“A vaccine that protects against a deadly form of meningitis is set to be introduced in the UK,” BBC News reports, while the Mail Online adds that a “New life-saving meningitis jab [will be available] for all children on NHS as Health Secretary announces policy U-turn.”
The widely covered story is based on the Department of Health’s expert advisers on vaccination and immunisation – the Joint Committee on Vaccination and Immunisation (JCVI) – has recommended that the meningitis B vaccine is added to the NHS childhood immunisation schedule for infants starting at two months of age. Bexsero provides a level of protection against the highly aggressive meningitis B bacterial infection, which, although rare, can cause permanent disability and sometimes death.
The JCVI says this is subject to the vaccine being made available by the manufacturer Novartis at a cost effective price. This means that further negotiations are still required before these recommendations become reality. The committee previously suggested in an interim statement for consultation last July that the vaccine would not be cost effective at any price, prompting protests from doctors, scientists and parents.
A catch-up programme for older infants and adolescents has not been recommended, however. This means that the Mail Online is premature in its reporting that “all” children will receive the vaccine as part of the NHS immunisation schedule.
The Department of Health says that the UK is on track to be the first country in the world to introduce a national meningitis B immunisation programme.
What is meningitis B?
Meningitis B is a highly aggressive strain of bacterial meningitis that infects the protective membranes surrounding the brain and spinal cord. It is very serious and should be treated as a medical emergency.
If the infection is left untreated, it can cause severe brain damage and infect the blood (septicaemia, also known as blood poisoning). In some cases bacterial meningitis can be fatal.
The charity Meningitis Now (formerly Meningitis UK) estimates that there are 1,870 cases of meningitis B each year in the UK. Meningitis B is most common in children under five years old, particularly in babies under the age of one.
What is the vaccine?
Bexsero Meningococcal Group B vaccine is manufactured by the pharmaceutical company Novartis Vaccines. It is licensed for use in the UK for the immunisation of individuals from two months of age and older to help protect against the disease caused by the Neisseria meningitides group B bacteria.
It is not a live vaccine. The vaccine works by stimulating the immune system (the body’s natural defence system), resulting in protection against the disease. It is given as an intramuscular injection, usually in the thigh or upper arm.
Bexsero is thought to provide 88% protection against meningitis B, which should significantly reduce the number of cases.
It is not recommended in people known to be allergic to the active substances or ingredients of the vaccine.
As with other vaccines, Bexsero should be postponed in people who have acute high temperatures, but the presence of minor infections such as colds should not lead to the vaccine being delayed.
Like all vaccines, this vaccine can cause side effects. Common side effects, affecting more than 1 in 10 people, include:
- redness of the skin at the injection site
- swelling and/or hardness of the skin at the injection site
- fever of 38°C or more
- loss of appetite
- tenderness or discomfort at the injection site
- skin rash (in children aged 12 to 23 months)
- feeling irritable
- unusual crying
The JCVI states that paracetamol given at the time or shortly after vaccination should reduce the likelihood or intensity of fever without lowering the immune response.
What recommendations have been made?
The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert committee that advises the Secretary of State for Health on vaccination and immunisation.
The JCVI has recommended that the meningitis B vaccine is introduced into schedule for children starting at two months of age with further doses at four and 12 months of age, subject to the Department of Health obtaining the vaccine from the manufacturer at a cost-effective price.
The JCVI has also suggested that when the new programme is introduced, babies aged 3 and 4 months, who would have missed the opportunity to have the vaccine at two months of age, should also be offered the vaccine. The JCVI has not recommended any “catch-up” programme or that the vaccine should be offered to adolescents. Further research is needed about the vaccine effectiveness in this age group.
The Department of Health says it is too early to provide information about when the programme will be introduced, as that will depending on obtaining a reliable supply of vaccine at a cost effective price from the manufacturer and ensuring that the NHS is able to provide the vaccine effectively. Last year, the NHS introduced three new vaccination programmes and another one was rescheduled. So it is important that the NHS is fully equipped to be able to deliver another new programme safely before introducing it.