Meningitis is also one of the best headline-grabbing diseases. The new (January 2001) recommendation by the American Academy of Pediatrics to vaccinate all college students living in dorms with meningococcal vaccine will cause many parents to bring their soon-to-be graduates to the doctor because the disease rate is "almost five times greater in dorm students than in the general population." Meningococcus is one of many organisms which can cause meningitis.

If one reads the original research data, the actual numbers might seems a little less impressive: The meningococcal meningitis rate in the general population is 1/100,000 and in the dorms it is 4.6/100,000. Yes, that is nearly five times greater but a few important facts may be omitted from the newspaper stories. If we give all 500,000 shots we could prevent about 15 to 30 cases of meningitis each year according to official estimates. The number of deaths prevented would be one per year according to the lowest estimate and three/year according to the highest estimate. Actuaries at insurance companies have therefore calculated a cost of nearly two million dollars/year/case of meningitis prevented and about $10,000,000 spent to prevent each death. One third of meningococcal meningitis is caused by Group B type and this type is not covered by the vaccine.

Assuming that this vaccination is covered by insurance companies the cost to each individual family is not a large concern. A much bigger concern might be the possible adverse effects on the vaccine recipients. Most studies have shown a high rate of minor problems such as swelling at the injection site and very infrequent kidney problems have followed the vaccine with no proven causal relationship. An interesting note not included in most stories about this vaccine: Because the disease is so rare, there have been never been clinical trials showing that it actually works. The antibodies are measurable in the blood stream and efficacy is assumed and probable but has never been proven.

Interestingly, ped ID and immunologists who should know how delicate the immune system is and how little we really know about it, are the doctors promoting this vaccine the hardest.

If your child will be living in a dormitory, conventional medical wisdom and official medical recommendations favor giving this vaccine. My minority point of view is to avoid it.

01/2001