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Meningitis B Vaccine (Bexsero)

October 23, 2014

UPDATE: March 2017 - Bexsero® (Meningococcal B vaccine) is now in stock at Globe Medical. We hope to maintain a continuous supply for the next few months.

“I have heard a great deal about a new meningitis vaccine on the radio.  I believe it is available from chemists but it isn’t a routine childhood vaccine. If meningitis is such a nasty disease then surely this vaccine should be offered under the childhood immunisation schedule.   I’m very supportive of childhood immunisations but a bit confused over this issue. Can you provide me with more information?” Concerned mum

 

Dear “pro vaccination” mum,  it’s always pleasing to receive communications from families who re-inforce the message of childhood immunisations and the need to maintain our community “herd immunity”.  Vaccination advice can sometimes be a bit confusing.

We are very fortunate in Australia to have immunisation levels high enough to lock out unwanted viruses such as measles and polio. Our childhood immunisation program is up with the best in the world. It is done at a cost and for this reason every new vaccine has to undergo scrutiny on a cost benefit basis.  The new vaccine for meningitis – Bexsero – is currently being evaluated and this will take time. The same process is taking place in many other countries including the USA. In the USA it hasn’t received general approval for use as yet but can be used under certain circumstances. At least in Australia it has been approved for use,just not funded as part of our childhood immunisation program. This means that the vaccine is accessible to all but isn’t funded publicly. The vaccines for Hepatitis B, Chickenpox and Human Papilloma Virus (HPV) were all available to the public before being funded by the Commonwealth. Many families sought out these vaccines before they became publicly funded. This is the case for Bexsero currently.

A number of “meningitis” vaccines have been made available in Australia over the last few years.  These include the excellent conjugate vaccines for Meningitis ACYW, Menactra and Menveo.  We call these quadrivalent as they cover 4 important strains of meningitis.  In the childhood immunisation schedule we have 2 important “meningitis” vaccines – Meningitis C and Haemophilus Influenzae. Both are very important and very effective. The Haemophilus Influenzae vaccine has also almost eliminated the very serious epiglottitis – a cause of upper airway obstruction in early childhood. As a paediatrician in the 1980’s I had to resuscitate a number of children with life threatening Haemophilus disease. I would hope this is now relegated to the text books only.

Meningococcal disease is rare but aggressive. It evokes a great deal of public interest as it can kill quite quickly – within 24hours. There is a 10% mortality rate and many survivors have long term disability. Early diagnosis isn’t always easy as the symptoms are non-specific and the rash a late sign. Much GP education is focussed on early recognition and early treatment. All medical practices are advised to have a “meningitis treatment pack”. Treatment is instituted just on suspicion. It would be unusual to refer for investigation without treatment started.

Meningococcal B is the commonest type of meningitis in Australia.  Over 80% cases reported in Australia are caused by Meningitis B each year. In 2012 there were 161 cases.  Fewer cases were reported in 2013 and the number looks to be lower in 2014 as well. Peaks of the disease occur in those under 4 years and those aged between 15 and 24 years. We have an excellent surveillance programme for meningitis in Australia and new vaccines are always reviewed in line with surveillance.   The health budget is always under pressure and economists will be required to look at the cost benefit ratio for any new vaccine.

  • Meningitis B vaccine (Bexsero) is available to anyone wanting protection against Meningitis B.

  • A three dose course from 3 months of age and a booster at 11 months will provide long term immunity

  • Two doses at least 2 months apart are recommended for ages 11 months to 50 years. There is no data for those over 50 years

CDC has provided an excellent summary of the new Meningitis Vaccine at:

http://www.cdc.gov/meningococcal/outbreaks/vaccine-serogroupB.html

There is also a very interesting use of the vaccine during an outbreak:

http://www.cdc.gov/meningococcal/outbreaks/princeton.html

Australian surveillance information may be accessed at:

http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-annlrpt-menganrep.htm

Globe Medical is now stocking Bexsero, the Meningococcal B vaccine. For more information about getting vaccinated against Meningococcal B vaccine, you can contact Globe Medical here or speak to your GP.


Author

Dr Bob Kass

Dr Bob Kass is Medical Director of Globe Medical. He holds specialist qualifications in paediatrics and public health medicine and is one of Australia's pioneers in the discipline of Travel Medicine. 

Full professional biography