A study on the after effects of invasive meningococcal disease (IMD) type B in children aged between 4 months and 14 years has suggested that there are long-term effects of the disease that have not been accounted for in previous studies due to their shorter follow up timeframes. The results indicate that these long-term effects could have an impact on the cost-effectiveness analysis for vaccines against meningococcal B.
The study, which was supported by a grant from CoMO, looked at 11 children admitted to the intensive care unit (ICU) of a hospital in Australia who were aged between 4 months and 14 years at their time of admission with IMD type B. Most studies of this nature end their follow up at one year post illness; however this study continued follow up for up to six years after.
Through this approach a number of after effects that otherwise would have been missed were identified, these included leg length discrepancy and potentially speech delay and anxiety. What was perhaps more notable was the amount of further medical care and sometimes re-admissions for some of the children in the study. In the past, cost-effectiveness analyses have looked at the immediate costs of the disease at admission and in the short term after, but have not taken this long term picture into account.
The authors noted that the impact of these longer term costs on the cost effectiveness analysis of the MenB vaccine was in part responsible for the UK’s Joint Committee on Vaccination and Immunisation (JCVI) deciding to introduce the vaccine into the national immunisation programme for infants. The vaccine is currently only recommended for certain at-risk groups in Australia after the Pharmaceutical Benefits Advisory Committee decided it was not cost effective for all children and infants.