Vaccination against meningitis B: is it worth it?

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Abstract

Background: The ‘holy grail’ for a vaccine is a product which is 100% effective in all groups at risk of the disease (including, for meningococcal disease, small infants); works for a long time; prevents carriage and not just disease; is very safe; and is cheap. Antigens should be constant across all groups (e.g., for meningococcus) and not mutate quickly to evade the vaccine antibodies (e.g., for influenza). In the real world, no vaccine will fully match up to these ideals but, the closer they come, the better.

Bexsero® was recommended for approval by the European Medicines Agency in November 2012 and approved on 22 January 2013.

Now the vaccine is licensed, government health departments have to decide if they should fund this vaccine. There will be no shortage of voices advocating for them to do so.

Does the burden of disease justify the cost of vaccination? In population terms, the illness is not that common. Most patients are not ill for very long, and most of those who survive soon recover. Compared with the costs of many other conditions with a longer duration of illness, meningococcal disease does not cost the taxpayer very much from a financial viewpoint. The number of deaths (and therefore the value of preventing these deaths) is not very high.

Conclusions: In general, governments take a careful approach to vaccine introduction, introducing vaccines only after careful economic appraisal. During the current period of financial stringency, it will be a bold country that makes the first move.

Keywords: health protection, meningitis B, meningococcal disease, meningococcal group-C conjugate vaccine

Citation: English P. Vaccination against meningitis B: is it worth it? Drugs in Context 2013;212246. doi: 10.7573/dic.212246

Provenance: Invited; externally peer reviewed

DatesSubmitted: 2 January 2013; Accepted subject to peer review: 3 January 2013; Publication: 24 January 2013

Copyright: © 2013 English P. This is an open-access article distributed under the terms of the Creative Commons Attribution License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No other uses without permission.

Correct attribution: Copyright © 2013 English P. http://dx.doi.org/10.7573/dic.212246. Published by Drugs in Context under Creative Commons Attribution License Deed CC BY 3.0.

Correspondence: c/o South West London Health Protection Unit, Building 15, Springfield Hospital, 61 Glenburnie Road, London, SW17 7DJ, UK

Emailpetermbenglish@gmail.com

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