines is advised.

Trumenba®: completed course within the last 5 years

If an individual has completed a 2 or 3 dose course of Trumenba® within the last 5 years, no further doses are required.

8. Where an eligible individual is uncertain about their vaccination history and is unable to produce any evidence of prior vaccination when they present, a 2 dose course of Bexsero® should commence rather than risk leaving them unprotected. In clinical trials, no increase in the incidence or severity of the adverse reactions to Bexsero® vaccination (commonly pain at the injection site, malaise and headache) was seen with the administration of further doses.

Inadvertent early administration of the second dose

9. The recommended schedule for Bexsero® vaccine is 2 doses, with the second dose given a minimum of 28 days after the first dose. Vaccinators should adhere to the recommended 28-day interval. If the second dose is inadvertently given from 21 days after the first dose, this will count as a valid dose. However, if the second dose is inadvertently given earlier than 21 days after the first dose, this dose should be discounted as this may lead to a reduced immune response. The dose should be repeated, ensuring an interval of at least 28 days from the dose that was inadvertently given early. Note: 21 days is off-label.

Consent

10. Guidance on informed consent can be found in chapter 2 of the Green Book.

Pregnancy and breastfeeding

11. Meningococcal vaccines may be given to pregnant women when clinically indicated. There is in addition no evidence of risk from vaccinating pregnant women or those who are breastfeeding.

Side effects

12. For Bexsero®, the most common local and systemic adverse reactions observed in adolescents and adults are pain at the injection site, malaise, and headache. Most symptoms resolve within 1 to 2 days but can also be managed with paracetamol where needed.