What is the difference between meningococcal C, ACWY, and B vaccines?

Meningococcal C protects against serogroup C only. ACWY protects against 4 serogroups (A, C, W, Y). Meningococcal B specifically protects against serogroup B. Together, ACWY + B provide the most complete protection against meningococcal disease.

Is the meningococcal B vaccine available through Brazil's public health system (SUS)?

No. Meningococcal B is only available at private clinics in Brazil. SUS provides meningococcal C (at 3, 5, and 12 months) and, since 2025, meningococcal ACWY for adolescents aged 11-12. The Brazilian Pediatric Society (SBP) recommends meningococcal B for all children.

At what age does a baby receive the meningitis vaccine in Brazil?

The schedule starts at 3 months (1st dose), with a 2nd dose at 5 months and a booster at 12 months. Meningococcal B follows its own schedule: 2 doses (3 and 5 months) plus a booster (12-15 months). Schedules may vary slightly depending on the specific vaccine used.

Do adolescents need a meningococcal vaccine booster?

Yes. The SBP recommends a meningococcal ACWY booster at 11-12 years, as immunity from childhood doses wanes over time. Adolescents are a risk group for meningococcal disease and can also transmit the bacteria to infants.

Does the meningitis vaccine cause many side effects?

Side effects are similar to other vaccines: local pain, redness, and mild fever. Meningococcal B may cause more fever than other vaccines. It is recommended to monitor temperature for the first 24 hours and use acetaminophen (paracetamol) if needed.

Meningitis Vaccine for Children: Types, Doses, and When to Vaccinate

Meningitis is one of the most feared diseases among parents — and for good reason. It can progress rapidly and cause severe complications. The good news is that highly effective vaccines exist against the main types of bacterial meningitis. In this guide, I explain the differences between meningococcal C, ACWY, and B vaccines, the recommended dose schedule, and when it is worth investing in private options. For the complete calendar, see our 2026 baby vaccination guide.

Understanding Meningococcal Disease

Meningococcal disease is caused by the bacterium Neisseria meningitidis and can manifest as meningitis (inflammation of the membranes surrounding the brain) or meningococcemia (bloodstream infection). It is a medical emergency that requires rapid diagnosis and treatment.

Why Is Meningitis So Dangerous?

• Rapid progression: Can progress from initial symptoms to a life-threatening condition within hours

• Mortality: Even with treatment, the case fatality rate is 10 to 20%

• Complications: Hearing loss, amputations, neurological damage, and developmental problems occur in 10 to 20% of survivors

• Most vulnerable groups: Infants going through key developmental stages, young children, and adolescents

At the first sign of high fever with skin rash, neck stiffness, or intense irritability, seek emergency care immediately.

Types of Meningococcal Vaccines

There are 5 main meningococcal serogroups: A, B, C, W, and Y. In Brazil, the most common are B, C, and W. The vaccines available are:

Meningococcal C (Conjugate)

Protection: Serogroup C only

Availability: Public (SUS) — free — and private clinics

SUS schedule: 1st dose at 3 months, 2nd dose at 5 months, booster at 12 months

Adolescent booster: SUS has offered meningococcal ACWY for adolescents aged 11-12 since 2025

My recommendation: The SUS meningococcal C vaccine is excellent and provides strong protection against serogroup C, historically the most prevalent in Brazil.

Meningococcal ACWY (Conjugate)

Protection: Serogroups A, C, W, and Y — 4x broader coverage

Availability: Private clinics (and SUS for adolescents)

Private schedule: 1st dose at 3 months, 2nd dose at 5 months, booster at 12 months — can replace SUS meningococcal C

Boosters: At 5-6 years and again at 11-12 years

Why consider ACWY? Serogroup W has been increasing in Brazil in recent years. ACWY provides broader protection with the same dose schedule. This vaccine is similar to MenACWY (Menactra/Menveo) used in the US.

