27 June, 2016

New Meningococcal B vaccine – a long awaited arrival

There are few conditions that arouse alarm in a parent as greatly as meningococcal related meningitis and septicaemia. It immediately conjures up images of an extensive rash with fever, gangrenous limbs or rapid mortality within hours in an otherwise previously healthy child.

Meningococcal disease is rare but serious, and is most prevalent in childhood. Although Meningococcal disease can affect anyone at any age, it appears to be most prevalent in 2 peak age groups within our community: ie 0-5 years, and 15-19 years. Theories as to why these ages are most susceptible abound, but the reasons for the most part remain unclear. There are 13 serogroups (strains) of disease worldwide, with serogroups B and C accounting for most cases in Australia.

Prior to the release of the Meningococcal C vaccine, which was introduced onto the Australian childhood vaccination schedule in 2003 , news reports of yet another cluster outbreak of the fatal condition in random pockets around the country were becoming commonplace and occurring far too frequently. Since 2004, there has been a significant and sustained reduction in serogroup C meningococcal cases. Following the rollout of the vaccine, cases of meningococcal C decreased from 225 in 2002, to 9 cases in 2011.

Whilst meningococcal C vaccination , a long awaited addition to the childhood schedule, was considered a significant breakthrough and eagerly welcomed at the time, it was only partially reassuring, in that only half the battle was able to be fought. That is, we were only equipped with a weapon against the C strain, and had nothing to combat the B strain……until now.

On 15th August 2013, the Australian therapeutics goods administration (TGA) announced the approval of Bexsero (meningococcal B vaccine) which has been in distribution in Australia since March 2014, and available for use in individuals from 2 months of age and older. And there is good reason to vaccinate against the B strain. In recent years, serogroup B was the cause of approximately 85% of meningococcal disease with an annual average of 204 notified cases per year.

The number of and interval between vaccination doses varies depending upon the age the course is commenced, and can range from a minimum of 2 to a maximum of 4 doses. Unfortunately, it is not currently funded under the National Immunisation Program, therefore as a private vaccine, there is no government reimbursement. The vaccine is now widely available, and is permanently stocked in our practice. It can be administered any time in a well individual. Side effects can include fever, irritability, and redness or soreness at the injection site within 24 hours of administration of the vaccine. Children under 2 years of age are recommended to receive a dose of Panadol within 30 mins prior to receiving the vaccination, or as soon as is practicable following the dose, with a further 2 doses of Panadol 6 hourly thereafter, to reduce the risk of these side effects occurring.

Expense aside, there is little other downside to protecting your child against this rare but aggressive disease.