Campus Alert Archive
Princeton

Princeton's Meningitis B Outbreak Forced the FDA to Authorize Bexsero a Year Early

NJdisease outbreakadvisorymedium confidence
Confirmed Threat

Between March 2013 and March 2014, nine cases of serogroup B meningococcal disease were associated with Princeton University. The eighth on-campus case was confirmed on November 21, 2013, prompting the FDA to authorize emergency importation of Bexsero, a MenB vaccine then licensed only in Europe and Australia. Princeton ran a mass vaccination campaign in December 2013 and February 2014, ultimately vaccinating 96% of undergraduates with both doses — the first MenB mass vaccination program in U.S. history.

Alerts
2
Response
—
Killed
1
Injured
8
Institution
Princeton University
Private R1 · NJ
~9,100 studentsPrinceton Emergency Management
Confirmed Timeline

Alert Sequence

2 messages in sequence

Some alert texts below are approximate reconstructions from news coverage, not confirmed verbatim transcripts. Reconstructed texts are shown in italic with a dashed border. Verified verbatim texts have a solid border and are marked accordingly.

INITIAL ALERTEmail
Approximate reconstructionReconstructed from Princeton Emergency Management archive and contemporaneous reporting1048 chars
Dear Members of the Princeton University Community: The University Health Services has been informed by the New Jersey Department of Health that three confirmed cases of meningococcal meningitis among Princeton students this spring constitute an outbreak cluster. The cases are caused by serogroup B, the most common cause of meningococcal disease in the United States. There is currently no vaccine licensed in the United States that protects against serogroup B. Close contacts of all confirmed cases have been identified and have been or are being treated with antibiotics as a preventive measure. We ask all members of the campus community to be aware of the symptoms of meningococcal disease, which can include sudden high fever, severe headache, stiff neck, sensitivity to light, nausea, vomiting, and a rash. Symptoms can develop rapidly. If you experience these symptoms, seek medical care immediately at University Health Services or the nearest emergency department, and tell the provider that there is a meningitis outbreak at Princeton.

This text has been reconstructed from news coverage and may not reflect the exact original wording.

Reconstructed from the Princeton Emergency Management meningitis page and contemporaneous coverage in The Daily Princetonian
The May 6, 2013 cluster declaration was the formal trigger for university-wide public health communication
At this point in the outbreak no MenB vaccine was licensed in the United States — a critical gap that would not be filled until Trumenba was approved in October 2014
UPDATEEmail
Approximate reconstructionReconstructed from Princeton announcements and CNN coverage of the FDA Bexsero authorization1038 chars
Important Update: An eighth case of meningococcal disease has been identified in a Princeton University student. The student is hospitalized and receiving treatment. The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have authorized the use at Princeton of Bexsero, a meningococcal serogroup B vaccine that is approved in Europe and Australia but is not yet licensed in the United States. The University, in cooperation with the New Jersey Department of Health and the CDC, plans to offer Bexsero to all undergraduate students, all graduate students living in dormitories or in University-owned housing of the Graduate College, and to other members of the campus community at increased risk for meningococcal disease. The first dose of the two-dose vaccine series will be offered in December 2013, with the second dose offered in February 2014. Vaccination is voluntary but strongly recommended. Information about the vaccination clinics will be communicated separately to eligible community members.

This text has been reconstructed from news coverage and may not reflect the exact original wording.

Reconstructed from Princeton's announcements and contemporaneous CNN/NPR/New York Times coverage of the FDA's emergency Bexsero authorization
This was the first time in U.S. history that a meningococcal B vaccine was offered through a mass campus vaccination campaign
Bexsero would not receive full FDA licensure until January 2015 — over a year after Princeton began administering it
Context

Background

The 2013-2014 Princeton meningitis outbreak is the foundational case in the modern history of U.S. campus meningococcal disease response — and in the regulatory history of the MenB vaccine. The first case was identified on March 25, 2013 in a Princeton student who had recently returned from spring break. Three additional cases by May 6, 2013 led the New Jersey Department of Health to declare a formal cluster. By November 2013, eight cases had been identified on campus, and a ninth — a fatal case at Drexel University — was linked to a Princeton student through close contact. At that time, no MenB vaccine was licensed in the United States. The FDA authorized emergency importation of Bexsero, then approved in Europe and Australia, in November 2013, and Princeton became the first U.S. university to conduct a MenB mass vaccination campaign. The first dose was offered in December 2013 and the second in February 2014. By November 2014, more than 98% of Princeton undergraduates had received at least one dose and 96% had received both. CDC declared in spring 2015 that Princeton's risk had returned to baseline. The outbreak directly prompted the FDA's accelerated approval of Trumenba in October 2014 and Bexsero in January 2015, making MenB vaccination available to all U.S. adolescents and college students. It also set the operational template later used by UC Santa Barbara, Oregon, Oregon State, Rutgers, and SDSU when their own MenB outbreaks emerged between 2013 and 2018. One Princeton student survivor required bilateral foot amputation, and the Drexel student fatality in March 2014 underscored that even an aggressively managed outbreak can cause irreversible harm.
Analysis

Key Findings

First U.S. university to conduct a MenB mass vaccination campaign, using Bexsero authorized through FDA emergency importation
9 confirmed cases (8 on-campus + 1 fatality at Drexel linked through contact with Princeton cases) over 12 months
98% of undergraduates received at least one dose; 96% received both doses by November 2014
Outbreak directly accelerated FDA approval of Trumenba (October 2014) and Bexsero (January 2015), creating the modern MenB vaccine market
Outcome
9 confirmed cases (8 on-campus, 1 fatality at Drexel University in a student who had contact with Princeton cases). One Princeton student survivor required bilateral foot amputation. Mass vaccination program reached 98% of undergraduates with at least one dose by November 2014.
Provenance

Sources

  1. Official
    Meningitis - Princeton Emergency Management
    emergency.princeton.edu
  2. Source
    2013 Princeton outbreak - Wikipedia
    en.wikipedia.org
  3. Source
    8th case of meningitis confirmed at Princeton - CNN
    cnn.com
  4. Official
    Meningococcal Update 2013-2014 - New Jersey Department of Health
    nj.gov
  5. Official
    Understanding the Impact of Meningococcal B Vaccination Among Princeton University Students - High Meadows Environmental Institute
    environment.princeton.edu
  6. Source
    University-Based Outbreaks of Meningococcal Disease Caused by Serogroup B - CDC EID
    wwwnc.cdc.gov
  7. Source
    'Worth The Pain': A Life Transformed Overnight By Meningitis - NPR
    npr.org
Tags
meningitismeningococcal-bdisease-outbreakpublic-healthvaccinationbexseroprincetonnew-jerseyfdafirst-of-its-kind
Added May 2026Updated May 2026Via ingestion