GPs to administer meningitis B vaccinations following JCVI U-turn
GPs will administer meningitis B vaccinations free on the NHS after DH advisers reversed their previous assessment that the scheme would not be cost effective.
The Department of Health stated it would work to introduce the meningococcal B vaccine, Bexsero, into the primary childhood programme on the recommendation of the Joint Committee on Vaccination and Immunisation (JCVI).
In its February meeting minutes, the committee recommended the immunisation be scheduled at ‘2, 4 [and] 12 months of age’ – subject to the manufacturer, Novartis, making it available at a cost-effective price.
However, although GP leaders welcomed the move, they warned this could increase workloads.
Deputy chief medical officer Professor John Watson explained the Government will now work closely with Novartis to introduce the scheme – ‘making the UK the first country in the world to implement a nationwide [menB] vaccination programme.’
The Bexsero vaccine has been licensed in Europe since January 2013, but the JCVI did not recommend it for the NHS over concerns that the evidence base for its effectiveness wasn’t complete.
The Government has come under pressure to revaluate the vaccine’s merits after more than 200 leading researchers signed a petitioned saying the JCVI had underestimated the damage of the disease.
In July last year, the JCVI released its interim position on the vaccine, stating: ‘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 accepted threshold for cost effectiveness used in the UK and could not be recommended.’
However, after a six-month consultation they concluded the evidence needed to be reviewed informed by stakeholder comment and the latest evidence, eventually leading to the change in position.
The February minutes recommend: ‘A programme for use of the MenB vaccine with the NHS immunisation schedule at 2, 4, 12 months of age (2+1) in a carefully planned programme.’
‘Given the vaccine only demonstrated cost-effectiveness at a low price, plans for implementation should anticipate a sustainable and cost-effective programme.’
They also advise a one-off ‘catch-up programme’ be extended to immunise three and four month-olds with the vaccine when it is introduced.
Professor Watson said: ‘We will now be working closely with Novartis in the coming months and if negotiations are successful, we hope to work with the other UK health departments to introduce a vaccine to prevent MenB as quickly as possible.
‘This would make the UK the first country in the world to implement a nationwide vaccination programme.’
JCVI chairman, Professor Andrew Pollard said: ‘After very careful consideration, JCVI concluded that use of the new vaccine would reduce cases of meningococcal meningitis and septicaemia and lead to a reduction in deaths, limb amputations and brain injury caused by the disease.
‘Today the JCVI published its recommendation to the UK health departments that if the new vaccine can be purchased at a low price and is therefore cost effective for the NHS, it should be used in the routine immunisation programme for babies in the UK to prevent disease.’
GPC negotiator Dr Dean Marshall said: ‘The big concern is that this is an additional vaccine that’s being given to children at two, four and 12 months. From the point of view of the science behind it, the JCVI are the experts on that, but the concern for GPs will be it is additional workload.’
‘Some people assume it’s just adding another thing to the mixture. But giving a new vaccine to children involves quite a lot of discussion with the parents.’
RCGP chair Dr Maureen Baker said: ‘Worried parents and doctors will breathe a huge sigh of relief at today’s announcement. Meningitis and meningococcal infection is a dreadful disease and its consequences can be devastating.’
‘This vaccine has the potential to save thousands of lives, primarily children, and GPs will play a major role in promoting the new immunisation programme to parents and in ensuring a successful rollout.’
‘The College has been very vocal in the campaign to introduce the vaccine and we are pleased that our advice, together with other expert input, has been heeded.’