Vaccination against meningitis B: is it worth it?

Abstract

Background: The ‘holy grail’ for a vaccine is a product which is 100% effective in all groups at risk of the disease (including, for meningococcal disease, small infants); works for a long time; prevents carriage and not just disease; is very safe; and is cheap. Antigens should be constant across all groups (e.g., for meningococcus) and not mutate quickly to evade the vaccine antibodies (e.g., for influenza). In the real world, no vaccine will fully match up to these ideals but, the closer they come, the better.

Bexsero^® was recommended for approval by the European Medicines Agency in November 2012 and approved on 22 January 2013.

Now the vaccine is licensed, government health departments have to decide if they should fund this vaccine. There will be no shortage of voices advocating for them to do so.

Does the burden of disease justify the cost of vaccination? In population terms, the illness is not that common. Most patients are not ill for very long, and most of those who survive soon recover. Compared with the costs of many other conditions with a longer duration of illness, meningococcal disease does not cost the taxpayer very much from a financial viewpoint. The number of deaths (and therefore the value of preventing these deaths) is not very high.

Conclusions: In general, governments take a careful approach to vaccine introduction, introducing vaccines only after careful economic appraisal. During the current period of financial stringency, it will be a bold country that makes the first move.