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Doctors Not Talking About Newer Meningitis Vaccine

MONDAY, Aug. 20, 2018 — Many U.S. doctors aren’t telling teenaged patients and their parents about a newer vaccine for potentially deadly bacterial meningitis infections, a new study finds.

Bacterial meningitis is an infection of the brain and spinal cord. It is uncommon in the United States, but sporadic outbreaks occur — often on college campuses, where close quarters make it easier for the infection to spread.

Each year, around 4,000 Americans fall ill with bacterial meningitis, and roughly 500 die, according to the U.S. Centers for Disease Control and Prevention.

The new study surveyed doctors about the meningitis B vaccine. It protects against the “B” subtype of meningococcal bacteria, and became available in the United States in 2015.

But as of late 2016, the survey found, a majority of doctors were not routinely discussing the vaccine with teenaged patients and their parents.

What is going on? Researchers said the issue centers on the way the CDC’s vaccine recommendations are made.

The meningitis B vaccine has a “Category B” recommendation, which means it’s optional: The CDC says that 16- to 23-year-olds “may” get immunized, rather than “should.”

That’s in contrast to the other bacterial meningitis vaccine — the conjugate vaccine that protects against four other subtypes of meningococcal bacteria. Since 2005, the CDC has recommended it as a routine shot for all preteens and teenagers.

“Our data suggest that there are differences in how a Category B recommendation is being interpreted by providers,” said lead researcher Dr. Allison Kempe, a professor of pediatrics at the University of Colorado School of Medicine.

Some doctors, she said, may think it’s unnecessary to bring up the meningitis B vaccine because they’ve judged a patient to be at low risk.

In other cases, Kempe said, doctors may not feel they have enough information to discuss the pros and cons of the vaccine. The CDC said the Category B recommendation was made, in part, because it was still unclear how effective the vaccine would be in the real world.

In fact, meningitis B is rare in the United States. In 2016, there were only 130 cases reported, according to the CDC.

Given all of that, the latest findings are “not particularly surprising,” said Dr. Mobeen Rathore, a spokesperson for the American Academy of Pediatrics (AAP).

Like Kempe, he said doctors are likely interpreting the recommendation on meningitis B vaccination in different ways.

Plus, Rathore said, there is a lot to cover during routine doctor visits — particularly those pre-college appointments. So, doctors may be prioritizing other health concerns.

The findings were based on 660 pediatricians and family doctors nationwide. Kempe’s team asked them how often they discussed the meningitis B vaccine with 16- to 18-year-old patients and their parents. That age range is considered the optimal vaccine window, to protect kids who are heading off to college.

Overall, only half of pediatricians and 31 percent of family doctors said they often brought up the vaccine during routine check-ups, the findings showed.

Those discussions were more likely to happen when doctors said they were aware of meningitis outbreaks in their state — but that was no guarantee.

Even though the meningitis B vaccine is optional, the AAP says doctors should be discussing it with parents and patients — so they can make an informed decision for themselves. But not all doctors agree with that AAP advice, Kempe noted.

If your doctor doesn’t bring up the vaccine option, she said, you can.

“Parents should certainly feel empowered to ask about the vaccine if it isn’t brought up,” Kempe said.

Rathore agreed. “This vaccine is safe,” he said. “As a parent, if you’re concerned about this disease, you can certainly talk to your doctor about whether your child could benefit from vaccination.”

The findings were published online Aug. 20 in Pediatrics.

More information

The U.S. Centers for Disease Control and Prevention has more on meningococcal vaccine.

Posted: August 2018

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