evidence: In a manufacturer-sponsored cohort study of approximately 49,000 vaccinated adolescents aged 11–21 years with a self-controlled case series analysis, a statistically significant increased risk for Bell’s palsy during the 84 days after vaccination was observed when MenACWY-CRM was administered simultaneously with other vaccines but not when MenACWY-CRM was administered alone (138). However, this finding was based on only eight patients, most of whom received simultaneous vaccine administration, and several were noted to have had conditions or infections that might precede Bell’s palsy. Thus, the importance of this finding remains uncertain. No other safety signals were observed among the other predefined events of interest in this evaluation (138). No increased risk for Bell’s palsy or any other new safety concerns were observed in smaller studies conducted in the same health system among children aged 2 months–10 years (140,149). [...] - Routine vaccination for adolescents aged 11 or 12 years, with a booster dose at age 16 years. [...] After vaccine supply became sufficient, ACIP recommended vaccination for all adolescents aged 11–18 years. FDA expanded licensure of MenACWY-D to children aged 2–10 years, and ACIP recommended routine vaccination of children in this age group at increased risk for meningococcal disease.