Why we vaccinate: to prevent meningococcal disease

Meningitis-baby-watch

Update of 24 September 2013 article to address outbreak at Princeton University.

Meningococcal disease usually refers to a group of diseases caused by the bacteria, Neisseria meningitidis, typically known as meningococcus. The most common illness arising from the bacterial infection is meningococcal meningitis (or just meningitis, even though there are non-bacterial forms meningitis, unrelated to this form). In meningococcal meningitis, the lining of the brain and spinal cord have become infected with these bacteria. These bacteria also have a causative role in other serious infections, such as bacteremia or septicemia, which are blood-borne infections.

Meningococcus bacteria are easily spread through the exchange of respiratory and throat secretions. The bacteria can pass quickly from one individual to another in close quarters, for example, schools and dormitories. Although the disease can be very serious, it can be treated with antibiotics that prevent the more severe forms of the illness and can reduce the spread of infection from person to person. 

If meningococcus isn’t treated quickly (or prevented by vaccines), the disease can be disabling or even fatal. And if the infection spreads to the blood, the consequences can be quite severe, requiring hospitalization. Meningococcal disease cannot be treated at home with over the counter or woo-based remedies. In fact, the symptoms of the early stages of the infection can mimic less dangerous infections, and require a physician’s diagnostic tools to rule out other less-serious infections.

The most important and effective method to prevent meningococcal meningitis is immunization with the meningococcal polysaccharide vaccine and meningococcal conjugate vaccine in the USA or the Multicomponent meningococcal serogroup B vaccine (4CMenB) vaccine, available in Europe and other countries. Please note that 4CMenB is not available in the USA at this time–the vaccine has been approved by European Union regulatory authorities, who have similar, and some cases more strict, policies than the US FDA. However, Novartis, the manufacturer of 4CMenB, has submitted documentation (huge pdf file) to the FDA’s Center for Biologics Evaluation and Research for review and approval.

A recent study found that a booster dose of the 4CMenB vaccine considerably improved children’s immune response against the disease. The 4CMenB vaccine contains four protein components that are found in B serogroup of meningococcal bacteria. Vaccines can elicit better immune responses, with fewer side effects, by using protein components that allow the adaptive immune system to quickly recognize the pathogen.

The study compared two small groups of three year old children. One group of 17 children had received the 4CMenB vaccine when they were 2, 4, 6 and 12 months old (as recommended). The other 40 children in the study had never received the 4CMenB vaccine. Then, the children who had already received the vaccine were given a fifth booster dose. Those who had never received 4CMenB the received a single dose (for a total of one dose).

The researchers then measured the antibody titer (a measurement of the number of antibodies against a particular antigen or pathogen circulating in the blood–the higher the number, the higher the level of immunity) against the meningococcal bacteria. The researchers found the following results:

  • At commencement of the study, 41-76% of the children who had already received the 4CMenB shots had high levels of titers against the four major protein components of meningitis B.
  • As expected, the level of antibody titer varied according to each of the four strains.
  • The control group, who had not received  the first four doses of 4CMenB vaccines before the “booster” shot, showed that they had about 63% had titers for one protein, 68% for another, 3% for the third strain, and 0% for the fourth strain.
  • After both groups received the 4CMenB shot, the children who had previously received 4CMenB shots had a bigger increase in their titers than the children who were getting the shot for the first time.

The authors of the study made two important conclusions. First, the immunity provided by the 4CMenB faded over time after the children received their initial four shots in infancy. This type of fading immunity has been observed in the other meningococcal vaccines, and frankly to other types of anti-bacterial vaccines such as whooping cough. And secondly, and more importantly, those who already received the shots in infancy responded with better immunity to the booster than those who never received the shot before.

The authors concluded that, “if 4CMenB were introduced into routine vaccination schedules, assessment of the need for a booster dose would require data on the impact of these declining titres on vaccine effectiveness.”

By the way, and I’ve made the point numerous times, this is how science works. Make an observation that there is waning immunity post-vaccination. Determine why. Then see if a booster helps. It does.

Because of an outbreak of meningitis at Princeton University, and as I mentioned previously college dormitories are perfect incubators for spread of the disease, university officials have obtained the 4CMenB vaccine to immunize students against the disease, hoping to stem the outbreak. Science based medicine rules at one of our great academic institutions, and they took the lead to obtain and use the most advanced vaccine to keep the disease from hurting their students. Science Rules! Of course, if you’re an anti-science, anti-vaccine, anti-evidence-based-medicine paid shill for the vaccine deniers, you’d rather choose to put college kids at risk to a deadly disease rather than immunize them at nearly zero risk. But that’s what happens if you lack science.

There is just no excuse that supports putting college kids at risk for meningitis. None.

If you need to search for scientific information and evidence about vaccines try the Science-based Vaccine Search Engine.

 

 

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The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!