Meningitis outbreak in UK prompts call to widen vaccination
A patient advocacy group in the UK is calling for changes to the decade-old meningitis vaccination programme, after an outbreak in Kent that has killed two young people and left nearly a dozen others hospitalised.
The organism responsible for the outbreak has now been identified as a strain of meningitis B, one of the most common causes of meningitis in the UK, especially amongst under-fives and young people aged 15-24.
Vaccination with GSK's Bexsero has been available through the NHS for all infants since 2015, and protects against most MenB strains, which has led to a 75% reduction in infections.
That said, there is a sizeable population of children aged 11 or more and young adults who remain unvaccinated, unless their parents paid for the vaccine privately, typically at a cost of £200 or more for a full course.
Extending immunisation to older young people has not been deemed cost-effective by regulatory authorities, in part because it does not stop the infection from being transmitted but reduces the risk of severe symptoms.
In light of the outbreak, charity Meningitis NOW has launched a new campaign, No Plan B for MenB, to address what it says is "rising concern" about unvaccinated young people born before 2015.
It is calling for the vaccine to be given to all those at most risk of disease, the introduction of a MenB booster programme to protect adolescents from 2030, and jobs to be made available "on the high street at a fair price."
"We believe the MenB vaccine should be offered to teenagers and young people," said the organisation in a statement. "It is vital that we protect this at-risk age group. There is no other way to prevent MenB disease – we must vaccinate young people to protect them."
The UK Health Security Agency (UKHSA), which has responsibility for responding to infectious disease outbreaks, has been forced to defend the speed of its response to the cases, saying it started to receive notifications on Friday, 13th March.
Its investigations are focusing on people who attended a Club Chemistry educational programme in Canterbury from 5th to 7th March, with some commentators suggesting that alarm bells should have rung sooner. Preventative antibiotics are being made available to those who need them, said the agency.
Dr Gayatri Amirthalingam, the deputy director of immunisation and vaccine-preventable diseases at UKHSA, told the BBC this morning that she did not believe there had been any delay in the public health response.
"With these individuals, some of whom are extremely unwell in hospital, it can be difficult to try and ascertain detailed follow-up information, but that was done very rapidly over the weekend to be able to give that information out and identify the links within 24 hours," she added.
Dr David Elliman, honorary associate professor in child health at UCL GOSH Institute of Child Health, said that not all MenB strains are prevented by the vaccine, and protection does not last as long as the shots used for meningitis A, C, W and Y (MenACWY).
"All these factors mean that, although the vaccine has been very useful, the benefits from the MenB vaccine are perhaps less than those from the MenACWY vaccines, overall," he suggested.
"I am sure the situation is kept under review, but before introducing the vaccine more widely, one would have to consider whether it would have sufficient benefit to outweigh the resources needed – it is an expensive vaccine. The money may be best spent on finding an alternative vaccine."
