New meningitis B vaccine gets go-ahead
The announcement of a new meningitis vaccine has been widely reported in the papers, with the Daily Star claiming it could soon save thousands of lives in the UK. The Daily Mail predicts it will “soon be offered to all babies” to protect against “the deadliest form of meningitis”.
The newly-approved Bexsero vaccine protects against group B meningococcus, which is the most common cause of bacterial meningitis in the UK.
Meningitis is inflammation of the protective membranes around the brain and spinal cord. It can be caused by infection with various organisms, including bacteria, viruses and fungi. Bacterial meningitis is very serious and can be life threatening. The most common cause of bacterial meningitis in the UK is the meningococcal bacteria Neisseria meningitidis, of which the two widespread strains are meningitis B and C.
A vaccine against strain C has been available since 2000, resulting in a massive drop of cases. But until now there has not been a corresponding vaccine that works against strain B of the bacteria.
As most cases of bacterial meningitis in the UK are caused by group B meningococcus, the fact that an effective vaccine for meningitis B seems to be on its way is a great medical advancement.
Bacterial meningitis can be deadly and if blood poisoning (septicaemia) complications develop, it can kill as many as one in 10. Other long-term complications of bacterial meningitis can include hearing loss and brain damage.
The meningitis B vaccine has been given a ‘positive opinion’ by the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP). This means that it is recommended that the vaccine is granted a licence for immunising people from the age of two months.
Once licensed, the government’s vaccination advisers will make a decision about if and when the vaccine should be introduced into the childhood immunisation schedule.
Isn’t there already a vaccine for meningitis?
There are several vaccines that protect against bacterial meningitis. This includes the pneumococcal, meningitis C and Hib vaccines, which are given as part of the infant vaccination programme in the UK. The meningitis C (MenC) vaccine only protects against Neisseria meningitidis strain C, but no others.
There is another vaccine that protects more widely against the four meningococcal strains A, C, W135 and Y, but isn’t part of routine vaccinations as these strains are rarely found in the UK. However, this vaccine is recommended for pilgrims travelling to the religious festivals of Hajj and Umrah in Saudi Arabia.
So far, a vaccine for meningitis B (or meningococcal group B) has not been available. In Europe, group B meningitis is the most common cause of meningococcal disease, with 3,406-4,819 cases reported annually between 2003 and 2007.
Tell me more about the vaccine
The new vaccine was manufactured by the pharmaceutical company Novartis and is called Bexsero. According to the company, meningitis B posed “unique challenges” for vaccine development, partly because it belongs to a group of more than 3,000 different bacterial strains.
A genomics-based technique called reverse vaccinology has allowed researchers to develop the vaccine after 20 years of research. Novartis says the vaccine has the potential to cover the majority of meningitis B strains, and that trials involving almost 8,000 patients have shown it can help protect all age groups.
When will the vaccine be introduced?
It is currently unclear when the vaccine will be introduced in the UK. The CHMP’s recommendation has been sent to the European Commission, which is expected to grant the vaccine a licence.
The UK’s Joint Committee on Vaccination and Immunisation (JCVI) will then make a decision on whether – and when – the vaccine should be introduced into the childhood immunisation schedule in the UK.
The UK charity the Meningitis Trust has said that, if licensed, the vaccine needs to be introduced as quickly as possible.
Some of the newspapers predict that the vaccine will be available in the UK by the end of 2013, but this is speculation.
How will it be given?
The vaccine will be given by injection.
Are there any side effects / safety concerns?
The CHMP says that the most common side effects are:
- pain at the injection site
- muscle and joint pains
In most cases these side effects were short-lived.
Novartis says that when given alone, adverse events were comparable to those seen after other vaccinations. Fever was a frequent side effect in infants who were given Bexsero at the same time as other routine vaccines.
How can I recognise the signs of bacterial meningitis?
It’s important to be alert to the early signs of bacterial meningitis, which usually begin suddenly and get worse quickly. If you suspect a case of bacterial meningitis, you should call 999 immediately.
Early warning signs of meningitis can include fever (e.g. shivering), severe headache, neck stiffness, other pains in the muscles, joints and limbs, vomiting, and dislike of bright lights.
In babies and young children possible symptoms include becoming floppy and unresponsive or stiff with jerky movements, unusually cold hands and feet, shivering, pale or blotchy skin, blue lips, irritability and unusual crying, vomiting and refusing feeds, a staring expression, and extreme sleepiness.
A rash that doesn’t fade under pressure is a sign of blood poisoning and is a medical emergency.