How well does the vaccine work?
A new study by Public Health England shows that infant vaccination against MenB has resulted in a significant decline in cases of the disease in young children since the programme was introduced.
The study shows that by the third year of the programme, cases of MenB disease were 62% lower in children who were eligible for at least 2 doses of the vaccine. Between 2015 and 2018, an estimated 277 out of an expected 446 cases were prevented because of the programme.
Read the full study here: Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England
Meningococcal clusters and outbreaks
Although most cases of meningococcal disease are sporadic, occurring infrequently or in isolated scenarios, outbreaks of the disease can occur within communities, such as in schools and universities.
In an outbreak, the vaccination used must be appropriate to the strain of infection spreading. Therefore, a different vaccine to the one offered within the UK immunisation schedule may be used.
For example, the MenB-fHbp vaccine (Trumenba) may be used if Bexsero, the vaccine usually used in the UK, is predicted not to be suitable. Trumenba is only available privately in the UK.
The patient information leaflet for Trumenba can be found here.
Policy decision around the cost-effectiveness of the MenB vaccine
In September 2015, the UK included the MenB vaccine in the routine immunisation schedule. This decision was made by the Joint Committee on Vaccination and Immunisation (JCVI) – the committee that advises the UK government on vaccines. Initially, the evidence available to them suggested that this vaccine would not be cost-effective, however after further analysis, the JCVI statement from 2014 suggests that the vaccine could be cost-effective if the vaccine could be supplied at a low cost. This led to the recommendation that this vaccine should be included within the UK schedule if it could be purchased at a low cost.
Read the 2014 JCVI statement here
Bexsero is approved for use in various countries, including Argentina, Australia, New Zealand, and Turkey, but the borderline cost-effectiveness of this vaccine means that it is yet to be introduced into some immunisation schedules internationally.
MenB vaccine to protect against gonorrhoea
The JCVI have recently suggested that the MenB vaccine should be used in a targeted programme to prevent gonorrhoea. Cases are currently at a record high in the UK and this recommendation should help to reduce this.
Meningococcal disease (Neisseria meningitidis) and gonorrhoea (Neisseria gonorrhoeae) are closely genetically related, with evidence showing that the MenB vaccine provides some cross-protection against gonorrhoea (between 32.7% to 42%).
This advice will now be considered by the Department of Health and Social Care before any policy decisions are made on any new routine immunisation programmes.
Read the JCVI statement here.