Making a Serious Illness Even Rarer

Pneumococcal meningitis has high rate of death and disability but vaccine helps

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) One of the childhood vaccinations recommended by the CDC is the one for pneumococcal bacteria. This bacteria can cause some types of meningitis.

A recent study found that the rate of death and long-term disability from pneumococcal meningitis remains fairly high among children.

Pneumococcal meningitis is not common, and it became even less common after the introduction of the vaccine.

Yet more than half of the children in this study who became ill with the disease had not been vaccinated against it.

"Ask your doctor about the CDC recommended vaccines."

The study, led by Chris Stockmann, MSc, of the Division of Pediatric Infectious Diseases at University of Utah Health Sciences Center, looked at the effects of pneumococcal meningitis in children since the introduction of the vaccine.

Pneumococcal meningitis is a serious condition involving infection and inflammation in the fluid and tissue covering surrounding nerves, spinal cord and/or brain.

There is a vaccine that can often protect against this form of meningitis. It's called the 7-valent pneumococcal conjugate vaccine (PCV7), and it was introduced in the US in 2000.

The vaccine protects against seven types of bacteria that cause the disease, but it does not protect against all forms of the bacteria that cause it and does not protect against meningitis caused by viruses.

The researchers looked at all the cases of pneumococcal meningitis in Utah children between 1997 and 2010. They used medical records and only included illnesses that were confirmed by lab results.

The researchers identified 68 cases of pneumococcal meningitis among Utah children, and 13 percent of the children died.

Of the cases that occurred before the introduction of the vaccine, 64 percent were caused by the bacteria that the vaccine protects against.

Of the cases occurring after 2000, a quarter (25 percent) were caused by the bacteria that PCV7 protects against.

Among those who had pneumococcal meningitis after the introduction of the vaccine, 54 percent could have been immunized against it but were not.

The children who were affected by the disease both before and after the introduction of the vaccine were of similar age ranges.

Because this type of meningitis can be caused by multiple types of bacteria, some of the children's illnesses were caused by bacteria that the vaccine cannot protect against.

Among the children who died, the cause of their meningitis was split about evenly between the bacteria prevented by the vaccine and the bacteria not prevented by the vaccine.

Among the children who needed artificial ventilation (breathing by machine), a higher percentage had the bacterial strain that would have been prevented by the vaccine.

Among the children whose disease was caused by bacteria that the vaccine protects against, 68 percent required mechanical ventilation.

Among children whose disease was caused by bacteria not prevented by the vaccine, 34 percent required mechanical ventilation.

Meanwhile, among all the children who survived (from meningitis caused by any kind of bacteria), 63 percent had long-term neurological conditions caused by the disease, regardless of which bacterial strains they had.

The researchers concluded that the disease still has a high rate of death and long-term disability, regardless of what bacteria causes it.

However, improved immunization rates could help considerably, the authors noted.

"Tragically, more than one-half of the children who were eligible for PCV7 were unimmunized at the time that they developed pneumococcal meningitis," the authors wrote.

"Given the high rate of death and disability from pneumococcal meningitis, strategies to increase immunization rates and to address immunization hesitancy are urgently needed," they wrote.

Bridget Boyd, MD, a pediatrician and child safety expert at Loyola University Health System, told dailyRx News that the pneumococcal vaccine is a very important part of the childhood immunizations series.

"It prevents dangerous diseases such as meningitis and pneumonia but also protects against common diseases such as ear infections and sinus infections," Dr. Boyd said. "It is routinely given at 2 months, 4 months, 6 months and 15 months. Protect your child and follow the recommended immunization schedule to prevent this possibly disabling disease."

The study was published August 26 in the journal Pediatrics. The authors declared no conflicts of interest.

The research was funded by the National Institute of Allergy and Infectious Diseases, the Centers for Disease Control Prevention, the University of Utah, the Pediatric Clinical and Translational Research Scholars Program, the H.A. and Edna Benning Presidential Endowment and the Primary Children’s Medical Center Foundation.

Review Date: 
August 25, 2013
Last Updated:
August 30, 2013