One of the key issues around the outbreak of bacterial meningitis centred in Kent is the fact that most of the UK people affected would not have been offered a vaccine for meningitis B – the pathogen responsible.
The race to vaccinate students and sixth formers in Canterbury now is a late attempt to remedy that and offer protection to those most likely to have been exposed to the bacteria.
‘The UKHSA have reported the current outbreak in Kent is meningococcal B, so Neisseria meningitidis bacteria of the B type which is the most dangerous of the NM types, but disease can also be caused by other types including ACWY,’ explains Professor Andrew Preston, a professor of microbial pathogenicity at University of Bath.
However, although MenB is the most common cause of bacterial meningitis in the UK, the NHS only offers babies and those with specific underlying medical conditions the MenB vaccine. And only from 2015, meaning that most students were not included.
‘These bacteria inhabit the nasopharynx and in the vast majority of cases colonise that niche without causing any issues,’ explained Professor Preston. ‘In a very small number of cases, the bacteria can gain access to the blood, where the pathogenic Neisseria meningitidis can survive and multiply. This is sepsis, another devastating disease.
From there, bacteria can cross the blood brain barrier to access the Central nervous system, leading to meningitis.’
‘Vaccination is hugely important to protect against meningitis,’ says Dr Michael Head, Senior Research Fellow in Global Health, Faculty of Medicine at the University of Southampton. ‘The vaccine developments in the last decade or so have broadened and improved the protection, such that outbreaks like these are relatively rare in the UK.
‘We are calling on the government, NHS and industry to look again at how effective these vaccines are and how to make them more widely available at a fair price.’
Dr Helen Campbell, Lead Scientist at UKHSA, said: ‘The fight against meningococcal meningitis and septicaemia continues with MenB still causing most of the cases last year. That’s why it’s crucial parents remain alert to symptoms and ensure their children are protected with the infant MenB vaccinations.
Teenagers should get their MenACWY in school when offered. All teenagers remain eligible for the MenACWY jab until their 25th birthday. If they have missed out, it is vital they get vaccinated, particularly if they are going to university or colleges where their risk of this often-devastating disease is much higher. For students especially, it’s vital they know the key symptoms and keep a close watch on any friends who suddenly get sick and, if concerned, seek medical help immediately.’
‘MenB vaccine offers protection against meningococcal group B bacteria and is administered to babies, as of July last year at 8 and 12 weeks with a 1 year booster,’ explains Professor Preston.
However, although MenB is the most common cause of bacterial meningitis in the UK, the NHS only offers babies and those with specific underlying medical conditions the MenB vaccine.
As many of the cases among adolescents tended to be due to the other types, an ACWY vaccination is given to years 9 or 10 (13-14 years old). The MenACWY vaccine offers protection against 4 types of bacteria that can cause meningitis: meningococcal groups A, C, W and Y.
The vaccine is offered to teenagers aged 14 years old. It is also offered to people up to the age of 25 who have never had a vaccine containing MenC.
“The vaccines are highly effective at protecting against invasive disease. Unusually, they also reduce carriage as they generate immune responses that reach the nasopharynx, and cases decreased very significantly on implementation of the ACWY vaccine,’ says Professor Preston.
‘Uptake of the ACWY vaccine among adolescents is around 73%, so there are a lot of unvaccinated students given the size of the student cohort.
Meningitis B vaccinations are available to buy privately, but there are very limited supplies and many pharmacies cannot get stocks at all. The government has said that people should not buy these vaccines and those who need them will be offered them.
Private Meningitis B (MenB) vaccinations (Bexsero) are available in the UK for children over two and adults at select private clinics and pharmacies including Boots and Superdrug. The course typically requires two doses (usually one month apart) costing approximately £110–£155 per dose.
However, Meningitis Now is campaigning for the MenB booster vaccine to be made available to teenagers and young people through the NHS. As well as calling for a MenB booster programme to be available by 2030, the charity is calling for the booster jab to be available privately at a fair price.
The charity’s Chief Executive Dr Tom Nutt said, ‘Vaccines are the best way to prevent against meningitis. There is no plan B for MenB. We must vaccinate those most vulnerable to protect them – now.”
‘We are calling on the government, NHS and industry to look again at how effective these vaccines are and how to make them more widely available at a fair price.’
For older adults, who are worried about meningitis, the pneumococcal vaccine offers protection against serious infections caused by pneumococcal bacteria, including meningitis.
Babies are offered the pneumococcal vaccine as 2 separate injections at 16 weeks with a booster given at 1 year of age. A single dose is offered to adults aged 65 or over.
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