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Adolescent preventive visit — USMLE Step 3 MCQ

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HardPediatricsAdolescent preventive visitUSMLE Step 3

A 22-year-old woman undergoes elective splenectomy and has never received meningococcal vaccines. Which long-term meningococcal strategy is appropriate while her risk persists?

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Correct answer: A — Give MenACWY at 0 and 8 weeks, then every 5 years; give MenB at 0, 1–2, and 6 months, then after 1 year and every 2–3 years

The best answer is “Give MenACWY at 0 and 8 weeks, then every 5 years; give MenB at 0, 1–2, and 6 months, then after 1 year and every 2–3 years”. Asplenia creates persistent risk from both ACWY and B serogroups. She needs the 2-dose MenACWY primary series with 5-year boosters and the 3-dose high-risk MenB series with a booster after 1 year and then every 2–3 years. Persistent anatomic asplenia requires a 2-dose MenACWY primary series 8 weeks apart with boosters every 5 years and a 3-dose MenB series at 0, 1–2, and 6 months with a booster 1 year later and every 2–3 years thereafter.

Reference: CDC: Meningococcal Vaccine Recommendations: https://www.cdc.gov/meningococcal/hcp/vaccine-recommendations/