Gov't Panel to Decide on Meningitis Shots

Thursday, February 10th 2005, 12:46 pm

By: News On 6

ATLANTA (AP) _ A government advisory panel will decide whether to recommend for the first time that children be vaccinated for the bacteria responsible for most college outbreaks of meningitis. The idea has long been debated because of the high cost and low risk.

If the shots are recommended, the government will have to pay millions of dollars to provide the drug under the federal Vaccines for Children Program. Up to 4 million children who are uninsured or on Medicaid could get the shot under the program.

Children not in the program could get the shot from a pediatrician, but vaccination would not be mandatory.

A panel that advises the Centers for Disease Control and Prevention will meet Thursday in Atlanta where it will discuss whether to recommend the meningitis drug Menactra for the children's program.

Health officials are debating what's the best age for children to get the drug. Made by Sanofi Pasteur, the drug won government approval Jan. 14 for use for people ages 11 to 55. While officials generally agree that the new vaccine should be given to people before age 18, some are pushing for a recommendation that all 11-year-olds be vaccinated.

Infants in the United States are already are immunized with the drug Prevnar, which prevents them from acquiring meningitis through pneumococcal bacteria. Menactra prevents the spread of meningococcal bacteria, which causes the form of meningitis most commonly found in teenagers and young adults.

Meningococcal bacteria infects about 3,000 people each year, killing about 300. It can be spread through contact such as kissing, sharing kitchen utensils and sneezing. Studies have found that students who live in dormitories are at high risk. Among the millions of students who attend college, up to 150 cases are reported on campuses each year.

Those who don't die from the disease _ which infects the membranes around the brain and spinal cord _ often are left with severe complications, such as amputations or brain damage. Menactra replaces the drug Menomune, also made by Sanofi Pasteur, which has been around since the 1980s and has been used to immunize military recruits but never children.

School and health officials have been reluctant to recommend the vaccination of all students because it is expensive, and the disease is so rare.

Health officials say Menactra should be longer-lasting than its predecessor, which only provided up to five years of protection. In addition, the new drug is thought to be able to be able to curb the spread of the disease, something Menomune was not designed for, said Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn.

Although Sanofi Pasteur officials declined Wednesday to specify the price of the new vaccine, health experts have said it likely will approach $100 per dose.

While some question the vaccine's cost versus the low risk of getting meningitis, at least one panel member believes it's worth it.

``If this were a more minor illness, no, I couldn't justify it,'' said Dr. Gregory Poland of the Mayo Clinic in Rochester, Minn. ``But this is such a morbid disease, it causes such disruption. Every time there is a case, communities panic, it closes schools down.''

``I don't want that to happen to any child _ yet you have to be able to pay for it,'' he added.

Because of the disease's severity, parents like Lynn Bozof of Marietta, Ga., have been pushing the government to recommend the vaccine. Bozof founded the National Meningitis Association after her 20-year-old son Evan died of bacterial meningitis in 1998 when he was a student at Georgia Southwestern State University in Americus, Ga.

Hours after complaining of a headache, Evan Bozof was hospitalized. He died weeks later after suffering complications including damage to his brain, lungs and liver, and amputation of all of his limbs.

Had her family known about the vaccine, ``Evan would definitely have been immunized. He would be alive today,'' Lynn Bozof said.

Health officials say they must determine what age of children will benefit the most through vaccination.

While they believe the shot should be given to teenagers in the years leading up to college, doctors said they would could vaccinate more children if the recommended age was 11 _ a time when parents are still taking their children to the doctor for routine shots.

That's because during the late teen years many children don't see a doctor for immunizations. High school students are most likely to only get routine physical examinations and many of those are administered by sports physicians who aren't carrying vaccines or have access to a teen's vaccination records, Schaffner said.

``At the younger ages ... more children are coming in all the time for preadolescent visits, so you can build in immunization,'' said Schaffner, a liaison member of the CDC committee who represents the National Foundation for Infectious Diseases. ``We are trying to prevent the most cases as quickly as possible.''