‘Cost-effective anti meningitis B, even 1 case is too much’

by time news

“We know that meningococcal B infection has a rather low incidence, but it is a disease with truly frightening consequences. And the medical community and society send a clear message: even one case is too much.” With these words Paolo Bonanni, professor of Hygiene and Public Health at the University of Florence, introduces the data that photograph the impact of vaccination in reducing invasive disease in the most vulnerable age groups and in various contexts, presented during a symposium supported by GSK as part of the 39th annual meeting of the European Society for Pediatric Infectious Diseases (Espid).


An overview of the various immunization strategies with the 4-component Men B vaccine, in infants and adolescents, from Australia to Italy and other European countries, shows how “today we have strong evidence of the vaccine’s safety and efficacy profile, but also assessments on the cost-effectiveness of this vaccination, which show a favorable profile in all countries if all factors are taken into account, from the long-term sequelae of the disease to the impact on health costs and the repercussions on families, therefore considering the overall burden of the disease in the economic evaluations “, explains Bonanni.

In Italy, explains the expert, “vaccination with 4cMenB has shown a high coverage and efficacy. It was preferred to avoid administering it together with others, but this could change because in most regions we are switching to the 2 + 1 scheme. “. Bonanni brings the data of Tuscany and Veneto: in the first region the coverage in the cohorts of the years of birth 2014-2017 was 83.9% and the effectiveness was 93.6%. In Veneto the coverage in the 2015-2017 cohorts was 81.7% and the effectiveness of 91%. In both cases the figures are very high. But the benefit of earlier administration was also observed. Where earlier “, at a lower age,” there has been a higher relative reduction in cases, highlighting the importance of starting “with shield injections” before the age at which the disease is at peak (i.e. between 5 and 8 months) “.

From the experiences of the various countries, the importance of the role played by scientific societies and public opinion and patient associations also emerges. “In Gb for example – says Bonanni – the weight of their advocacy activity has led to a review of the recommendation on this vaccine. In Italy, where vaccination has begun to be offered free of charge, starting with children born after 1 January 2017, factors key were the increase in the incidence and awareness of people about the extent of this disease, and the inclusion in the vaccination calendar for life “.

‘Covid adds new challenges, important to ensure routine immunization programs’

“In this world dominated by Covid we have seen unexpected consequences that show us how essential it is to guarantee routine vaccination programs. We have seen reductions in the months of lockdowns and we cannot leave anyone behind – highlights Federico Martinón-Torres, from Hospital Clínico. Universitario de Santiago – If Sars-CoV-2 is a virus that has a basic reproductive index (R0) of 2-4, we must not forget that some of the microorganisms from which we are protected with routine vaccinations are even more dangerous in terms of transmission, and mortality in children “. The “additional challenges” that Covid can bring to the prevention of meningococcus and to the diagnosis and management of the disease should also be considered for the expert, since early symptoms can often be similar.

From South Australia, which in 2012-2016 had the highest notification rate of meningococcal disease in the country, data on meningococcal B vaccination also arrive in adolescents. Here the 4cMenB shield injection is indicated for active immunization from 2 months of age. The first infant and adolescent program was introduced in South Australia in October 2018 to provide direct protection to high-risk age groups, explains University of Adelaide researcher Helen Marshal: two years on, the data show an efficacy of “93.4% in newborns”. While “no cases were observed in vaccinated adolescents (100% efficacy)”. But the cross protection against gonorrhea was also evaluated: “Two years after the introduction of the vaccination program, preliminary data indicate an efficacy of the vaccine against gonorrhea in 15-20 year olds (29.2%)”. The vaccine is not currently indicated to prevent infections of this type. But studies continue, even on other fronts.

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