Immunize patients against meningococcal infections at least 2 weeks prior to starting ZILBRYSQ1

The Advisory Committee on Immunization Practices (ACIP) recommends patients with persistent complement component deficiency or patients receiving complement inhibitors, including ZILBRYSQ, follow the meningococcal vaccination schedule below.1

Complete or update both vaccines >2 weeks before starting ZILBRYSQ1

If ZILBRYSQ must be initiated immediately for a patient who is not up to date with both vaccines, administer as soon as possible and provide antibacterial drug prophylaxis.1*

Vaccination schedule.
Vaccination schedule.

Several antibiotics are available for the treatment of meningococcal disease, including ceftriaxone, cefotaxime, and, when the diagnosis is confirmed, penicillin.3

MenACWY-D (Menactra) was discontinued in 2022. For MenACWY vaccines, the same vaccine product is recommended, but not required, for all doses.3,4

MenB vaccines are not interchangeable; the same brand must be used for each dose of the primary series and all booster doses.2

If dose 2 was administered at least 6 months after dose 1, then dose 3 is not needed. If dose 3 is administered earlier than 4 months after dose 2, a fourth dose should be administered at least 4 months after dose 3.2

Complete or update meningococcal vaccination (for both serogroups A, C, W, and Y [MenACWY] and serogroup B [MenB]) at least 2 weeks prior to administering the first dose of ZILBRYSQ, according to current ACIP recommendations for meningococcal vaccinations in patients receiving a complement inhibitor.1

Revaccinate patients in accordance with ACIP recommendations considering the duration of ZILBRYSQ therapy. Note that ACIP recommends an administration schedule in patients receiving complement inhibitors that differs from the administration schedule in the vaccine Prescribing Information.1

The benefits and risks of antibiotic prophylaxis for prevention of meningococcal infections in patients receiving ZILBRYSQ have not been established.1

Please see the respective meningococcal vaccine Prescribing Information for complete details, including vaccine Warnings, Precautions, and Contraindications.

The optimal durations and drug regimens for prophylaxis and their efficacy have not been studied in unvaccinated or vaccinated patients receiving complement inhibitors, including ZILBRYSQ.


  1. ZILBRYSQ [Prescribing Information]. Smyrna, GA: UCB, Inc.
  2. Centers for Disease Control and Prevention. Updated April 27, 2023. Accessed May 9, 2023.
  3. Mbaeyi SA, Bozio CH, Duffy J, et al; Advisory Committee on Immunization Practices. Centers for Disease Control and Prevention; 2020. Accessed May 9, 2023.
  4. Transition from Menactra to MenQuadfi meningococcal conjugate. Connecticut Department of Public Health. Accessed November 1, 2023.