Building a case for extending MenB vaccine
19 February 2016
We all want to see an end to tragic cases like the death of Faye Burdett.
The overwhelming support that the petition for extension of the MenB vaccine to other age groups has received following little Faye's death demonstrates how passionately people feel about preventing this devastating illness. We feel that passion as well.
All of us at MRF were deeply moved by the tragic loss of Faye and are so grateful to the bravery of Matt Dawson and his family for posting the pictures of young Sami in hospital. All of these things have done so much for raising awareness and the profile of this terrible disease
To see the end of meningitis in the UK we need the widest possible protection against all forms of the disease, including MenB. Men B has for decades been the leading cause of life-threatening meningitis in the UK. That may mean extending the current vaccination to other age groups. But we need more evidence in order to make a credible case to policy makers.
Babies under the age of 1 are at the highest risk of disease and are over 4 times more likely to contract this illness than any other age group. This is why all babies are offered the vaccine routinely on the NHS at 2, 4 and 12 months of age. Data from Public Health England www.gov.uk/government/uploads/system/uploads/attachment_data/file/498057/hpr3815_imd-crrctd.pdf
shows that in the latest year for which we have a full record (2014-5), there were 101 confirmed cases of MenB in children under one year of age in England and Wales.
In order to prevent those cases, all ~700,000 babies were offered 3 doses of MenB vaccine.
The data shows that there were 139 confirmed cases in children aged 1 to 4, so on average 139/4 =35 cases in 1 year olds, 35 cases in 2 year olds, 35 cases in 3 year olds and 35 cases in 4 year olds. In order to prevent those cases, the ~700,000 one year olds would need 3 doses of MenB and the ~2,100,000 children aged 2 to 4 would need two doses of MenB. This would be much more costly because there is no routine programme to deliver the vaccine to children in these age groups.
Of course it’s up to the government to find the money to do this: MRF does NOT
advocate restricting access to life-saving vaccines simply because it is costly. Vaccines are for saving lives, not for saving money.
However, we are acutely aware that within the existing framework for cost effectiveness analysis, MenB vaccine just barely made it into the immunisation schedule for children under age one.
It took years of campaigning, including presenting detailed arguments about the true cost of this devastating illness - MRF’s Counting the Cost campaign
– as well as the evidence we presented to the JCVI
(the government’s vaccine advisers) along with numerous letters written to medical journals to make the case, e.g. ‘Winter is coming
’ as well as our Where’s our Vaccine campaign, which so many of our members joined in with.
In order to make the case for widening access to the vaccine, we have to have evidence that the vaccine is working as it was supposed to work, and advocate a strategy for delivering it that will benefit the most people.
MenB vaccine was introduced based on laboratory evidence estimating that it would cover around 70-85% of circulating MenB strains. MRF-funded research was instrumental in establishing a laboratory ‘correlate of protection’ for MenB vaccines. Without that there would be no way to determine whether a MenB vaccine is likely to prevent cases or not, and without a lab test for this it would be impossible for a MenB vaccine even to get a licence. Because there are so few MenB cases an efficacy trial to demonstrate in advance that a MenB vaccine works would be impractically huge.
That’s why it’s so important that we look at the evidence from evaluating the UK’s MenB immunisation programme to see how well it is working.
The UK is the first country in the world to introduce the MenB vaccine as a national programme. Since the decision was made to introduce the vaccine, circulating strains have changed, so coverage may not be as high, or indeed it may be higher. The lab ‘correlate of protection’ may or may not represent the true picture.
This is why MRF is investing in research to find out if the vaccine works as well as we all hope it will, see www.meningitis.org/current-projects/determining-whether-menb-98763
, one of which was recently described in the Lancet
You can onate to support our research projects analysing the data from the current MenB vaccination programme
We also know how important it is to ensure that there is a level playing field in the cost effectiveness analysis framework.
MRF represents the meningitis and children’s liver disease charities on a government working group that is considering what the rules should be for cost effectiveness analysis.
We are working very hard to make sure that the rules don’t discriminate against vaccines. If you want to find out more about how this works, why not come along to MRF’s next research discovery day in Cambridge, which will give us all a chance to discuss and learn more about how the government decides whether to introduce new vaccines.Find out more about the current MenB vaccination programme in the UK
MRF promises to its members, and everyone that has been affected by this devastating disease to work with fervour and reason for a world free from meningitis.
Hi, I’m Sam and I’m MRF's PR Manager.
If you want to know more about this story call me on 0333 405 626251, out of office hours on 07875 498047 or email email@example.com