WHO recommends that countries with high (>10 cases/100 000 population/year) or intermediate endemic rates (2–10 cases/100 000 population/year) of invasive meningococcal disease and countries with frequent epidemics should introduce appropriate large scale meningococcal vaccination programmes. Conjugate vaccines are preferred over polysaccharide vaccines due to their potential for herd protection and their increased immunogenicity, particularly in children <2 years of age. Both conjugate and polysaccharide vaccines are efficacious and safe when used in pregnant women.