Experts consider expanding meningitis vaccine eligibility after Kent outbreak | Meningitis

Experts are investigating the possibility of routinely vaccinating more people against meningitis B in response to the deadly outbreak in Kent.

The review by the Joint Committee on Vaccination and Immunization was announced after Health Secretary Wes Streeting asked it to “review eligibility for meningitis vaccines” for a wider range of people than are currently eligible.

Health officials in Kent, where there have been two deaths, said cases could spread outside the county as students return home for Easter. On Friday, Britain’s Health Security Agency said there were 18 confirmed cases and 11 more under investigation.

The Guardian understands that the JCVI has begun a review of the outbreak in Kent and is considering a wider review of eligibility for routine meningitis B vaccinations.

The JCVI, which is the government body responsible for advising the four countries on vaccination policy, has so far said that a catch-up campaign for young people born before 2015, when the MenB vaccine was introduced for infants, would not be cost-effective. Experts say the protection only lasts a few years and does not stop the transmission of the bacteria.

Kent County Council’s director of public health, Dr Anjan Ghosh, said that over the next month there were likely to be “sporadic” cases of meningitis elsewhere in the UK as students returned home for the Easter holidays.

While he “fully” expects the growth in cases to slow after a month, it has not yet been possible to say with certainty whether it has peaked.

At a briefing, Ghosh said there were three possible scenarios over the next four weeks because “that’s how long it’s going to take for this to really calm down.” In the first case, the epidemic remains contained in Kent.

In the second case, students returning home or leaving for the Easter holidays contract the disease. “They were incubating when they left, and then they become cases, and there are small sporadic outbreaks outside of Kent,” Ghosh said. But he stressed that such cases were “highly unlikely” to trigger a new outbreak.

The third, “worst case” scenario would result in the creation of another cluster outside of Kent. However, he said this was “highly unlikely”.

Earlier, the family of a teenager who died of the disease on March 15 described their “immeasurable loss”. Juliette Kenny’s father, Michael Kenny, said: “No family should have to experience this pain and tragedy”, adding that he wanted his daughter’s legacy to be one of “lasting change”. The family is now campaigning so that adolescents and young people have systematic access to the meningitis B vaccine.

Dr Michael Head, senior research fellow in global health at the University of Southampton, said one possible option for JCVI would be to add MenB to routine year 9 vaccines. He said: “It would certainly be helpful to have an updated review by the JCVI to understand the value of an adolescent booster rollout for MenB. We already have school-based vaccination, including for the MenACWY vaccine. If there is a policy review, this could be a more simplified approach to the addition of the MenB vaccine.”

But Professor Andy Pollard, director of the Oxford Vaccine Group at Oxford University, said he doubted the JCVI would recommend expanding MenB vaccination.

“There is certainly reason to reconsider broader use in adolescents, but it is unlikely that a different answer will be reached unless circumstances change (i.e. more cases or observations of broader benefits). There is a clear potential health benefit from a program and would likely avoid the relatively small number of cases that occur in this age group each year.

“However, JCVI is unable to make a positive recommendation as it is constrained by Treasury rules on profitability.”

The UKHSA said initial genetic analysis had shown that “the Bexsero vaccine currently offered in Kent should provide protection against the type of MenB present in this outbreak”.

It said: “The strain belongs to a group of bacteria known as group B meningococci, sequence type 485 belonging to the larger ST-41/44 clonal complex. Similar strains have been circulating in the UK for around five years, but detailed analysis of the outbreak pathogen is required.”

Experts stressed that there were sufficient supplies of vaccines, as queues for vaccines continued throughout Friday. NHS Kent and Medway said more than 4,500 people had already been vaccinated and 10,561 doses of antibiotics distributed.

Ed Waller, deputy chief executive and director of strategic commissioning at NHS Kent and Medway, said: “We have plenty of vaccine here in Kent. We will draw more from the national stock. And we will do everything we can over the weekend to put as much capacity into sites as possible and see as many cohorts as possible.”