Search

Introduction In September 2015, the UK became the first country in the world to introduce the 4-component meningococcal B vaccine(4CMenB) into the routine vaccine schedule for infants. 4CMenB is known to cause fever in infants. Infants presenting with fever, particularly those under 3 months, have a significant risk of serious bacterial infection(SBI). Method Between September 2015 and January 2016, we performed a prospective audit of management of infants between 30 and 180 days attending the regional paediatric emergency department(ED) in Northern Ireland, within 4 days of receiving 4CMenB. Results 35 ED attendances in infants aged 30–180 days were due to symptoms occurring after primary vaccinations including 4CMenB, representing an estimated 0.8% of the vaccinated population in the catchment area. 86% of infants presented after the first vaccine and parents reported giving paracetamol to 94% of infants. 80% of infants presented with fever. Blood tests were performed in 62% of infants and leucocytosis was present in 73%. All cultures taken were negative and 51% were admitted to hospital. 100% of final diagnoses were vaccine related (diagnosis made by exclusion). Discussion In this study, an estimated 0.8% of the vaccinated population in the catchment area attended ED with symptoms occurring after primary vaccinations including 4CMenB. Infants with fever have a higher risk of SBI, but infants with fever in the post-vaccination period may not have the same risk. Further data are essential to inform national guidelines on investigation and management of fever in infants following vaccination with 4CMenB, possibly incorporating a less-invasive approach.

We were interested to read the report by So et al 1 describing an infant who was unwell prior to receiving their first set of primary immunisations (including the four-component meningococcal B vaccine 4CMenB; Bexsero; GSK Biologicals) and was subsequently diagnosed with meningococcal group W meningitis shortly after vaccination. The authors highlight factors that would not have been consistent with an adverse event following immunisation (AEFI), namely the onset of fever prior to immunisation and the presentation with focal seizures, which is rare following 4CMenB vaccination, even when administered concurrently with routine immunisations.2 Such a …

On 1 September 2015, the UK became the world’s first country to introduce a novel meningococcal B vaccine (Bexsero) into its national childhood immunisation programme. Bexsero is the only market authorised meningococcal B vaccine in the UK. Meningococcal B strains accounts for ~80% of all laboratory confirmed cases of invasive meningococcal disease (IMD) in England and Wales.1 Bexsero is estimated to protect against 73%–88% of the meningococcal B strains causing invasive disease in England and Wales.2 After observing more instances of clinical instability in our immunised neonates following the introduction of the new …

The number of cases of meningitis and septicaemia caused by meningococcal group B infection in infants has halved since the introduction of a new vaccine last year, Public Health England reports.1 All newborn babies in the United Kingdom are now routinely offered the vaccination against meningococcal group B, the world’s first infant programme to use this vaccine. In the 10 months since the programme began only 37 recorded cases of meningococcal B were recorded in infants aged under 1, compared with an average of 74 in the same …

The Meningitis Research Foundation welcomes publication of Christensen and colleagues’ model,1 which enables comparison with their original study2 and the interim opinion of the Joint Committee on Vaccination and Immunisation (JCVI),3 and shows a range of cost effective options. However, this model undervalues the impact of meningococcal B infection. As we previously argued,4 the MOSAIC study,5 which underlies many parameters in this model, is a snapshot that inevitably underestimates disease burden. In addition, …

The meningococcal B vaccine Bexsero is to be brought into the childhood vaccination programme in the United Kingdom if it can be purchased at a low price, the Department of Health for England has said. The decision comes after a U turn by the Joint Committee on Vaccination and Immunisation. Last July it said that the vaccine would not be cost effective in an infant vaccination programme at any price.1 However, after widespread protest, the committee carried out a consultation with stakeholders and then repeated the cost effectiveness analysis with additional information. As a result of this new analysis the committee has now said that it would recommend Bexsero if it could be bought at a cost effective price.2 It said that cost effectiveness would be improved through the use of an abbreviated schedule at ages 2, 4, and 12 months, which would be sufficiently immunogenic. The vaccine’s manufacturer, Novartis, …