7 responses to “Meningococcal Serogroup B Vaccine”

  1. I would like a cost analysis based on the very low incidence of the disease – 0.33 per 100,000 vs. the cost of the vaccine ( $125 x 3?). The fact that most post secondary students at BC schools have coverage for 150 per year for any vaccines I am much less likely to promote this vaccine over the HPV vaccine. which also is very expensive. Would love to hear your thoughts.

  2. Good article. However, the comment that medical practitioners have a duty to advise patients about this vaccine is a bit over the top.

  3. Thank you for this interesting update, but the statement “Nevertheless, primary care providers have a duty to inform the public about this vaccine” seems a bit strong when balanced with the previous statement “We do not yet have data on effectiveness, NNV (number needed to vaccinate), impact on carriage, and duration of protection.”

    I think it is important to avoid words such as “duty” when the evidence is so tenuous.

  4. The article states that the vaccine is approved in Canada for ages 2-17, however you see it most frequently being given to university aged students, who would be mainly over 17. Immunize BC website indicates use up to 55 years of age. Is it approved for adults in Canada?

    As well, many children who are now in high school received Men C vaccine in grade 6, but are not eligible for a booster according to Immunize BC, even though CDC recommends a booster after 5 years in that age group. If they are going to university in eastern Canada, should they have the quadrivalent vaccine for better protection from A, C, Y and W, as well as the meningitis B vaccine?

  5. Thank you for your excellent points. I would like to respond with some further comments.
    The published resources on 4CMenB vaccine in Canada include the NACI recommendations and the BCCDC Immunization manual. There is not yet a Canadian Immunization Guide statement on this vaccine. The vaccine is approved in Canada for ages 2-17 based on manufacturer’s studies. The manufacturer does not list an adult schedule. However, clinical trials in ages 18-55 have shown this vaccine to be safe and immunogenic when used as a two dose schedule, 4 weeks or more apart.
    I agree that the wording “duty” to inform patients is a little strong. However, it is based on CMPA guidelines on the physician’s obligations to inform patients of new and unfunded vaccine products https://www.cmpa-acpm.ca/-/new-vaccines-what-are-your-obligations. There are similar statements in the PHAC documents on Immunization Practice in Canada. I also agree that it is impossible to do in an evidence- based manner, given that there are no published trials yet on efficacy and effectiveness of this vaccine!
    I do see it being given in conjunction with the MenACYW-135 as a booster for the MenC vaccine in students going to University. However, looking at the NACI data for incidence of MENB disease per 100,000 population for the years 2007-2011 in the university age group 20-24 years, the incidence in BC was 0.33, the incidence in Ontario was 0.29, and the highest incidences were in Que at 1.01, and New Brunswick at 0.43. During the same time period, the total of cases in Canada due to serogroups A,C, Y and W-135 was 0.19 per 100,000, or much lower than the total for MenB.
    It is, at this time, a personal and financial-based decision, as we do not yet have cost effectiveness data or NNV statistics for this vaccine for a very low incidence, yet potentially fatal illness.

  6. I agree that as this vaccine is not recommended by NACI for routine use, we are not legally mandated by CMPA to
    discuss this vaccine with patients/parents. Why is this not funded for at risk patients in BC ?

  7. Thanks Jane,
    I just checked the BCCDC Immunization Manual again and this vaccine is currently provided free to:

    “ Close contacts 2 months to 55 years of age of a case of serogroup B invasive meningococcal
    disease who meet the public health criteria for chemoprophylaxis.
     In consultation with BCCDC, individuals 2 months to 55 years of age at risk during IMD outbreaks caused by N. meningitidis serogroup B or the emergence of hyperendemic and/or hypervirulent N. meningitidis strains that are predicted to be susceptible to vaccine.”

    These situations are unique public health decisions and not routinely delivered by primary care providers.
    It would seem that high risk patients should receive this vaccine as they do quadrivalent Men vaccine. I would hope that this would be covered, on a case by case basis, for these rare patients on request from Public Health. Would like to hear if this is so.

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