On May 14, 1796, Edward Jenner jabbed 8-year-old James Phipps with some substance he collected from a cowpox sore on the hand of milkmaid, Sarah Nelmes. Phipps was a bit sick for a couple of days as a result, but he soon recovered. Jenner then jabbed him with some substance taken from a fresh human smallpox sore but this time, Phipps remained fit and well.
Jenner’s work marks the first stages of vaccination in Europe, but wanting to build immunity against infectious diseases isn’t a new phenomenon. According to Glynn and Glynn, in The Life and Death of Smallpox, Chinese Emperor K'ang Hsi, who had survived smallpox as a child, had his children inoculated in the late 1600s. That method involved grinding up smallpox scabs and blowing the matter into the nostril.
Similarly, prior to Jenner’s work on vaccination against smallpox, Lady Mary Wortley Montagu went travelling in Turkey and discovered variolation (inoculation) against smallpox. She returned, bringing with her the practice that she had witnessed save so many lives against smallpox in Turkey.
Since then, society has seen enhanced development in almost every field of human activity. We have also seen a variety of pandemics occur in recent years, including: SARS, Swine flu, MERS and, of course, COVID-19. In response to these, we have seen the production of a variety of vaccines and, over the last century, we have also seen the ongoing development of and research into vaccination against meningitis. Preventing deadly diseases like bacterial meningitis is particularly important because the disease progresses rapidly, potentially causing death within 24-48 hours. 1 in 5 of those who survive experience severe life altering after effects such as loss of limbs or deafness.
But the research into and development of vaccines is only the first step required in protecting us from life-threatening diseases like meningitis. People also need to come together to advocate for the inclusion of vaccines in their national and regional immunisation programmes. Moreover, people need to actively make appointments, receive their vaccines and maintain their immunity with booster jabs.
Misinformation hinders progress and, unfortunately, there has been a lot of controversy surrounding vaccines over the years, most memorably, when Andrew Wakefield’s study erroneously claimed that the MMR vaccine caused autism, (which has since been proven false). Fear around vaccines isn’t new, the aforementioned Chinese Emperor, K’ang Hsi, wrote about confronting objection to vaccines during the 1600s:
'In the beginning, when I had it tested on one or two people, some old women taxed me with extravagance, and spoke very strongly against inoculation. The courage which I summoned up to insist on its practice has saved the lives and health of millions of men. This is an extremely important thing, of which I am very proud.'
This is certainly something to be proud of and likewise, something we should remember in relation to modern day vaccination programmes. In countries where routine vaccines have been widely available for a long time, it’s easy to take them for granted because it’s rare to see the result of meningitis or other harmful diseases. For this reason, it is imperative that we continue to raise awareness of vaccine-preventable diseases like meningitis so people know the risks, the options available to them and can then make an informed decision.
However, lacking access to vaccines is as a barrier; the vast majority of people do want to be protected against diseases but, sadly, not everyone is able to be. The tricky thing is, vaccines are often only paid for by public funds when they’re recommended in the country’s national immunisation programme (NIP). For diseases like meningitis, which is considered pretty rare, not all vaccines are included in the NIP, meaning that people may not even realise that they’re missing a certain vaccine.
This affects people who have fewer resources or lack private insurance. A recent study assessing the link between socioeconomic status, the risk of having IMD (invasive meningococcal disease), and the likelihood of being vaccinated against it, found that the poorest households have the highest risk of getting meningitis and the lowest vaccination rates. This remained true even in countries with successful vaccination programmes, showing how easy it is to entrench health inequalities.
It also highlights the important role health organisations and meningitis charities like CoMO members play in advocating for the extension of national and regional immunisation programmes, providing even more people with greater access to life-saving tools. CoMO members also play a vital role in reaching communities, busting meningitis myths and providing accurate information on what kinds of vaccines are available and where to get them. This is timelier than ever; in 2020, 23 million children missed out on basic vaccines, warranting catch-up campaigns. Many of our members have achieved amazing things over the years, and every change counts as we collectively progress towards defeating meningitis by 2030. In 2018, Nederlandse Meningitis Stichting played an important role in getting the MenACWY vaccine for all children aged 14-18 introduced in the Netherlands. In the same year, Meningitis Centre Australia similarly pushed to introduce the MenACWY vaccine into the National Immunisation Programme for 12-month-olds. In 2019, Fundación Velasco welcomed the introduction of the pneumococcal vaccine into the Mexican National Immunisation Programme. In 2021, Asociación Española contra la Meningits (AEM) worked on measuring the long-term costs of meningitis and they saw the MenB vaccine added to Catalonia’s Regional Immunisation Programme in Spain. In France, Ensemble contre les Méningites (ECLM) succeeded in preventing meningitis further by expanding access to the MenB vaccine through the recommendation of France’s High Authority of Health (Haute Autorité de Santé or HAS).
The image above maps out the timeline of vaccine development and introduction of routine vaccine programmes in the UK. From 1796, when Jenner trialed his theory of vaccination, to 1870, when Louis Pasteur created the first live attenuated bacterial vaccine, all the way to 2019, with the introduction of Human Papillomavirus (HPV) Universal Programme.
The UK boasts a variety of meningitis vaccines as part of the routine immunisation schedule. From February 2022, the schedule states that at 8 weeks old, children should receive their Haemophilus Influenzae type B (Hib) and MenB vaccines. At 12 weeks, they should receive their pneumococcal conjugate vaccine (PCV). At 16 weeks, they should receive another MenB jab, followed by a booster for all of them at a year old. At 14 years old, they should their MenACWY vaccine. The schedule also includes the pneumococcal polysaccharide vaccine (PPV) for 65-year-olds. There is a still a lot to do in the way of vaccination against meningitis in the UK; on average, 2 babies a day develop GBS infection and, as of yet, this there is no existing vaccine to prevent this major cause of meningitis.
Likewise, it isn’t just children who contract meningitis, anyone can get it at any age. It’s important that on our journey to prevent meningitis, we don’t forget other vulnerable age groups. Campaigns like that of our Peruvian member, Una Vida por Dakota, named Narradores de Historias (Storytellers), honed in on vaccinating the elderly generation against pneumococcal disease and directed attention to other age groups that are also susceptible to fatal attacks of pneumonia and meningitis.
This week is World Immunisation Week and the theme is ‘Long Life For All’. Part of ensuring a long life for all is being immunised against deadly diseases like meningitis and being aware of what options are available to you. We all have a role to play; everyone can raise awareness about these diseases, campaign for worldwide vaccine equality, talk to their doctors and get vaccinated to increase our chances of immunity against these diseases.