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Kiwi Parents Unaware Of Child’s Meningococcal Vaccination Status - Research

Health experts say more needs to be done to raise awareness among Kiwi parents of the risks of meningococcal disease with new research showing many lack understanding of the need to vaccinate and are unaware of whether their children have been immunised against this disease[1]

The call comes as latest figures show a 16% increase in the number of reported cases of invasive meningococcal disease last year[2]. The data shows New Zealand infants under 1 year of age are among the most heavily impacted with an 82% rise recorded over this period[3].

Meningococcal disease is an uncommon but life-threatening bacterial infection causing two serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning)[4].

There are several different types or serogroups of meningococcal bacteria including groups A, B, C, W and Y, the most common in New Zealand being meningococcal group B with over 50 percent of cases caused by this strain in 2019[5],[6],[7].

In New Zealand meningococcal B can strike at any age, but is most frequent in babies and children under five, followed by teenagers[8],[9]. Maori and Pasifika infants under one year of age have higher meningococcal B rates compared to other populations in New Zealand8.

Even with appropriate medical care, around one in every ten patients who contract the disease will die, and up to one in five survivors will have permanent disabilities; such as brain damage, amputated limbs and hearing loss[10],[11],[12].

New research among Kiwi parents shows nine in ten (90%) understand the disease is serious, but awareness of their children’s vaccination status, and an understanding of the need to immunise against the different strains of meningococcal disease is much lower[13].

According to the study, meningococcal disease, along with whooping cough, is believed to be the most important disease to immunise children against and yet almost a third (30%) of parents have a child who has not been vaccinated against the disease14.

A further half of respondents did not know whether their children had been vaccinated against meningococcal or were unsure which types of the disease they were immunised against14.

The research also found only four in ten (43%) New Zealand parents have had a discussion with their health care professional (HCP) about meningococcal vaccinations. Amongst those the group of parents who had discussed immunising their child, this was more likely to have been initiated by the parent (55%) than the HCP (41%)14.

The topic was most often raised by parents following a conversation with family or friends in almost half (46%) of the cases, with a decision made independently of others coming from about a fifth (21%) of those surveyed14.

Other sources of information included; articles in the media (15%), or some form of advertising (40%) - with social media sparking around a tenth (11%) of conversations14.

Amongst the half of Kiwi parents who had not talked to an HCP, more than a third (36%) were more likely to seek advice from friends or family about the vaccination in the future than their child’s health care provider (35%). An even larger proportion (44%) say they will do their own research about immunisation options rather than consult a professional14.

Vaccinologist and Associate Professor in the Department of General Practice and Primary Health Care at Auckland University Dr Helen Petousis-Harris, says while it is good to see parents discussing immunisation with family and friends when it comes to making a decision about vaccination for a loved one it also needs to be based on scientific and accurate information.

“The common misconception with meningococcal disease is that because it's reasonably rare people can be inclined to think that it won’t happen to them or a family member, but it does.” says Dr Petousis-Harris.

She says while the realities of COVID-19 are still salient for us we are about to head into the traditional peak season for meningococcal disease - which can thrive in overcrowded conditions during winter months.

Due to its flu-like symptoms meningococcal disease can be difficult to diagnose, but can progress quickly. Along with headaches, fever, and a sore neck, patients may also present with a rash[14].

A strain of the disease specific to New Zealand, resulted in a significant and prolonged meningococcal B epidemic between 1991 and 2007 resulting in 6128 cases and claiming 252 lives[15]. In response to the epidemic, a short-term nationwide vaccination programme using a tailor made vaccine (MeNZB) was introduced from 2004-2008[16].

Dr Petousis-Harris says under fives who were immunised during the last epidemic will now be entering the high risk adolescent age group and will need to be vaccinated again if protection from the disease is to be maintained.

“The ages for those most at risk for meningococcal disease are the under fives, adolescents and young adults, this means the best ages to vaccinate are infants, young teens and those at university.

“As well as infants, young adults living in crowded conditions such as hostels and those with underlying medical conditions are the key groups most at risk.

