Broken Hearts, Broken Promise

Broken Hearts, Broken Promise
  • The government has broken a promise to review unfair rules that restrict access to the MenB vaccine by delaying a key report by at least a year.
  • A report reviewing the lifetime value of vaccines was due in 2016 but it is now delayed until at least Autumn 2017. They have now said that the report will not be available for public scrutiny.
  • MRF estimates that 400 cases of MenB are likely to occur in children under 5 who are not eligible for the vaccine.
  • Meningococcal B (MenB) infection has for decades been the largest cause of life-threatening meningitis in the UK.

One year since the death of two-year-old Faye Burdett from MenB, and following the biggest ever public petition on health, the government has broken a promise to review unfair vaccine rules that deny access to the MenB vaccine for many preschool children.

A report reviewing the lifetime value of vaccines was due in 20161 but red tape means that it is now delayed.

Meningitis Research Foundation (MRF) highlights evidence showing that fairer rules would have meant wider access to the MenB vaccine.

Currently only babies get the vaccine but fairer rules could have enabled those under 5 to access it too. MRF estimates that there are likely to be 400 cases2 of MenB in the under 5s who are not eligible for the vaccine.

Unfair rules

MRF has long been calling for a reform of the rules that determine the lifetime value of vaccines. The current rules are unfair and put vaccines that prevent rare but severe illness in children at a disadvantage so that access to vaccines is limited.

The current rules undervalue the long term benefits of vaccines and do not take public preference into account.3

A working group called the Cost Effectiveness Methodology for Immunisation Policy and Procurement (CEMIPP) was set up to assess these rules for vaccines. MRF, as representative of four charities, fed into some CEMIPP discussions and a report was promised in 2016 but has never been published.

Report delay

The charity wants to see the report open to public consultation as soon as possible to help create fair rules. Government has now said that the report is delayed and a public consultation will not take place.

A letter from the Deputy Chief Medical Officer, Professor John M Watson, said: “Nicola Blackwood MP, the minister for public health and innovation, has referred the report to the Appraisal Alignment Working Group (AAWG) for advice… Due to the complexity of the issues to be considered and the need to take into account the views of key stakeholders and research that will not be available until next summer, the minister has asked for advice by autumn 2017.”

Vinny Smith, Chief Executive of MRF said, “Introducing the MenB vaccine for babies was a major step forward and we know it is already reducing cases in the under-ones. However, only about one quarter of all cases occur in this age group. Older children were denied access because of unfair rules and that equates to around 400 cases of MenB that there’s no protection against. We want this to change so it doesn't happen again. The government's report needs to be published urgently and it needs to be open to scrutiny so that fairer decisions on vaccines can be made as quickly as possible. This will preserve access to current vaccines and ensure the best access to new vaccines."

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Notes:

1. https://petition.parliament.uk/petitions/108072 Debate Summary. Accessed 8th February 2017. Written April 2016: “The Minister said that the Government would publish the report of this group when it is ready later this year.”

2. The figure represents the numbers of cases (not deaths) of MenB disease we would expect to see in children under the age of 5 and vaccine ineligible (over 5 months old) when the MenB vaccination programme began (in Sept 2015) until they reach 5 years of age. Cases are counted until the last of this vaccine ineligible group reach 5 (April 2020). Data is based on age related incidence of MenB for the epidemiological year 2014/15.

3. The rules are unfair because they undervalue the impact of severe illness in children and do not take into account public preference or the impact of the disease on carers. In addition, the long term benefits of vaccines are underestimated. An example: using the current rules, if a vaccine prevents the death of a baby who could have lived to 81, rather than assuming that 80 years of life are saved, it only accounts for around 28 years. This is short sighted and simply doesn’t account for the lifelong benefits of prevention through vaccines. Had fairer rules been used which better account for the long term benefit of vaccines, research shows that under 5s may have been granted access to the MenB vaccine back in 2015. (http://www.bmj.com/content/349/bmj.g5725)

The full response from Nicola Blackwood is available here.

MenB
MenB
Meningococcal B: The main cause of bacterial meningitis in the UK and Ireland
Media contact
Elaine Devine - Director of Advocacy, Communications & Support
Tel: 0333 405 6248