Meningitis Vaccination–Mandatory In Texas Unless You Opt Out–Videos
Weighing the benefits and costs of bacterial meningitis vaccination
Credit: Texas Pediatric Society
In May, Texas became the first state in the nation to pass a law, officially known as the Jamie Schanbaum and Nicolis Williams Act, requiring every college student under the age of 30 transferring or entering a Texas college after January 1, 2012 to be vaccinated for bacterial Meningitis.
The vaccine is in short supply and can cost students anywhere from $10 to $165. The leading vaccine manufacturers Sanofi Pasteur and Norvatis sell the Meningococcal Conjugate (Groups A, C, Y and W-135) vaccine in a five pack 1-dose vial with a per dose wholesale CDC cost of $82.16 and a retail private sector cost of $106.49, according to the online CDC Vaccine Price List dated November 2, 2011.
Individuals may qualify for a taxpayer paid government subsidy for low income or uninsured individuals at their local county health department immunization clinic. Dallas County Health and Human Services Department charges $10 and has requested 50,000 doses, according to the department’s director, Zachary Thompson. Currently it has none available at the $10 price. However, individuals willing to pay the unsubsidized regular price of $150 can get vaccinated.
Students can exercise their consumer sovereignty and opt out of the vaccination program for reasons of conscience. If you choose to opt out, under the provisions of the original Jamie Schanbaum Act you must sign “…an affidavit stating the student declines the vaccination for bacterial meningitis for reasons of conscience, including religious belief.”
Keep in mind that individuals between the ages of 16 and 21 have the second highest incidence of meningococcal disease after infants according to the CDC. There are approximately 1,000 invasive meningococcal disease cases annually in the U.S. with 20 percent occurring in adolescents and young adults ages 14–24. Fatalities are between 10 to 14 percent of the cases with 11 to 19 percent of the survivors suffering deafness, neurologic deficit, or limb loss, according to the CDC.
However, the CDC also points out that meningococcal disease is not a common disease. This is indicated by the rate of meningococcal disease per 100,000 by age shown in the chart below:
Credit: Center for Disease Control and Prevention (CDC)
The CDC recommended in 2005 that all individuals ages 11-12 receive meningococcal conjugate vaccine (MCV4) with a booster shot in five years. MCV4 offers a high level of immunity against four bacteria serogroups A, C, Y and W-135 but does not protect against bacteria serogroup B, which is the most common cause of bacterial meningitis in the U.S.
A student between the ages of 18 and 24 has less than a 1 per 100,000 projected rate of catching meningococcal disease. The CDC estimated that an American has a 1 in 88,000 chance of being killed by a terrorist. Before students make a decision to get vaccinated or opt out, students should have a better appreciation and understanding of meningitis.
Meningitis is an inflammation of the thin outer protective lining of the brain and spinal cord, collectively called the meninges caused by an infection. The meninges are a three layer system of membranes consisting of the dura mater, arachnoid and pia mater mater (see above picture) that protects and cushions the brain and spinal cord. The infection can be caused by a virus, bacteria or rarely a fungus.
By far the most common form of meningitis is caused by viruses and is much less debilitating than bacterial meningitis. There are many viruses that cause the disease but approximately half of the viral cases in the United States are due to common intestinal viruses, or enteroviruses. The viruses are in droplets of respiratory secretion from the mouth and nose or shed in the feces. Viruses are usually transmitted by coughing or sneezing, kissing, hand-to-mouth contact or through poor hygiene. The vast majority of people exposed to viruses that cause meningitis have no or mild symptoms and fully recover without complications.
While there is no immunization available against viral meningitis, it can be prevented by washing your hands regularly, carefully washing and preparing food and eating food by their “sell by” or “eat by dates.”
In the United States the leading cause of meningococcal disease in older children and young adults of college age is the bacterium Neisseria meningitidis, also referred to as meningococcus. Invasive meningococcal disease occurs in three primary forms: meningitis (50 percent of cases), blood infection (30 percent) and pneumonia (10 percent) with other forms accounting for the remaining (10 percent) of the cases, according to the (CDC).
Thirteen serogroups of N. meningitidis have been identified and described of which six (A, B, C, X, Y, and W135) are responsible for meningococcal disease with greater than 99 percent of meningococcal infections caused by serogroups A, B, C, 29E, or W-135. A serogroup is defined as “a group of bacteria containing a common antigen, sometimes including more than one serotype, species, or genus” by Mosby’s Medical Dictionary. An antigen is defined “as any substance capable of inducing a specific immune response and of reacting with the products of that response’ by Mosby’s Medical Dictionary. Antigens are substances including bacteria, toxins or implanted cells from organs that when they enter the body stimulate the production of antibodies. Antibodies are part of the immune system and are proteins generally found in the blood that detect and destroy invaders, like bacteria and viruses.
