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DH advisors reject meningitis B jab for infant vaccination schedule

Routine vaccination against meningitis B is ‘highly unlikely’ to be cost effective and has been rejected by Department of Health advisors in a preliminary judgement published today.

The Joint Committee on Vaccination and Immunisation (JCVI) ruled out the introduction of routine vaccination against meningitis B after it also found concerns about how it could be incorporated into existing infant immunisation schedules.

The only available meningococcal B (MenB) vaccine – marketed under the name Bexsero – was authorised for use by the European Medicines Agency in January this year and was shown in a large European study to be effective as part of the infant vaccine schedule.

But experts on the JCVI panel met last month and issued an interim report today that says the MenB vaccine could be effective against around three quarters of meningococcal strains present in the UK, but there is currently insufficient evidence that routine immunisation can provide indirect protection of the population against the disease.

An independent cost-effective analysis from the University of Bristol and London School of Hygiene and Tropical Medicine found that, although routine infant immunisation would directly prevent up to around a quarter of cases of meningitis in each vaccination birth cohort, and potentially more cases through catch-up campaigns, this is highly unlikely to be cost effective based on the current price of the vaccine.

Furthermore, giving MenB vaccine alongside other routine infant immunisations would significantly increase the rate of fever, which cannot be relieved with paracetamol because of ongoing concerns this reduces the immunogenicity of the other immunisations.

It concludes: ‘On the basis of the available evidence, routine infant or toddler immunisation using Bexsero is highly unlikely to be cost effective at any vaccine price based on the current threshold for cost-effectiveness in the UK and could not be recommended.’

Dr David Elliman, immunisation lead at the Royal College of Paediatrics and Child Health, said the decision would disappoint many people, but that there was not enough evidence on the safety and efficacy of the vaccine to support it.

Dr Elliman said: ‘No studies have been done to show, in practice, whether the vaccine protects against disease. It is true that the meningococcal C vaccine was introduced on the basis of similar evidence, however, this is a different sort of vaccine and so estimating whether protection results from it is not so straightforward.’

But campaign groups said the decision was ‘extremely disappointing’. Sue Davie, Chief Executive of the Meningitis Trust/Meningitis UK, said ‘We understand the committee’s concerns about impact and cost, but we believe this vaccine is safe and we know it will save lives.’

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