MRF highlights concerns around vaccine changes

The Joint Committee on Vaccination and Immunisation (JCVI), the UK government’s expert vaccine advisers, have recommended that the number of doses of pneumococcal vaccine given to babies should be reduced.

Meningitis Research Foundation (MRF) is calling for wider consultation on the decision which could risk increasing cases of meningitis, septicaemia and pneumonia in the UK.

UK babies are currently offered three separate injections of pneumococcal vaccine: two in infancy (at two and four months of age), with a booster dose at one year of age. This is known as a 2 + 1 schedule. It is now recommended that the schedule be reduced to one dose in infancy at three months of age with a booster at one year (known as a 1 + 1 schedule).

The pneumococcal vaccine protects against 13 strains of pneumococcal bacteria. A recent study found that, for 9 of the 13 strains, infants receiving two injections get an ‘equivalent or superior’ protective response after two doses compared to infants who received all three injections.

The JCVI aims to achieve the best possible protection through the smallest number of vaccines given at the most effective times. This approach has enabled early introduction of new vaccines with reduced schedules that may not otherwise have been considered affordable, and these vaccines have saved many lives.

MRF is calling for the JCVI to consult more widely on the recommendation so that concerns can be formally addressed.

Vinny Smith, Chief Executive of MRF said, “We appreciate that the evidence highlighted in the JCVI minutes suggests removing one dose of vaccine will not make significant changes to protection but we would like to understand how they reached this conclusion. Any change that increases the number of cases would be of real concern.

The JCVI have a code of practice which says they will collect evidence from stakeholders, but as a patient group representing thousands who have been affected by meningitis and septicaemia, and a stakeholder previously consulted by the JCVI, we have not been consulted this time.

While any move to simplify vaccine schedules for families is welcomed, protection must be maintained. We would like to see confirmation that mechanisms are in place to quickly respond to any resurgence in disease following the proposed change to the schedule. Crucially, we would also like clarity on when and how the vaccine would be re-introduced if cases increased. An open consultation would allow these concerns to be dealt with.”

The JCVI recommendations can be found here: https://app.box.com/s/iddfb4ppwkmtjusir2tc/file/247634612957

The JCVI report suggests that the pneumococcal vaccine has not only successfully reduced cases of disease due to the 13 strains covered by the vaccine, but that it has also dramatically reduced the circulation of these bacteria amongst the wider population. They believe this means the risk of exposure to the strains of disease covered by the vaccine has reduced so much that removing a vaccine dose in infancy would not result in a significant increase in cases.

MRF have written to the JCVI asking for open and transparent consultation on this recommendation in line with their code of practice on consulting about major changes to immunisation programmes which have implications for public health.

You can read our letter here.