Since World War II, serogroups B and C are the chief cause of meningococcal meningitis in the U.S. Prior to the war, serogroup A was the chief cause of the disease. For the Americas and Europe, serogroup B is the predominant cause of the disease followed by serogroup C.
Historically and globally the main cause of epidemic meningococcal disease is serogroup A, which predominates in Africa and Asia. The sub-Saharan Africa meningitis belt extends from Senegal in the west to Ethiopia in the east. The meningitis belt has by far the highest rate of meningococcal meningitis with serogroup A accounting for an estimated 80-85 percent of all cases with epidemics occurring at 7 to 14 year intervals, according to the United Nations’ World Health Organization (WHO).
The N. meningitides bacterium may enter the body through the nose or mouth. The bacteria are in droplets of respiratory or throat secretions that are transmitted from person to person when a person kisses someone or coughs and sneezes on someone. The sharing of anything that someone has put in or near their mouth such as a drinking glass or eating utensils are activities to be avoided. Kissing, smoking, being exposed to smoke and being in crowded rooms such as bars and college dormitories are possible activities that could spread the N. meningitides bacteria.
One form of meningococcal disease is meningococcal meningitis, a serious bacterial infection that has the potential to kill a healthy person within one day of the first appearance of the disease’s symptoms. The disease can start with extreme fatigue and an abrupt high fever, headache, painful stiff neck, nausea and vomiting. Other symptoms include irritability, confusion, inability to look at bright lights, rash, convulsion and unconsciousness. In babies the arching of the back and high pitch screaming are symptoms as well.
Meningococcal meningitis can be easily misdiagnosed as the flu. Therefore individuals with any of the above symptoms that occur suddenly and severely should seek medical attention immediately at your hospital’s emergency room. The disease progresses very rapidly and if not treated early with penicillin or antibiotics can result in death or permanent disabilities including brain damage, hearing loss, seizures or limb amputation. If left untreated Meningococcal meningitis is fatal in 50 percent of all case, according to the WHO. Even in cases where the disease is diagnosed early and treatment started, 5 to 10 percent of the patients die within 24 to 48 hours from onset of the symptoms.
Meningococcal meningitis is a rare disease with about 1,400 to 3,000 Americans coming down with the disease annually including 100 to 125 cases on college campuses. However, it can be a fatal bacterial infection with about 150 to 300 deaths per year including about 5 to 15 students on college campuses, according to the American College Health Association. College students living in dormitories are more likely to catch meningococcal disease than the general college population because of crowded conditions and sharing of personal items such as drinking glasses and eating utensils.
In the U.S. for the period 2005 through 2010 there were about 1,000 reported cases annually caused by serogroups B, C and Y, according to the CDC. For developing countries and the Meningitis Belt of sub-Saharan Africa, the burden of the disease is much greater and caused by serogroups A, X and W135.
There are currently three vaccines available for the serogroup A, C, Y and W135. There are no FDA approved vaccines for serogroups B and X. However, the Swiss drug company Novaritis has developed a new vaccine called Bexsero® that would cover five strains including serogroup B.
A second form of Meningococcal disease is meningococcal septicemia (“blood poisoning”), a form of sepsis, which is less common but often more severe and fatal than meningococcal meningitis. The meningococcus bacteria multiply uncontrollably in the bloodstream and release toxins into the blood that break down the walls of the blood vessels. This allows blood to leak into the skin causing a characteristic hemorrhagic rash. This rash can occur anywhere on the body and if left untreated will grow and multiple in other areas of the body. The rashes resemble fresh bruises under the skin and will not blanch or turn white if pressed.
Severe sepsis is a potentially deadly medical condition if not treated with antibiotics and intravenous fluids. Antibiotics are drugs that destroy or weaken bacteria and are used to treat various types of bacterial infections.
You are free to choose. Which will it be, the blue pill or the red pill, meningitis vaccination or opt out?
