Meningitis outbreak sparks demand for vaccine action

The Joint Committee on Vaccination and Immunisation has said GPs should be “strongly encouraged and supported” to improve coverage among young people between 18 and 25. Their call came after 64 cases of meningococcal C infection in England between July 2017 and June this year, including 15 infants.

Almost all were hospitalised, Public Health England told HSJ.

Public health officials registered concern over a regional outbreak in the Yorkshire and Humberside area which saw nearly a third of the total cases, including eight children.

PHE has not said how many cases led to amputations or death. Data from the Office of National Statistics said there were 52 deaths between January and December 2017, though it is likely most of them were meningococcal B infections, which has for decades been the single largest cause of life-threatening meningitis in the UK, according to the Meningitis Research Foundation.

The number of cases across England is low compared with the hundreds of infections recorded each year in the late 1990s, before the national vaccination programme began, “but there has been a very gradual rise over the last few years,” according to the JCVI, which advises the government on immunisation programmes.

In a statement the JCVI said while most of the infections in England last year were in children under one and people over the age of 25, the response to the current spike in cases must focus on adolescents and young adults who are “known to be the main carriers of the meningococcal bacteria.”

Coverage of the vaccine programme administered to younger teenagers in school has been high, the JCVI said. However, coverage has been lower among school-leavers and people up to 25 years old.

“Optimum control of MenC disease can only be achieved if vaccine coverage in older adolescents and young adults is improved,” the committee said.

The committee “therefore believes that GPs should be strongly encouraged and supported to improve coverage in those aged 18 to less than 25 years who are eligible for vaccination.”

NHS England, which commissions GP services, told HSJ it did not need to comment and refused to say how it would follow the advice of the JCVI to encourage GPs to improve vaccination coverage.

It is not clear what caused the outbreak in Yorkshire and Humber. There is no clear variation in vaccine coverage for the 22 CCGs in the region and the rest of England. The JCVI believes it could be random, according to Dr Mike Gent, PHE’s deputy director of health protection in Yorkshire and the Humber.

Dr Gent said a review of all the cases had been carried out adding: “No specific genetic strains were found to be circulating solely in our region and no other common factors to explain the increased incidence in Yorkshire and the Humber was identified.”

He added that localised increases were common for meningococcal disease, in part due to the small number of cases involved, which allows chance to play a larger role in regional data.

PHE told HSJ it continued to monitor cases closely and routinely report them to JCVI. It added it would be using targeted communications towards the 18-25 year old age group through national media, social media, universities and student unions to encourage vaccine uptake.