Meningitis B Outbreak in Kent and Vaccine Coverage
Meningitis B, or MenB, is the bacterial strain responsible for the recent outbreak of meningitis cases among young people in Kent, according to experts. Although less common than viral meningitis, MenB is significantly more severe and can cause blood poisoning (sepsis) and brain complications, with some cases resulting in death.
Two fatalities have been reported in Canterbury, with additional students hospitalized. While babies in the UK have routinely received the MenB vaccine since 2015, older teenagers and university students have not been vaccinated because the vaccine was not available when they were born.
The UK government chose not to implement a catch-up vaccination campaign for teenagers, though some parents have opted to purchase the vaccine privately. Currently, teenagers are offered the MenACWY vaccine, which protects against meningococcal groups A, C, W, and Y, but not MenB.
Communication Issues Highlighted by Bereaved Parents
Helen and Lee Draper lost their daughter Meg to meningitis B last October while she was at university. They expressed that they would have willingly paid £220 to vaccinate her privately.
"Megan had called us on the Friday night to say she was feeling a bit lethargic and she didn't really want to go out that evening."
"That rang alarm bells with us because Megan always wanted to go out and socialise so that was the first point."
"She'd gone to bed, she'd woken up in the morning and she was nauseous and she had a rash on her stomach."
"She'd contacted me and then said I'm going back to sleep to try and sleep it off. She woke up at 3 o'clock in the afternoon, the rash had spread, she felt worse, her arms and legs were aching and she just felt really unwell, so we advised her to contact 111 to seek medical help."
Lee Draper emphasized the lack of clear communication regarding vaccine coverage.
"That's where I think the communication's been really, really poor over the years."
"We assumed that Megan had had a meningitis vaccination and to us, we sent her off to university thinking that. It was after we knew what strain she had, meningitis B, that she wasn't vaccinated against that and we had no idea that she didn't have protection against that."
Calls for a MenB Catch-Up Vaccination Campaign
Helen Whatley, former health minister and Conservative MP for Faversham and Mid Kent, urged the government to consider a catch-up MenB vaccination campaign targeting young people.
Meningitis can affect individuals of any age, but the highest risk groups are babies and young children under five, followed by teenagers and young adults aged 15 to 24.
Experts note that the decision to vaccinate teenagers against MenB is complex. While the vaccine effectively protects infants, its efficacy in young people is less robust.
Professor Sir Andrew Pollard, immunologist at Oxford University, explained:
"The B strain is more complicated because although we call it the B strain, it's actually a collection of a very large number of different strains, some of which are covered by the B vaccine and some aren't."
The MenB vaccine is designed to protect against as many strains as possible but does not cover all. Many individuals carry meningitis B bacteria harmlessly in their nose and throat without becoming ill, yet they can transmit the bacteria to others.
It is estimated that approximately one in four teenagers and young adults carry meningitis-causing bacteria in their throats. The MenB vaccine is not highly effective at preventing transmission, even when it matches the strain carried.
Additionally, the vaccine’s protection duration is limited, leading the Joint Committee on Vaccination and Immunisation (JCVI) to conclude that vaccinating teenagers against MenB is not cost-effective.
During an outbreak, the priority is to prevent further infections. Professor Pollard noted:
"The problem with vaccination is it doesn't protect you immediately and it takes some time after vaccination for the immune response to kick in."
He added that the current approach in Kent involves administering antibiotics to individuals, including healthy carriers, to reduce transmission.
Full vaccine protection typically requires a couple of weeks and may involve booster doses.
A small subset of teenagers and adults are recommended to receive the MenB vaccine on the NHS due to higher risk from certain health conditions, such as absence or dysfunction of the spleen, sickle cell anemia, coeliac disease, and immune disorders.
Private Purchase of MenB Vaccine
Some parents have sought the MenB vaccine privately for their teenagers, though it is costly. Pharmacies typically charge around £220 for the two-dose course.
The charity Meningitis Now advocates for the vaccine to be available at a fair price and has called for wider NHS provision to protect teenagers and young adults. However, no catch-up campaign currently exists for MenB, unlike other vaccines.
Other childhood vaccines help prevent different types of meningitis. The MenACWY vaccine protects against meningococcal groups A, C, W, and Y and is offered to 14-year-olds.
Individuals uncertain about their vaccination status are advised to consult their GP or review their personal vaccination record, commonly known as the red book, which is provided at birth.
The MenACWY vaccine is free for anyone who missed it at school up to their 25th birthday.
Dr Leyla Hannbeck of the Independent Pharmacies Association reported increased demand for private MenB vaccines in Kent following the outbreak, with some pharmacies experiencing stock shortages.
Risk to the Wider Population
Dr Gayatri Amirthalingam, deputy director of immunisation and vaccine-preventable diseases at the UK Health Security Agency (UKHSA), described the meningitis outbreak as "unusual" but stated there is no evidence of spread beyond Kent.
"I think it's important to stress that the cases have all been linked to a particular geographical area, in the Kent area."
"We have no evidence of any wider spread."
"So it's really important to reassure people across the country that there's no evidence of wider spread at the current time but it's important, in terms of vaccination, to make sure that your children are fully up to date with the vaccines that are available, and to be alert to the signs and symptoms of meningococcal disease."
Meningitis symptoms can develop suddenly and include lethargy, nausea, rash, aching limbs, and general unwellness. Students in Canterbury are advised to trust their instincts and seek medical help promptly without waiting for all symptoms or a rash to appear.