“Meningococcal disease is caused by a bacteria that we can prevent through vaccination,” she says.

Dr Petousis-Harris says overcrowding and prior respiratory infections could also be key factors in why Maori are disproportionately affected.

Spokesperson for the Meningitis Foundation Aotearoa NZ Andrea Brady says meningococcal disease is devastating and can be caused by a number of different types, or strains of the disease. She says meningococcal B is the most common in NZ, and has increased by 22% in the past year, but the number of cases of meningococcal W is also on the rise and has seen a 9% increase over the same period[17].

“It is important that parents talk with their health care professional about all of the vaccines available and make a fully informed decision about vaccinating their child. We would encourage parents to vaccinate against all forms of the disease to give their child the best start in life and the widest possible protection,” says Brady.

“It’s important all parents are aware of the full range of symptoms that may present. Most people know about the rash that may appear with meningococcal disease, but in some circumstances, this may be one of the last symptoms to appear. If your child is ill, don’t wait for a rash. Trust your instincts and get your child to a doctor or hospital as quickly as possible,” she says.

Vaccines are available in New Zealand to protect against the most common forms of meningococcal disease and details can be found on the Ministry of Health website - these vaccines are not currently funded.

The vaccine for meningococcal B, Bexsero, includes the active component of the MeNZB vaccine, as well as three other antigenic components to help improve strain coverage[18],[19].

Bexsero has recently been funded as part of a meningococcal B immunisation program for children and young people in South Australia and is funded on the National Immunisation Programme for infants in the United Kingdom[20],[21].

--

[1] New Zealand Meningococcal Market Research 2019. Commissioned by GSK and conducted by IPSOS, an independent research provider

[2] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Available here. Accessed 16 April 2020

[3] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Available here. Accessed 16 April 2020

[4] Ministry of Health website. Meningococcal disease (including meningitis.) Summary Tab. Available at: https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/meningococcal-disease-including-meningitis Accessed 16 April 2020

[5] Ministry of Health. Immunisation Handbook 2017 (2nd Edition, March 2018). Available at https://www.health.govt.nz/publication/immunisation-handbook-2017. Accessed 16 April 2020.

[6] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Available here. Accessed 16 April 2020

[7]Of those cases that could be typed.

[8] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Available here. Accessed 16 April 2020

[9] Ministry of Health website. Meningococcal disease (including meningitis.) Summary Tab. Available at: https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/meningococcal-disease-including-meningitis Accessed 16 April 2020

[10] Thompson MJ, et al. Lancet 2006; 367(9508): 397–403.

[11] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Available here. Accessed 16 April 2020

[12] Rosenstein NE, et al. N Engl J Med 2001; 344(18): 1378–88

[13]New Zealand Meningococcal Market Research 2019. Commissioned by GSK and conducted by IPSOS, an independent research provider.

[14] Ministry of Health Meningococcal Brochure 2013. Available at https://www.healthed.govt.nz/system/files/resource-files/HE2395-Meningococcal_Brochure-WEB_0.pdf Accessed 16 April 2020

[15] Martin, D. and L. Lopez, The epidemiology of meningococcal disease in New Zealand in 2007. May 2008: Wellington.

[16] Ministry of Health. Immunisation Handbook 2017 (2nd Edition, March 2018). Available at https://www.health.govt.nz/publication/immunisation-handbook-2017. Accessed 16 April 2020.

[17] The Institute of Environmental Science and Research. Invasive Meningococcal Disease Report 2019. Accessible here. Accessed 16 April 2020

[18] GlaxoSmithKline NZ. Bexsero Data Sheet 2018. Available here. Accessed: 16 April 2020.

[19] Petousis-Harris H, et al. Lancet. 2017; 390: 1603–10.

[20] GOV.UK website. The Routine Immunisation Schedule. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/849184/PHE_complete_immunisation_schedule_Jan2020.pdf. Accessed 16 April 2020

[21] SA health website. Meningococcal B Immunisation Program. Available at: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/immunisation/immunisation+programs/meningococcal+b+immunisation+program. Accessed 16 April 2020

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