The problem is not just lack of vaccine provision, but also when they don’t get to the people who need them, even when the official policy is to provide them.
This isn’t just a resource-poor, developing economy, or African meningitis-belt issue either. Just ask the 60% of young people in the UK who were meant to be vaccinated against MenACWY in a catch up vaccination programme – but who slipped through the net.
Gaps in vaccine coverage will mean that effective diagnosis and treatment of meningitis are always essential parts of the health toolkit. And that of course means antibiotics.
But when antibiotics don’t treat meningitis any more two things happen for certain: more people die and more people live with life-long disabilities.
Antibiotics become less useful as more people use them badly. Using antibiotics for a virus is pointless. Not finishing a course of antibiotics means the bug can come back even stronger. Doing both - as frequently happens - is like training bacteria to get smarter and more deadly.
Meningitis Research Foundation considers this issue - known as antimicrobial resistance - to be a major emerging threat to the progress that has been seen in the past 20 years in the fight against this awful disease. It will affect people globally. And it will need a global change of direction towards more effective vaccination programmes and better use of antibiotics to deal with it.
1. The Review on Antimicrobial Resistance Chaired by Jim O'Neill. TACKLING DRUG-RESISTANT INFECTIONS GLOBALLY: FINAL REPORT AND RECOMMENDATIONS. 2016 [cited 2017 March]; Available from: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf.
2. Prasad, K. and N. Karlupia, Prevention of bacterial meningitis: an overview of Cochrane systematic reviews. Respir Med, 2007. 101(10): p. 2037-43.
3. Laxminarayan, R., et al., Access to effective antimicrobials: a worldwide challenge. Lancet, 2016. 387(10014): p. 168-75.
4. Hampton, L.M., et al., Prevention of antibiotic-nonsusceptible Streptococcus pneumoniae with conjugate vaccines. J Infect Dis, 2012. 205(3): p. 401-11.