Petition number: P-05-693

Petition title: Give Every Child in Wales the Meningitis B Vaccine for free

Text of petition: Health is completely devolved to Wales. We ask the Assembly and Mark Drakeford to change the age range that all children receive the vaccine .

All children are at risk from this terrible infection, yet the Government in Wales only vaccinate 2-5 month olds. There needs to be a rollout programme to vaccinate all children, at least up to age 11. Meningococcal infections can be very serious, causing MENINGITIS, SEPTICAEMIA& DEATH

Background

Meningitis B is a bacterial infection that particularly affects children under the age of one. It commonly affects children under five years of age and is also common among teenagers aged 15-19. There are about 1,870 cases of meningitis B each year in the UK and it is fatal about 10% of the time. About one in four of those who survive are left with long-term problems, such as amputation, deafness, epilepsy and learning difficulties.

The UK is the first country to introduce the meningitis B vaccine to its routine childhood vaccination programme. The programme started on 1 September 2015 for those babies due to receive their primary immunisations starting at 2 months of age on or after 1 September 2015 (i.e. those born on or after 1 July 2015). A one off catch-up programme for infants born from 1 May 2015 to 30 June 2015 (aged 3 or 4 months of age when the programme launched) has also been rolled out. This ensured that those infants were offered the vaccine before the winter peak of the disease. By May 2017, all children under the age of two years should have been offered the vaccine. The vaccine is also available for a small number of older children and adults who are at increased risk of infection, such as those with no spleen.

Why not all children?

In 2014, the Joint Committee on Vaccination and Immunisation (JCVI) - the expert body that advises the UK Government on vaccinations, recommended that babies be given the meningitis B vaccine, from two months of age. The JCVI highlighted that infants under one year are those most at risk from meningococcal disease and the decision was made to protect those most at risk. The Meningitis Research Foundation states that the current incidence of disease amongst the under 1s is around 22 per 100,000, reducing to 5 per 100,000 in the 1-4 age groups. The incidence of disease amongst older age groups is substantially less.

A petition that calls for all children, at least up to the age of 11 years, to be given the meningitis B vaccine was created on the UK Parliament and Government petitions website in September 2015. The petition acquired over 820,000 signatures (the highest number of signatures since the launch of the UK Parliament and Government Petitions website), and received increased attention in February 2016 following the publication of pictures of Faye Burdett, a two year old girl who died from meningitis B on 14 February 2016.

The UK Petitions and Health Select Committees jointly considered the petition on extending the meningitis B vaccination in February 2016 and agreed to schedule a parliamentary debate, which took place on 25 April 2016. A number of issues were raised during the sessions. These included consideration of extending the vaccine to older children. Professor Pollard, the Chair of the JCVI reported that the UK Public Health Minister had requested that the JCVI reconsider the meningitis B vaccination in the 1-2 year age group and confirmed that they would be looking at this in the near future.

The UK Government’s Department of Health responded to the petition, stating that the programme introduced protects those most at risk from meningococcal B disease, and is in line with the recommendations from the JCVI. It said:

With this programme, our priority is to protect those children most at risk of Men B, in line with JCVI's recommendation. The NHS budget is a finite resource, it is therefore essential that JCVI's recommendations are underpinned by evidence of cost-effectiveness. Offering the vaccine outside of JCVI's advice would not be cost effective, and would not therefore represent a good use of NHS resources which should be used to benefit the health and care of the most people possible.

During the debate UK Health Minister, Jane Ellison MP, announced that - based on the evidence and advice that has been received - the UK Government could not support extending the meningitis B vaccination programme to older children. But that doesn't mean that the UK Government and Parliament won't continue to look into this issue. The Minister confirmed that the UK Government has set up a working group to look at how decisions about the cost-effectiveness of vaccines are made, which is due to report later this year.

The meningitis charities (Meningitis Now and the Meningitis Research Foundation) have also recently announced (March 2016) a ten point Meningitis B action plan. This includes calling for the UK Government to fund research into how peace of mind health benefits can be included in cost-effectiveness analysis and that a catch up campaign for under 5s to be reconsidered by the JCVI in light of a new fairer cost effectiveness framework and emerging data on vaccine effectiveness.

It is worth noting that the meningitis B vaccine can be purchased privately in the UK, so people who are not currently eligible for the vaccine on the NHS can get it if they pay for it, but it may be costly. Further, following high demand for the vaccine in 2015, the manufacturer GlaxoSmithKline (GSK) issued a statement regarding a shortage of the vaccine. It has said that the NHS childhood immunisation programme is prioritised and will not be affected but private clinics should not start new courses at present.

Welsh Government Action

The JCVI is an independent expert advisory committee which provides expert advice to UK Health Ministers on all issues relating to immunisation and vaccination. As health is a devolved responsibility it is the responsibility of the Cabinet Secretary for Health as to whether the advice from JCVI is implemented in national policy. However, it has been normal practice for Wales to adopt JCVI recommendations, along with the other UK countries, to ensure UK-wide coverage against the specified disease.

On 8 April 2015, the then Health and Social Services Minister Mark Drakeford AM confirmed that the meningitis B vaccine would be introduced to the routine childhood vaccination programme in Wales from 1 September 2015. The Minister confirmed that the Welsh Government had committed to being included in the UK-wide procurement for the vaccine, and had made £7.7m of funding available to make sure the vaccination was available in Wales as soon as practicable.

Public Health Wales published a document in August 2015 entitled Immunisation against meningococcal B disease for infants aged from two months which clarifies the Welsh position. In line with the rest of the UK, it states that:

starting on 1 September 2015, all infants born on or after 1 July 2015 will be eligible for the meningococcal B vaccine which will be administered together with the other primary immunisations at 2 months, 4 months and 12-13 months.

It also confirms that there would be a catch-up programme for infants attending at age 3 and 4 months for routine immunisations. This would be for infants born from 1 May 2015 to 30 June 2015. Infants born before 1 May 2015 are not eligible to receive the meningococcal B vaccine.

Further information is provided in Welsh Health Circular (2015) 040 that was issued in July 2015 and also on the NHS Direct Wales website.

Every effort is made to ensure that the information contained in this briefing is correct at the time of publication. Readers should be aware that these briefings are not necessarily updated or otherwise amended to reflect subsequent changes.