Penn and Teller on Vaccinations
What You Should Know About Meningococcal Disease & the Vaccine July 18, 2011
Headache, Fever, & Stiff Neck – Your Body’s Red Light Warning Signals
Meningitis – Saving a Life, Protecting our children from dangerous meningococcal disease
Overview of Meningococcal Meningitis
Meningococcal Disease: Clinical Overview
National Network for Immunization Information (NNii)
Review of Meningitis
Managing Meningitis – Mayo Clinic
National Vaccine Information Center
Barbara Loe Fisher On New Meningitis Vaccine (Part 1 of 2)
http://www.mercola.com/ Internationally renowned natural health physician and Mercola.com founder Dr. Joseph Mercola and Barbara Loe Fisher, founder of the National Vaccine Information Center, talk about a vaccine that’s being seriously considered and recommended on a regular basis for Meningitis. (Part 1/2)
Barbara Loe Fisher On New Meningitis Vaccine (Part 2 of 2)
Mandatory Meningitis Vaccine in Texas!
The State of Texas is now mandating that all students receive meningitis vaccine within 5 years of starting college. There are many problems with this policiy and its effectiveness is highly questionable, as you will see.
If you are living in Texas, maybe you can do the same to your government and prevent this vaccine from being mandatory. news report: http://www.youtube.com/watch?v=VoDnwJjGw6Y
Requirement.html stats: http://www.meningitis.org/disease-info/types-causes/trends
different vaccines: http://www.novaccine.com/specific-vaccines/vaccine.asp?v_id=49
Meningitis B most common strain: http://ehealthmd.com/library/meningitis/mg_causes.html
aluminum hydroxide and Alzheimer’s http://www.ncbi.nlm.nih.gov/pubmed/19740540
The Centers for Disease Control and Prevention estimates about 3,000 cases of meningococcal disease occur each year in the United States. Many of those cases are found in adolescents and young adults, particularly those in the college setting. In this video, you can learn about the risk from icyous medical editor, Dr. Mona Khanna.
Meningitis in Other Countries
UCT’s Assoc Prof Neil Ravenscroft on a new meningitis vaccine
Head of the Bioanalytical and Vaccine Research Unit in the Department of Chemistry at the University of Cape Town, Associate Prof Neil Ravenscroft, speaks about his involvement in an international collaboration that developed a vaccine, called MenAfriVac, to protect millions in Africa against meningitis. He also explains what meningitis is, its incidence rate in high risk areas in North Africa and its impact.
Background Articles and Videos
Lethal Injection: The Story Of Vaccination
Vaccine Safety Conference Opening Address – Barbara Loe Fisher
“…Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammation’s proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.
The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Sometimes, especially in small children, only nonspecific symptoms may be present, such as irritability and drowsiness. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash.
A lumbar puncture may be used to diagnose or exclude meningitis. This involves inserting a needle into the spinal canal to extract a sample of cerebrospinal fluid (CSF), the fluid that envelops the brain and spinal cord. The CSF is then examined in a medical laboratory. The usual treatment for meningitis is the prompt application of antibiotics and sometimes antiviral drugs. In some situations, corticosteroid drugs can also be used to prevent complications from overactive inflammation. Meningitis can lead to serious long-term consequences such as deafness, epilepsy, hydrocephalus and cognitive deficits, especially if not treated quickly. Some forms of meningitis (such as those associated with meningococci, Haemophilus influenzae type B, pneumococci or mumps virus infections) may be prevented by immunization.
Neck stiffness, Texas Meningitis Epidemic of 1911–12.
In adults, a severe headache is the most common symptom of meningitis – occurring in almost 90% of cases of bacterial meningitis, followed by nuchal rigidity (inability to flex the neck forward passively due to increased neck muscle tone and stiffness). The classic triad of diagnostic signs consists of nuchal rigidity, sudden high fever, and altered mental status; however, all three features are present in only 44–46% of all cases of bacterial meningitis. If none of the three signs is present, meningitis is extremely unlikely. Other signs commonly associated with meningitis include photophobia (intolerance to bright light) and phonophobia (intolerance to loud noises). Small children often do not exhibit the aforementioned symptoms, and may only be irritable and look unwell. In infants up to 6 months of age, bulging of the fontanelle (the soft spot on top of a baby’s head) may be present. Other features that might distinguish meningitis from less severe illnesses in young children are leg pain, cold extremities, and an abnormal skin color.