Meningococcal B

Protection: Serogroup B — the most frequent in infants in Brazil

Availability: Private clinics only (not available through SUS)

Schedule: 2 doses (at 3 and 5 months) + booster (12 to 15 months)

Note: May cause more fever than other vaccines — see our guide on vaccine reactions

SBP recommendation: The Brazilian Pediatric Society recommends meningococcal B for all children, even though it is not available through SUS. In the US, MenB (Bexsero/Trumenba) is recommended for teens and college students.

Public (SUS) vs Private: Comparison

Feature	Public (SUS) — Free	Private — Paid
Serogroups covered	C only	ACWY + B (5 serogroups)
Baby (1st year)	MenC: 3, 5, 12 months	ACWY: 3, 5, 12 months + MenB: 3, 5, 12-15 months
School-age booster	Not available	ACWY at 5-6 years
Adolescent	ACWY: 11-12 years (since 2025)	ACWY: 11-12 years
Cost	Free	R$300-600 per dose (approx. US$55-110 in 2026)

Recommended Schedule (SBP)

3 Months

• Meningococcal ACWY — 1st dose (or MenC through SUS)
• Meningococcal B — 1st dose (private)

5 Months

• Meningococcal ACWY — 2nd dose (or MenC through SUS)
• Meningococcal B — 2nd dose (private)

12 to 15 Months

• Meningococcal ACWY — booster (or MenC through SUS)
• Meningococcal B — booster (private)

At this age, your child also receives several other vaccines. See the complete calendar.

5 to 6 Years

• Meningococcal ACWY — booster (private)

11 to 12 Years

• Meningococcal ACWY — booster (SUS or private)

Essential because adolescents are nasal carriers and can transmit the bacteria to infants.

What If My Child's Vaccines Are Behind?

If your child did not receive the doses at the ideal time, don't worry. The schedule can be done at any age with adjustments. The important thing is to start. See our complete guide on catch-up vaccination.

Late Start Schedule (after 6 months)

7 to 11 months: 2 doses of ACWY 2 months apart + booster after 12 months. MenB: same schedule.

12 to 23 months: 2 doses of ACWY 2 months apart. MenB: 2 doses + booster.

2 years or older: 1 dose of ACWY (+ booster at 11-12 years). MenB: 2 doses 2 months apart.

For Expat Families: Key Differences

Compared to the US (CDC): In the US, MenACWY is routinely given at 11-12 years with a booster at 16. MenB is recommended for teens 16-23 years. In Brazil, MenC/ACWY starts at 3 months, providing much earlier protection. If your child was vaccinated in the US, Dr. Paula will assess what additional doses are needed.

Compared to the UK (NHS):The UK includes MenB in its routine infant schedule (similar to Brazil's private recommendations) and MenACWY for teens. If coming from the UK, your child may already have MenB coverage.

Key point: Regardless of where your child was vaccinated before, Dr. Paula reviews all records during the first consultation and creates a plan that ensures complete protection under Brazilian guidelines.

Common Questions from Parents

"Is it worth paying for ACWY if SUS provides MenC for free?"

If financially possible, yes. ACWY protects against 4 serogroups including W, which has been increasing in Brazil. But if the choice is between vaccinating with SUS's MenC or not vaccinating at all, always vaccinate through SUS.

"Can ACWY and MenB be given on the same day?"

Yes. The SBP allows both ACWY and B on the same day. However, since MenB may cause more fever, some pediatricians prefer to give them on separate days for easier management of reactions. I discuss this with each family individually.

"My child started with MenC at SUS. Can we switch to ACWY?"

Yes. It is possible to start with MenC through SUS and complete the schedule with ACWY at a private clinic. ACWY already contains the C component, so the transition is safe and recommended when possible.

My Recommendation as a Pediatrician

Meningitis is one of the diseases that concerns me most as a pediatrician, precisely because of how quickly it can become life-threatening. Vaccination is the best — and only — effective form of prevention.

In my practice, I guide each family on the best schedule considering the child's age, vaccines already received, and financial situation. If the family can invest in private vaccines, I recommend ACWY + B for the most complete protection.

During routine checkups, I always review the vaccination calendar and adjust as needed. It is a fundamental part of pediatric follow-up care.