This is the fourth in a series of reports about actual consequences from not vaccinating against infectious diseases. The reports are all based on verifiable reports from health agencies and/or articles published in high impact peer-reviewed journals.
Bacterial meningitis is a usually severe inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities. For example, in the United States, about 4,100 cases of bacterial meningitis, including 500 deaths, occurred each year between 2003–2007.
There are several pathogens that can cause bacterial meningitis including Haemophilus influenzae (most often caused by type b, often called Hib), Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes, and Neisseria meningitides. Depending on the pathogen, bacterial meningitis is highly contagious, especially among groups that are in enclosed areas such as schools, college dormitories and other such situations. There are other types of meningitis, viral, fungal, parasitic and non-infectious, but they are significantly different than bacterial meningitis, about which is the focus of this article.
Short- and long-term mortality in children who have been diagnosed with bacterial meningitis is well understood. The infection can lead to brain damage, along with inflammation and subsequent seizures that cause neuronal necrosis, which puts survivors of childhood bacterial meningitis at risk for hearing loss, seizure disorders, motor deficits and cognitive impairment. Long-term learning disabilities, with implications on reduced educational achievement in later life is well understood.
In a recently published study, researchers determined that certain types of bacterial meningitis, specifically Hib and Streptococcus pneumoniae, were strongly associated with reduced educational achievement and lowered economic self-sufficiency. The study included 2784 Danish-born children diagnosed with all types of bacterial meningitis were compared to a similar cohort of over 11,000 children who never had meningitis. They calculated the educational achievement and economic status at age 35, which was long enough to include individuals who might complete education at a later age. To remove bias from the results, the researchers made sure the control group closely matched the meningitis diagnosed group in socio-economic status, age, and sex.
They found that about 11% fewer of the meningitis cohort completed high school, and about 8.9% fewer had completed a higher education (either vocational school or college/university) as compared to the control cohort. Of particular interest was that those who had contracted the Hib and pneumococcal types of meningitis had less economic self-sufficiency, and higher claims for disability pension payments.
The authors concluded that:
A diagnosis of meningococcal, pneumococcal, or H influenzae meningitis in childhood is associated with lower educational achievement and economic self-sufficiency in adult life. This association may apply particularly to pneumococcal and H influenzae meningitis, whereas for meningococcal meningitis the lower educational achievement may be family related. Our study suggests that children diagnosed as having pneumococcal or H influenzae meningitis may benefit from follow-up into adulthood to identify those who could potentially benefit from psychosocial support.
These statistically significant results tell us that even if a child survives meningitis, and does not get overt neurological damage, they are at risk to a lower level of educational achievement, and may not even become economically self-sufficient in later life.
We can prevent this disease, specifically the pneumococcal or H influenzae forms (which are more serious and were found to reduce educational achievement in the study), through vaccination. The CDC recommends the pneumococcal conjugate vaccine (PCV13) for all children younger than 59 months old and for adults with certain risk factors, such as immunocompromised conditions. The CDC also recommends that children 24 months or older who are at high risk of pneumococcal disease should also receive the pneumococcal polysaccharide vaccine (PPSV23). The CDC recommends the Hib vaccine for all children younger than 5 years old in the US, and it is usually given to infants starting at 2 months old. Although not implicated in reduced educational achievement and lowered economic status, the meningococcal form of meningitis is the most prevalent one, and can cause severe neurological damage and death. There is also a vaccine for the meningococcal form of the disease.
All three types of bacteria are highly contagious, transmitted by coughing, sneezing, or just touching one another, which makes them a huge problem in places with a lot of close contact like colleges and schools. And there aren’t any secret junk medicine preventions to catching the disease. It hits everyone equally.
So vaccines not only save lives, but they can increase the quality of life. Again, learning about the consequences of not vaccinating against a particular disease should be sufficient evidence to balance the risk of vaccinating (very small, and mostly, very minor) against the benefit of stopping a disease that has both short-term and long-term negative outcomes.
- Bedford H, de Louvois J, Halket S, Peckham C, Hurley R, Harvey D. Meningitis in infancy in England and Wales: follow up at age 5 years. BMJ. 2001 Sep 8;323(7312):533-6. PubMed PMID: 11546697; PubMed Central PMCID: PMC48156.
- de Louvois J, Halket S, Harvey D. Effect of meningitis in infancy on school-leaving examination results. Arch Dis Child. 2007 Nov;92(11):959-62. Epub 2007 Mar 22. PubMed PMID: 17379662; PubMed Central PMCID: PMC2083607.
- Roed C, Engsig FN, Omland LH, Skinhoj P, Obel N. Long-term mortality in children diagnosed with Haemophilus influenzae meningitis: a Danish nationwide cohort study. Pediatr Infect Dis J. 2011 Aug;30(8):e147-54. doi: 10.1097/INF.0b013e3182191a63. PubMed PMID: 21487329.
- Roed C, Omland LH, Skinhoj P, Rothman KJ, Sorensen HT, Obel N. Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis. JAMA. 2013 Apr 24;309(16):1714-21. doi: 10.1001/jama.2013.3792. PubMed PMID: 23613076.
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