Vaccine protects against serious meningococcal infection

An effective vaccine has been available for 20 years against meningococcal infection, but the vaccine is not routinely recommended by public health agencies and parents are often unaware of it. Vaccine is currently optional

A nationally prominent vaccine expert proposes that physicians and public health officials make a stronger effort to inform parents and patients about the vaccine and its potential benefits. He adds that health insurance companies should consider paying for such vaccines when parents and patients request them.

Given high health care costs and limited public resources, implementing mass vaccination against meningococcal disease may not be cost-effective public policy, but a parent's individual decision about the vaccine is a different issue, says Paul A. Offit, MD, chief of Infectious Diseases and director of the Vaccine Education Center at The Children's Hospital of Philadelphia. Dr Offit is the lead author of a commentary in the Dec. 11, 2003 issue of the New England Journal of Medicine.

"Although the meningococcal vaccine may be an inefficient use of public health resources, the decision to receive the vaccine could save lives and prevent the devastating effects of meningococcal infection," writes Dr Offit.

Invasive meningococcal infection strikes an estimated 2,200 to 3,000 US patients annually. Some 10 percent of those patients die, sometimes within hours of the first signs of illness, from meningitis (inflammation of the brain's lining) or sepsis (bloodstream infection). Survivors may suffer hearing loss, seizures, mental retardation or limb amputation.

The contagious disease is most likely to strike infants under the age of one -- for whom the current vaccine is, unfortunately, not effective. The infection may also affect older children and adults in close proximity to one another. Outbreaks that occur in college dormitories, schools and child-care centers may cause considerable anxiety in a community.

The meningococcal vaccine is routinely given to military recruits. The Centers for Disease Control and the American Academy of Pediatrics recommend that students entering college be informed of the risks of the disease and benefits of the vaccine.

However, neither agency routinely recommends that the vaccine be given, and not all health plans reimburse the cost (approximately $80). Thus, parents may face the decision of whether to pay out of pocket to vaccinate their child against a one in 125,000 chance of contracting meningococcal infection.

Many parents may not even be aware of the meningococcal vaccine, because it is not routinely recommended. The authors urge physicians to inform parents and patients about the vaccine during routine adolescent visits. They also recommend that physical examination forms required for school, camp and sports activities include information about the vaccine and that school nurses and parent-teacher organizations disseminate information through the schools.

The authors suggest that health maintenance organizations and health insurance companies consider paying for these vaccinations when parents or patients request them. "The meningococcal vaccine is safe and effective, and is the only currently available method to protect against invasive meningococcal disease," adds Dr Offit.