Nuchal rigidity occurs in 70% of adult cases of bacterial meningitis. Other signs of meningism include the presence of positive Kernig’s sign or Brudzinski’s sign. Kernig’s sign is assessed with the patient lying supine, with the hip and knee flexed to 90 degrees. In a patient with a positive Kernig’s sign, pain limits passive extension of the knee. A positive Brudzinski’s sign occurs when flexion of the neck causes involuntary flexion of the knee and hip. Although Kernig’s and Brudzinski’s signs are both commonly used to screen for meningitis, the sensitivity of these tests is limited. They do, however, have very good specificity for meningitis: the signs rarely occur in other diseases. Another test, known as the “jolt accentuation maneuver” helps determine whether meningitis is present in patients reporting fever and headache. The patient is told to rapidly rotate his or her head horizontally; if this does not make the headache worse, meningitis is unlikely.
Meningitis caused by the bacterium Neisseria meningitidis (known as “meningococcal meningitis”) can be differentiated from meningitis with other causes by a rapidly spreading petechial rash which may precede other symptoms. The rash consists of numerous small, irregular purple or red spots (“petechiae”) on the trunk, lower extremities, mucous membranes, conjuctiva, and (occasionally) the palms of the hands or soles of the feet. The rash is typically non-blanching: the redness does not disappear when pressed with a finger or a glass tumbler. Although this rash is not necessarily present in meningococcal meningitis, it is relatively specific for the disease; it does, however, occasionally occur in meningitis due to other bacteria. Other clues as to the nature of the cause of meningitis may be the skin signs of hand, foot and mouth disease and genital herpes, both of which are associated with various forms of viral meningitis.
A severe case of meningococcal meningitis in which the petechial rash progressed to gangrene and required amputation of all limbs. The patient, Charlotte Cleverley-Bisman, survived the disease and became a poster child for a meningitis vaccination campaign in New Zealand.
People with meningitis may develop additional problems in the early stages of their illness. These may require specific treatment, and sometimes indicate severe illness or worse prognosis. The infection may trigger sepsis, a systemic inflammatory response syndrome of falling blood pressure, fast heart rate, high or abnormally low temperature and rapid breathing. Very low blood pressure may occur early, especially but not exclusively in meningococcal illness; this may lead to insufficient blood supply to other organs. Disseminated intravascular coagulation, the excessive activation of blood clotting, may cause both the obstruction of blood flow to organs and a paradoxical increase of bleeding risk. In meningococcal disease, gangrene of limbs can occur. Severe meningococcal and pneumococcal infections may result in hemorrhaging of the adrenal glands, leading to Waterhouse-Friderichsen syndrome, which is often lethal.
The brain tissue may swell, with increasing pressure inside the skull and a risk of swollen brain tissue causing herniation. This may be noticed by a decreasing level of consciousness, loss of the pupillary light reflex, and abnormal posturing. Inflammation of the brain tissue may also obstruct the normal flow of CSF around the brain (hydrocephalus). Seizures may occur for various reasons; in children, seizures are common in the early stages of meningitis (30% of cases) and do not necessarily indicate an underlying cause. Seizures may result from increased pressure and from areas of inflammation in the brain tissue. Focal seizures (seizures that involve one limb or part of the body), persistent seizures, late-onset seizures and those that are difficult to control with medication are indicators of a poorer long-term outcome.
The inflammation of the meninges may lead to abnormalities of the cranial nerves, a group of nerves arising from the brain stem that supply the head and neck area and control eye movement, facial muscles and hearing, among other functions. Visual symptoms and hearing loss may persist after an episode of meningitis (see below). Inflammation of the brain (encephalitis) or its blood vessels (cerebral vasculitis), as well as the formation of blood clots in the veins (cerebral venous thrombosis), may all lead to weakness, loss of sensation, or abnormal movement or function of the part of the body supplied by the affected area in the brain.
Meningitis is usually caused by infection from viruses or microorganisms. Most cases are due to infection with viruses, with bacteria, fungi, and parasites being the next most common causes. It may also result from various non-infectious causes. …”
“…Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). It carries a high mortality rate if untreated. While best known as a cause of meningitis, widespread blood infection (sepsis) is more damaging and dangerous. Meningitis and Meningococcemia are major causes of illness, death, and disability in both developed and under developed countries worldwide.
The disease’s host/pathogen interaction is not fully understood. The pathogen originates harmlessly in a large number of the general population, but thereafter can invade the blood stream and the brain, causing serious illness. Over the past few years, experts have made an intensive effort to understand specific aspects of meningococcal biology and host interactions, however the development of improved treatments and effective vaccines will depend on novel efforts by workers in many different fields.
