Protecting Students Against Meningococcal B

Health Experts Call for More to Be Done to Protect Students Against Meningococcal B

Health experts are calling for secondary schools to take a greater role in preventing the spread of meningococcal B with new figures showing a rise in the number of confirmed cases this year.[1]

Meningococcal disease is an uncommon life-threatening bacterial infection causing two serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning).[2]

A new Institute of Environmental Science and Research (ESR) report shows there have already been 91 cases of meningococcal disease confirmed so far this year, a 42% increase for the same period last year.1

Students, young adults and those aged under 29 are disproportionately represented in the statistics making up 73% of all cases in 2019, along with Māori and Pasifika, representing 56% of the cases of the disease.1

Meningococcal B represents more than half (52%) of the confirmed cases that could be identified in 2019.1

Even with appropriate medical care, around one in every ten patients who contract the disease will die, and up to one in five survivors will have permanent disabilities; such as brain damage, amputated limbs and hearing loss.[3],[4],[5]

In New Zealand, meningococcal B can strike at any age but is most frequent in babies and children under five, followed by teenagers.4

While parents are encouraged to immunise infants, doctors say schools and parents of teens also need to be more vigilant in immunising against meningococcal disease.

Dr Graeme McCrory, GP for Lindisfarne College, recently vaccinated 165 boys in a two-day period and advises parents to vaccinate their children before they begin tertiary education.

“We are trying to ensure our students have the best possible protection before they head off to university and into hostels and flats where there isn’t mum or dad there looking out for them,” he says.

Dr McCrory says ideally physicians should offer the vaccine to students entering their first year of high school (Year 9) and not just those in Years 12 and 13 to ensure the best protection.

“I have offered it to all adolescents in my private practice and the concern is there is variable uptake simply because of the cost. I would like to see the vaccine subsidised so more children can be protected from this devastating disease,” he says.

Dr Karen Irwin, school physician for Iona and Woodford House also vaccinated 60 girls over a two-day period.

Both she and Dr McCrory have offered students the meningococcal B vaccine and also the vaccine for the A, C, W and Y strains.

Due to its flu-like symptoms, meningococcal B can be difficult to diagnose but can progress quickly. Along with headaches, fever, and a sore neck, patients may also present with a rash.[6]

“It’s like an insurance policy, we insure our homes yet not many of them burn down, but when they do its catastrophic, it's a disaster, it's the same with meningitis”.

“The concern is that once the teens are independent and, in a hostel, or flat, and are out all night, that it's easy to miss someone looking like they are simply sleeping when in fact they could be unconscious in bed,” she says.

Dr Irwin says that she is aware there is an inequity in the ability for some families to provide the vaccine for their children and until it is funded there will continue to be some who will miss out.

There is also some confusion around the current immunisation schedule with many parents unaware that this is not covered, nor that there is a new vaccine available, she says.

A strain of the disease specific to New Zealand, resulted in a significant and prolonged meningococcal B epidemic between 1991 and 2007 resulting in 6128 cases and claiming 252 lives.[7] In response to the epidemic, a short-term nationwide vaccination programme using a tailor-made vaccine (MeNZB) was introduced from 2004-2008.[8]

Infants who were immunised during the last epidemic are no longer protected against meningococcal B. They are now going to be in the high risk teenage group and will need to be vaccinated again to ensure they are protected.8

Otago University Student Health nurse Melanie Philip says parents are encouraged to immunise their young adults before they enter residential colleges and prior to orientation week.

Last year, three students on campus were struck with the disease and Philip says there is potential for it to spread quickly with students living in close quarters and attending lectures together.

She said this year alone Student Health Services has administered 1290 doses of the Bexsero vaccine to help guard against meningococcal B, as well as over 400 doses of the meningococcal ACWY vaccine, but her preference would be to see that done before they arrive on campus.

“I’d love everyone to have the vaccine and I would like it to be on the schedule so that everyone has access to it, in the meantime we try and educate students and their families on how important it is to be vaccinated.

Director of the Meningitis Foundation Andrea Brady says protecting our loved ones from meningococcal disease by having them vaccinated is one thing that we as parents can do now. “The vaccine is not funded, but our children’s health and wellbeing is definitely worth the investment”.

“We encourage friends and family to be vigilant if someone gets sick - as every second counts. The symptoms can be similar to the flu and are often overlooked until it is too late. Meningococcal disease moves swiftly and can take a life within 24 hours”.

“To ensure all students have the opportunity to fulfill their potential, we would like to see the vaccines funded and available to everyone”.

The new vaccine, Bexsero which became available last year, includes the active component of the MeNZB vaccine, as well as three other antigenic components to help improve strain coverage.[9],[10]

Bexsero has recently been funded as part of a meningococcal B immunisation program for children and young people in South Australia and is funded on the National Immunisation Program for infants in the United Kingdom.[11],[12] Bexsero is not currently funded on the NZ National Immunisation Schedule but is available for private purchase through healthcare professionals.

Bexsero® (Multicomponent Meningococcal group B Vaccine) is for immunisation against invasive disease caused by N. meningitidis group B from 2 months of age or as per official recommendations. Bexsero is available as an unfunded prescription medicine – you will have to pay normal doctor’s visit fees and a prescription charge. A trained pharmacist can also administer Bexsero to a person aged 16 years and older. A 0.5 mL dose contains contains 50mcg of Neisseria meningitidis Group B Neisseria Heparin Binding Antigen fusion protein, 50mcg of Neisseria meningitidis Group B Neisseria Adhesin A protein, 50mcg of Neisseria meningitidis Group B Factor H Binding Protein fusion protein, 25 mcg of Outer membrane vesicles (OMV) from Neisseria meningitidis group B strain NZ98/254 measured as amount of total protein containing the PorA P1.4. Bexsero has risks and benefits. Use strictly as directed. Bexsero should not be administered if you or your child are hypersensitive to any component of this vaccine. Common side effects Infants & Toddlers: eating disorders, sleepiness, unusual crying, diarrhoea, vomiting, rash, fever (39.5°C), injection site reactions, irritability, arthralgia. Adolescents & Adults: headache, nausea, injection site reactions, malaise, myalagia, arthralgia. If you or your child have side effects, see your doctor, pharmacist, or health professional. Additional Consumer Medicine Information for Bexsero is available at www.medsafe.govt.nz. Ask your doctor if Bexsero is right for you or your child. Bexsero is a registered trade mark of the GlaxoSmithKline group of companies. Marketed by GlaxoSmithKline NZ Limited, Auckland. Adverse events involving GlaxoSmithKline products should be reported to GSK Medical Information on 0800 808 500. TAPS NA11337-PM-NZ-BEX-PRSR-19OC0002.

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