Is the excitement about a new meningitis vaccine warranted or is it premature?

[Guest guest]

http://www.vaccinationnews.com/Scandals/2004/Jan_7/Scandal70.htm

 

 

Scandals - 12/07/04

 

Is the excitement about a new meningitis vaccine warranted or is it premature?

 

by Sandy Mintz

 

The headlines are arresting, the hope almost palpable: Vaccine 'could beat

meningitis'; Scientists: Meningitis Vaccine Breakthrough; Meningitis experts

pin hopes on new vaccine; Research Raises Hope for New Meningitis Vaccine.

 

But what is this " meningitis " and can a vaccine really protect us from it?

According to the CDC, " Meningitis is an infection of the fluid of a person's

spinal cord and the fluid that surrounds the brain. People sometimes refer to it

as spinal meningitis. Meningitis is usually caused by a viral or bacterial

infection. Knowing whether meningitis is caused by a virus or bacterium is

important because the severity of illness and the treatment differ. Viral

meningitis is generally less severe and resolves without specific treatment,

while bacterial meningitis can be quite severe and may result in brain damage,

hearing loss, or learning disability. For bacterial meningitis, it is also

important to know which type of bacteria is causing the meningitis because

antibiotics can prevent some types from spreading and infecting other people.

Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of

bacterial meningitis, but new vaccines being given to all children as part of

their routine immunizations have reduced the occurrence of invasive disease due

to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are

the leading causes of bacterial meningitis. "

 

Sounds pretty scary, and it certainly can be. But as with anything involving

for-profit drugs and other biological products, the hype must be separated from

the hope.

 

First, it must be determined what the incidence of the disease has been, both

before and after introduction of vaccination, in order to ascertain if there has

been a benefit from vaccination, i.e., it has caused a decline in disease

incidence. As part of determining whether or not the vaccine is responsible for

any declines, incidence of meningococcal disease among the vaccinated must then

also be compared to those receiving no meningococcal vaccine, particularly those

who have never been vaccinated, period. Finally, the cost (as in negative

consequences) of vaccinating must be honestly and fairly compared to the costs

of not vaccinating.

 

Sadly, even the incidence of meningitis is not all that well-established.

Currently (as of year-end 2002), only Haemophilus influenzae and certain forms

of Streptococcus pneumonia are separately notifiable, with all other

meningococcal disease being reported together.

 

What is known is fairly reassuring, though: bacterial meningitis, although

dramatic and frightening, is thought to be quite rare and not highly contagious,

only affecting " about 2,400-3,000 people " in the United States each year.

(Although the data are a bit confusing. For instance, although in 2000,

according to the CDC, there were fewer than 2400 cases reported in the combined

category " meningococcal disease " , it is unclear whether or not that figure

includes both bacterial and viral meningitis. On the other hand, it does not

include the over 4500 cases of Streptococcus pneumoniae reported that year as

well. Still, the numbers are relatively small.)

 

Being armed with historical morbidity and mortality data is of little value

without additional information, however. Unfortunately that information is also

not available. Little to nothing is known about whether or not vaccination is

necessarily causally related to either a decline in deaths or a decline in

incidence, since no long-term studies comparing the vaccinated to the never

vaccinated have ever been conducted. Nor is much known about the possible

negative consequences of vaccinating, if there are any. (Although it is true

that there have been 644 adverse meningitis vaccine-associated reactions

reported to VAERS so far, indefensibly, it is unknown if they represent 644,

6,440 or even 64,400 cases! Nor do we know if and when the vaccine actually

caused the reported events.)

 

Regardless, it is becoming increasing clear that the consequences of vaccinating

against meningitis may well be regrettable in the long run. The bacteria

targeted by vaccination, rather than remaining content to retreat into the

background like a dutiful troop of shrinking violets, seem determined to survive

and thrive - and one way they appear to be doing so is by changing serotype and

serotype prevalence. Thus vaccination, rather than removing or diminishing the

threat of disease, may instead create an endless ostensible need for additional

vaccines by causing pathogens to re-emerge in different forms.

 

At some point might it not be prudent to question " Public Health's " debatable

vaccination policy, the strategy it has adopted in what increasingly appears to

be a misguided " war against disease " ? At some point wouldn't it make sense to

take a stab at fashioning some other disease prevention/disease survival plan?

 

Perhaps now would be a good time to start - by not buying into the hysteria

about a rare disease and by questioning the drug company solution to preventing

it. For while it is eminently clear that the vaccine manufacturers and those

with financial ties to them benefit from the ever-increasing putative need for

vaccines, the more important question is, does anyone else?

 

(To read a related column on this topic, go to Scandals: Changing Disease

Epidemiology Via Vaccines - Are We " Robbing Peter To Pay Paul " ?.)

 

Sandy Mintz

 

" Eternal vigilance is the price of liberty. " - Wendell Phillips (1811-1884),

paraphrasing John Philpot Curran (1808)

 

Sandy Mintz is the publisher of the website " Vaccination News " , and writer of

the columns " Scandals " and " Out of Control " . To join her political action

egroup or learn more about it, please send an email to sandym,

indicating the purpose of your email in the subject line.

 

 

 

 

 

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