Trying to Stamp Out More Meningitis

Vaccine for another meningitis strain appears safe and effective with other shots

(RxWiki News) Another vaccine may be on the horizon to protect against additional forms of bacterial meningitis - and it appears to get along with other vaccines too.

A vaccine for serogroup B Neisseria meningitidis, the bacteria that causes one form of meningitis and can cause sepsis, performed well in a trial looking at the immune response it created and whether it created problems when giving with other shots.

"Vaccinate your child according to the CDC schedules."

Dr. Nicoletta Gossger of the University of Oxford in the U.K. and colleagues tested two possible schedules for administering the shot, called 4CMenB, both with and without other routine immunizations.

The trial enrolled 1,885 2-month-old babies in Europe from August 2008 to July 2010.

One group received 4CMenB at 2 months plus boosters at 4 and 6 months along with the five other standard shots given at those ages (Dtap, pneumococcal, hepatitis B, polio and Hib).

Another group received 4CMenB at the same two-month intervals from 2 to 6 months, but they received the other five vaccines at 3, 5 and 7 months.

A third group received 4CMenB with the routine vaccines at 2, 3 and 4 months, and a fourth group got the routine vaccines at 2, 3 and 4 months but without the 4CMenB shot.

In both groups who received 4CMenB at the same time as the other routine vaccinations, 99 percent of the babies had at least the minimum level of immunity that the researchers were using as a baseline for two strains of the disease.

For a third strain, 79 to 86 percent of the babies across the three groups receiving 4CMenB had the minimum level of immunity.

When the researchers tested the children's immunities from the routine vaccinations, they found the responses to be sufficient for all of them except one part of the pertussis and pneumococcal vaccines.

When 4CMenB was given by itself, 26 to 41 percent of the babies experienced a fever, compared to 23 to 36 percent getting a fever after just the routine vaccines.

Giving 4CMenB with other vaccines increased the number of babies who got a fever to 51 to 61 percent.

Only one child in the study experienced a seizure from high fever two days after getting the 4CMenB shot. No other significant adverse events were reported.

"In conclusion, 4CMenB was immunogenic, generally well tolerated, and showed minimal interference with routine vaccines in the first year of life," the authors wrote.

"The flexibility in schedule allows it to be incorporated into a range of country-specific immunization schedules and for primary immunization to be completed in early infancy," they concluded.

The authors said the vaccine "could potentially provide improved protection for infants against meningococcal disease beyond the protection provided by currently licensed vaccines."

However, an accompanying editorial published with this study in the February 8 issue of JAMA noted that the advantages of 4CMenB need to be weighed against the costs of adding vaccines to the infant schedule. These potential costs were not discussed in the trial study.

Dr. Amanda Cohn and Dr. Nancy Messonnier from the Centers for Disease Control and Prevention wrote in the editorial that 4CMenB may not create herd immunity as another meningococcal vaccine has done because it may not necessarily prevent people from carrying the bacteria in their nasal areas.

The study was funded by Novartis Vaccines and Diagnostics. Most of the authors disclosed compensation of some form from several vaccine manufacturers, including Novartis, Pfizer/Wyeth, GlaxoSmithKline, Crucell and Sanofi.

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Review Date: 
February 7, 2012