A dangerous strain of meningitis has caused outbreaks of the disease at Princeton University and the University of California at Santa Barbara, but health experts are leaving the decision of whether to take the vaccine or not to doctors, writes Sabrina Tavernise of The New York Times.
The CDC brought together a committee, the Advisory Committee on Immunization Practices (ACIP) made up of medical and public health experts, which voted 14 to 1 to recommend a limited use of the vaccine in adolescents and young adults ages 16 to 23.
A cautious approach was chosen because the vaccine is both costly and new, and also because the illness is rare. Some on the committee were also uncomfortable because not enough is known about the vaccine's safety.
"There are some red flags with safety for this vaccine," said Dr. Edward Belongia, the director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Foundation in Wisconsin.
The recommendation will take effect in the next few months and will function as a guideline for health practice in the US, as well as being the basis for the childhood immunization schedule, or what guides clinical practices. Until now, the vaccine was recommended only for people at high risk of being infected.
Many patients and family members, some of whom had lost children to the disease, testified in Atlanta at the offices of the CDC to advocate for broad usage of the vaccine. The decision to let doctors make the recommendations was at least an improvement over the current policy, those in attendance agreed.
Meningitis B is a bacterial infection that can be difficult to diagnose. It targets the linings of the spinal cord and brain. From 2009 to 2013, there were fewer than 300 cases a year and only five to 10 deaths a year, according to the CDC. In 2013 a new strain infected four students at the University of California, Santa Barbara and seven students at Princeton. The only vaccine available at that time was one approved in Europe and Australia, which the FDA allowed for use in these cases.
Now, two companies have been approved for manufacturing the vaccines. Bexsero is made by GlaxoSmithKline and Trumenba is made by Pfizer. Five strains have been found in the US, with Meningitis B being the most prevalent. The cost of the vaccines averages $400 for the two to three dose series.
A vaccine for the other types of meningococcal disease, A, C, W-135, and Y, has been available for children ages 11 and 12 by the CDC since 2005. Parents and advocates wanted the same approval for the new vaccine for serogroup B, or MemB, writes Sandee LaMotte for CNN.
"I know there are concerns about the cost of these vaccines, but I hope you're accounting for the costs of not vaccinating," said meningitis survivor Andy Marso, as he showed the committee his fingerless hands. "That first year after my initial infection, I racked up almost $2 million in medical bills. That would have bought a lot of vaccines, right?"
The recommendation is enough to get insurance companies to allow coverage for the new vaccines. Some colleges may even require freshmen to take the vaccine series.
Currently, the US sees only 50 to 60 cases of B-strain meningitis in teens and young adults annually. The disease is spread by coughing, sneezing, and kissing and, for the most part, occurs in previously healthy children and young adults, according to Mike Stobbe of Associated Press.
Those who survive the disease can have permanent disabilities such as hearing loss and brain damage, psychological disorders, and reduced IQ, reports Phoenix Business Journal's Angela Gonzales.
Lynn Bozof, president of the National Meningitis Association, said in a statement:
"[The] decision will help parents and health care professionals protect our children from all forms of meningitis by providing access to the vaccines. While we would have preferred a routine recommendation, the permissive recommendation, if accepted by CDC, will ensure these vaccines are covered by private and public insurance, including the VFC program, and medical practices will be more likely to stock and administer them."