MARK B. LEVIN, M.D.
JOHN M. COTTON, M.D.
TIMOTHY J. PATRICK-MILLER, M.D.
LOUIS J. TESORO, M.D.
HELEN M. ROSE, M.D.
THE PEDIATRIC GROUP, P.A.
66 Mt. Lucas Road, Princeton, N.J.
08540-2733 tel: (609) 924-4892, fax: (609) 921-9380
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INFORMATION REGARDING MENINGOCOCCAL DISEASE AND VACCINE - UPDATED
November 8, 1999
Based on a revised statement of policy from the
Centers for Disease Control and
Prevention and the Advisory Committee on Immunization Practices
to give information
to students and their parents about this disease, we wish to make
you aware of the
following:
The incidence of the disease in the general
population is about 1.4 per 100,000 (.0014%).
The incidence of the disease in one study at the
University of Maryland in 1998 was 1.8
per 100,000 (.0018%). Most (86%) of the cases at this university
occurred in freshmen
living in a dormitory (risk of disease 0.001548%). This
information has not been confirmed by studies at other times
elsewhere in this country. It is not known whether this data
represents valid generalizable information or is a statistical
blip. In 1997, a study in a University in England found an
association between acquisition of the germ (not disease
incidence) and sexual activity, smoking, visits to bars and
nightclubs and living in mixed gender living quarters. This is a
frightening disease that kills 10-13% of those who become
infected within hours (maximum risk of death for a first year
student at U of Maryland in 1998 0.0002%).
Information regarding the vaccine includes:
-meningococcal vaccine lacks 30-40% of the strains
of meningococcus that cause
disease in this country.
-the vaccine induces antibodies to the included strains in 85-95%
of
recipients, giving a maximum chance of 57-66% that a
college student might be
protected from a strain (s)he might encounter.
-There is currently no data to show that immunizing
a college population will
prevent “sporadic” cases. Immunization of military
personnel has reduced the
incidence of the disease in that population. Lifestyles of
military personnel may
differ from those of college freshmen.
-the vaccine induced antibodies last only 2-3 years.
-there have been no “outbreaks” (that is, 2 or more
cases of the same strain of this
germ) in colleges in this country in several decades.
-vaccination does not eliminate the carriage of the germ from the
nose of those
healthy individuals who are the source for others to get
infected.
-people with exposure to the germ need only get one dose of an
antibiotic called
Cipro® to prevent infection, whether or not they have
received the vaccine.
-recipients of the vaccine may feel a false sense of security and
not seek a dose of
Cipro® if they are exposed.
Adverse reactions to the vaccine include: local inflammation for
1-2 days (<5.3%),
headache (5.3%), malaise (2.6%), chills (1.7%), fever (3.5%).
Systemic allergic reactions
are rare (<1%). The vaccine is administered as one dose and
costs $115.
Many colleges have recommend (and some require)
that their students receive meningococcal vaccine in an
effort to prevent the sporadic case of meningococcal blood
infections and meningitis that
occur each year in this country. Many states, including New
Jersey and most of the northeastern states, have now
passed laws that require meningococcal vaccine for students
attending college in their state.
The vaccine is primarily intended for those
foreign travelers to high risk areas (e.g.,
northern Africa in the summer) where outbreaks occur with strains
that are in the
vaccine. We have meningococcal vaccine and will administer it
upon request to those
who would like to reduce their risk of acquiring this disease.
The expected benefit would
be a reduction in the chance of disease from the maximum of
0.0018% for a freshman at the
University of Maryland in 1998 to about 0.0006% and the risk of
death from 0.0002% to 0.000132%.
If any new information becomes available that
changes our opinion, you can be sure we
will notify our patient population immediately. A meningococcal
vaccine with longer duration
of immunity has now been marketed under the name of Menactra®. We hope this discussion helps
you in your
decision. If you have any further questions, please call to speak
to one of the physicians.
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