In the past year, two outbreaks of serogroup B meningococcal disease at Princeton University and University of California-Santa Barbara have led to the use of a vaccine that will prevent the spread of this bacterial strain, marking the first time the vaccine has been utilized in the United States. The recent revelation that the Princeton outbreak strain matches one found at Drexel University has created concerns that the initial outbreak strain still exists in the northeast. While the affected universities have responded with excellent public health campaigns, a more widespread response is needed to eliminate such a highly infectious and deadly disease.
Meningitis is the inflammation of membranes around the brain and spinal cord. It can cause fever, nausea, stiffness in the neck and may rapidly lead to death or debilitating injuries. Children under the age of 5 and college students living on campuses are the most vulnerable to all types of meningitis. Since it is often passed through close contact, most universities, including NYU, require meningitis vaccinations for all students. Unfortunately, the vaccines currently offered in the United States do not prevent serogroup B infections.
The meningitis B vaccine used at Princeton and UC Santa Barbara, called Bexsero, has been licensed in Europe since January 2013 and is also used in Canada and Australia. The Food and Drug Administration approved its use for those living on-campus at the two most recently affected universities under an Investigational New Drug application. Because the vaccine is still considered experimental within the United States, those outside of the approved groups cannot receive it. The company that makes the vaccine is likely to submit an application for approval to the FDA in the second quarter of 2014, but discussions within the administration have been ongoing since 2011.
The delay in licensing stems partly from the FDA’s high safety standards and concerns over the effectiveness of the vaccine. The vast majority of meningitis cases are not related to an outbreak, but instead are caused by sporadic infections. Meningitis can stem from a harmless bacteria that one in 10 people carry in their nose and throat. It is not known if Bexsero prevents people from carrying the bacteria, so this vaccine may not induce widespread herd immunity. However, the lack of vaccination has clearly had consequences for college students.
The United Kingdom has taken an admirable position on vaccination that will hopefully be duplicated around the globe. Last week, the Joint Committee on Vaccination and Immunisation reversed their previous view that meningitis B vaccination was not cost-effective. As a result, Bexsero will soon be included in the childhood vaccination regimen free of charge. Given the terrible consequences of this disease, all individuals at risk should receive this new, demonstrably safe vaccine.
Tess Woosley is a staff columnist. Scientific Society is published every Tuesday. Email her at [email protected].