The incidence of endemic meningococcal disease during the last 13 years ranges from 1 to 5 per 100,000 in developed countries, and from 10 to 25 per 100,000 in developing countries. During epidemics the incidence of meningococcal disease approaches 100 per 100,000. There are approximately 2,600 cases of bacterial meningitis per year in the United States, and on average 333,000 cases in developing countries. The case fatality rate ranges between 10 and 20 per cent.
While Meningococcal disease is not as contagious as the common cold (which is spread through casual contact), it can be transmitted through saliva and occasionally through close, prolonged general contact with an infected person. …”
Novartis Says Menveo Met Phase III Trial Enpoints
Dr, Colin Marchant
FDA approves the Novartis quadrivalent meningococcal conjugate vaccine, Menveo®, for use in children from 2 years of age
Expanded age indication of Menveo offers new option to help protect young children from 2 to 10 years of age against potentially devastating meningococcal disease1
Novartis to resubmit Menveo infant indication within a few months
Basel, January 31, 2010
Novartis announced today that it received approval from the US Food and Drug Administration (FDA) for the use of Menveo® (Meningococcal [Groups A, C, Y and W-135] Oligosaccharide Diphtheria CRM197 Conjugate Vaccine) for active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135 in individuals 2 to 10 years of age1. Menveo received initial FDA approval in 2010 for use in adolescents and adults from 11 to 55 years of age1.
The FDA approval of Menveo for use in children 2 to 10 years of age is based on Phase III trial data involving 5,297 participants in that age group. In the pivotal trial, the safety and immunogenicity of Menveo against each of the four serogroups were compared with those of the other currently US-licensed ACW-135Y meningococcal conjugate vaccine
1. Novartis also agreed to conduct three post marketing studies.
Separately, Novartis received a Refuse To File (RTF) letter from the FDA regarding the Company’s supplemental Biologics License Application (sBLA) for the use of Menveo in infants from 2 to 12 months. The sBLA had been submitted to the FDA in November 2010. Novartis plans to resubmit a sBLA in 2011 for the expanded use of Menveo in infants and toddlers from 2 months to 2 years old. …”
As of January 2011, Menveo is registered in more than 40 countries for active immunization to prevent invasive meningococcal disease caused by
Neisseria meningitidis serogroups A, C, W-135 and Y in people from 11 years of age. Menveo has been administered to more than 18,500 participants in clinical trials across all age groups worldwide, and studies are ongoing in infants, toddlers, adolescents and adults2. Menveo received initial FDA licensure in May 2010 for use in adolescents and adults (11 to 55 years of age)1. Pivotal phase III data presented in October 2010 at the 48th Annual Meeting of the Infectious Diseases Society of America (IDSA) showed that Menveo induced immune responses in a high percentage of infants against four important meningococcal disease-causing serogroups (A, C, Y and W-135)2.
Novartis submits Bexsero®, a multi-component meningococcal B vaccine, for regulatory review in Europe
Bexsero is the first vaccine with the potential to offer broad coverage against a large number of circulating, deadly disease-causing MenB strains1,2
Data from more than 7,500 subjects support use of the vaccine in infants from two months of age and older, adolescents, and adults3,4,5
Basel, December 23, 2010 –
Novartis announced today that it has submitted a Marketing Authorization Application (MAA) to the European Medicines Agency (EMA) for Bexsero® (Multi-Component Meningococcal B Vaccine; formerly known as 4CMenB). Upon approval, Bexsero will be the first broad-coverage vaccine licensed for use against disease caused by meningococcal serogroup B bacteria (MenB) in all European Union (EU) and European Economic Area (EEA) countries1, 2. Submission is supported by comprehensive clinical and epidemiological data which characterize the safety and immunogenicity profile, and the predicted coverage of Bexsero3, 4, 5.
“The Bexsero submission in the EU is an important milestone toward achieving the world’s first broad-coverage MenB vaccine through our unique multi-component approach
1, 2,” said Andrin Oswald, Head of Novartis Vaccines and Diagnostics Division. “Meningococcal disease is sudden and aggressive, leaving little time for treatment6, 7. Proactive vaccination of individuals has been shown to offer the best protection against fatal infectious diseases. Novartis is committed to providing vaccines to protect people of all ages, including infants, and against all causes, of meningococcal disease.”
What You Need to Know- Meningitis – Part 1 – What is Meningitis —
What You Need to Know- Meningitis – Part 2 – Be Aware, Don’t Share
What You Need to Know- Meningitis – Part 3 – Symptoms of Meningitis
What You Need to Know- Meningitis – Part 4 – Diagnosis and Treatment