subject: Meningitis Booster Is Recommended [print this page] Meningitis Booster Is Recommended Meningitis Booster Is Recommended
Meningitis Booster Is Recommended
Federal vaccine advisers, by a bare majority (6-5), on Wednesday recommended that 15-year-olds be given a booster dose of a vaccine against meningococcal meningitis, a rare but deadly disease that mostly strikes college freshmen.
The reason for the recommendation is that two popular vaccines against the disease do not seem to work as well as hoped. Instead of providing 10 years of protection, the vaccines may work only for five years or less.
That is not long enough to protect teenagers and young adults through the riskiest years because the vaccine is usually given at 11 or 12 years of age. The hope is that a booster dose at 15 would yield protection through the first few years of college, when outbreaks occur most often.
Members of the Advisory Committee on Immunization Practices debated whether to recommend that the first dose simply be delayed by three or four years or to add a second dose. The vaccine is about $100 a dose, and the disease is rare. So adding a second dose ensures that every death averted would be expensive. Federal officials estimated that the current strategy prevents nine deaths each year, which delaying the first dose would prevent 14 deaths and that adding a second dose would prevent 24 deaths.
Since the federal government pays for about half of all vaccines, the additional cost would be partly borne by taxpayers. The committee voted 6 to 5 to support a booster, but for the recommendation to take effect, the Department of Health and Human Services would need to endorse it, which generally happens but not always.
Dr. Janet Englund, a committee member from Seattle Children's Hospital, said that simply delaying the vaccine by three or four years would result in many teenagers failing to be vaccinated. A lower share of 15-year-olds is vaccinated compared with pre-teenagers, she noted. And with so many teenagers dropping out of high school, "by moving the age up, I very strongly fear we're going to be missing at-risk youths," she said.
But Dr. James Turner, a liaison representative to the committee from the American College Health Association, said that if the vaccines were truly so ineffective after five years, more meningitis cases would be popping up on college campuses. But a recent survey of 207 schools found just 11 cases, and fewer than half of those cases would have been prevented by vaccination, he said.
"If there is waning immunity, we're not seeing any emerging disease yet," he said. "So I don't know that there's a lot of urgency today in deciding on a booster."
Meningococcal meningitis is a horrifying disease. It strikes so quickly that often only a day passes between the first signs of illness and the death of the child. Lori Buher, a mother from Mount Vernon, Wash., told the committee about how her 6-foot-4, 14-year-old son, Carl, was playing football one day and was being airlifted, near death, to Seattle Children's Hospital the next. His heart stopped three times during the flight.
Carl survived but lost both legs below the knee, three fingers and the use of his knuckles. He suffered through 11skin graft operations. She advocated for a booster shot, she said, because vaccination at age 11 would have saved Carl from his illness. His illness struck in 2003, before the present vaccines were approved.
"I can't tell you what it would have meant if we'd been able to vaccinate him at 11," Ms. Buher said.
