Questions and discussion about the costs involved in rolling out the Meningitis B vaccine

[Myredcardigan]

Partly a TAAT but obviously it's all over the news and Sugar has specifically asked me to start this thread to begin constructive debate.

So, from my pov, I totally get the massive cost implications of vaccinating all those under 11. However, id like to hear from anyone who is in the know and can tell me if link to data showing what the actual cost would be. I'd also like to see what the cost implications of treating children with the disease are. Both the acute care, which will cover all infected children, but also the long term costs both medically and educationally of treating those children lucky enough to survive but sadly left with life long disabilities. I know from an educational POV that a non mainstream state school place can cost 40% more. Sometimes much more. But I have no idea on the medical side. Questions such as,

-How much does it cost the NHS in acute care costs to treat a child with Men B for 1wk

-What about non acute NHS recovery support inc OT

-If you are the parent of a deaf child or are deaf yourself, can you comment on the cost implications of supporting your child (rightfully) both medically and educationally?

-Can anyone comment on the NHS and educational costs involved in supporting a child who is an amputee?

Any other relevant stats and info please add to the thread. Please remember that Sugar has asked for this thread to be put out there. Of course, from a personal perspective I don't think any of this should matter but should the petition get its debate then this is what they'll be looking at.

As a GP I agree it would been good if all new vaccines offered a catch up programme for those outside the target age group. However, currently there is a shortage of Men B vaccine and it is most useful to be retained for the under 2s, who are the most vulnerable from the disease.

We are getting a lot of phone calls about this from anxious parents, and I would like to put the message out that GPs can't offer the vaccine outside the current schedule (as we wont have enough) and we are not allowed to offer private vaccines to our own registered patients due to the NHS business rules. The first port of call for those who want the vaccine is a private GP, but expect to pay £££ unfortunately.

"Surely the loss of even one child is too many when it is avoidable, eg through vaccination?"

If you are thinking with your heart and have endless pots of money, then yes of course. However, there are lots of situations where the NHS does not fund treatments that are proven due to cost. Some years ago, a local child's parents raised £250k to take him to America for a cancer treatment that was proven to double chances of survival. The treatment eventually became available in the UK but it would have been too late for this child who, incidentally, remains cancer free and doing very well, despite the prognosis.

Dr Sarah Wollaston says decisions about vaccinations should be guided by science and cost-effectiveness despite petition gathering 580,000 supporters

I'd like to have a few words with this lady here - Guardian link

"Maybe total overhaul of nhs required, why do we fund smoking/drinking/drug related illness above the needs of a child?"

The nhs is there for everyone to treat without judgement. Our children might have problems caused by smoking, drinking or drugs one day. We need a service that looks after everyone. We might judge smokers and drinkers, but they have paid tax and should be allowed to use th nhs.

www.theguardian.com/society/2016/feb/19/meningitis-petition-adds-to-pressure-for-vaccine-for-every-child

This article talks about the different views. It is a good outcome that people are becoming more aware of symptoms.

(I was told that the Men B vaccine was £250 for one child privately. Not sure if this is standard across the country)

I'm a bit confused. I checked the children's red books and they have both had three Men C vaccines at 2, 4 and 12 months. They are 7 and 10. Is this the vaccine you mean? If so, how come we've had this on the NHS when others haven't?

Or is it something different, I'm a bit confused as it seems to say in the book it is for Men B but called Men C? (or I could be wrong)

Lovelybath, Men C is a different strain of meningitis than Men B. There are many different strains. The prevenar vaccine your children will have received is also a meningitis vaccine.

Of course the death of a child is horrendous for the family involved but we do need to think objectively and scientifically the merits of rolling out a full scale vaccination programme and that will include the cost of the programme and the efficacy of vaccinating every single child. If NICE and the experts involved in the decisions conclude that this isn't the best use of resources taking into account all the variables then that is the difficult decision they have to make
I'm sure the experts don't deliberately set out to let children die but they do have to decide on the model that gives the lower overall risk of children dying within the framework and finite resources of any proposed vaccination programme

Yep but the NHS must have colossal buying power to bring the price of the drugs down so that it is subsidised.

Completely understand your argument but it looks like 600,000 might want some sort of provision even if it means paying for it themselves.

The Meningitis Research Foundation is a very well respected organisation. I don't think they would recommend it being rolled out without good reason.

While both are reputable organisations I imagine they have totally different remits so while overall wanting the same thing they may not be on the same page as to how to get there. I believe there are pricing structures with the NHS and the drug companies but it's not as easy or straightforward as NHS bulk buying vaccine

I don't get why Corbyn is busy worrying about criminals in Calais but not campaigning for our children to be vaccinated. Whatever has happened to the Labour Party.

I am campaigning for our children and I am a Mum who has lost her child to MenB please leave out politicians as they are all as bad as each other.

I paid privately for the men b vaccination for my DD. It cost me a £120 per jab and she had to have 3 of them

The Men ACWY vaccine is given to young people, adding the Men B during that time at least until those who could get them a babies are of age seems sensible with teens being one of the biggest groups affected.

This is interesting...

www.meningitis.org/news-media/building-a-case-for-extending-109823

Interesting article. Thanks for the link :)

I'd like to know how much money is being invested in developing better diagnostic tests. There have been some really promising developments in recent years - tests which can pick up on meningitis quickly and identify which strain is present so that appropriate treatment can be given. Seeing as that would be beneficial across all age groups, I'd like to think that it is getting adequate investment.

JVCI paper on this is available here www.gov.uk/government/uploads/system/uploads/attachment_data/file/294245/JCVI_Statement_on_MenB.pdf

Unless I'm reading it wrong (which I might be as it is quite long) the conclusion states that Men B would be good for teenagers as well as children but that there are uncertainties because it is the first time Men B injections have been used.

1234Littleham thanks I signed the petition.

It is our taxes that make the NHS and it our voices should be heard. When a vaccination is safe and useful it should be available to all. That is my strong belief.

Sugar I am so very sorry for your loss. I hope you will find a way to rebuild your life and in time to move on. I have not suffered your type of loss but have had other issues and have found counselling/therapy to be most helpful. Bless you.

LittleLionMansMummy I too had thought that chicken pox was almost a childhood rite of passage. My dd had it no problems, and then I read of a mother who lost her child to it, and other who lost one of her twins to it. When our son joined us by adoption at three and had not been vaccinated against it or had it we choose to pay to have him vaccinated.

Yes, the NHS has a finite amount of money and faces difficult decisions but what could be more helpful than actually preventing disease!

Prevention is better than cure.

Maybe if the government were taking more taxes from all those companies making money selling us sugar laden foods and drinks, and alcohol (I know cigarettes are already quite highly taxed) that money could go into the NHS! I'm not a smoker any more, or a big drinker but I am happy to pay taxes for anything, including sugary foods to be more expensive, then those taxes could go into the NHS!

The biggest threats to the NHS might include obesity, diabetes and dementia, the care for people with these problems costs millions and millions. Preventing these and other problems or delaying the onset of the should be our focus, not managing them once people have them.

I think we should offer limited IVF treatment on the NHS because our country has an ageing population and we need those babies to grow up and be NHS doctors and the like.

Re Perhaps one answer is to have subsidised private vaccinations to anything other than 'core' illnesses. The core preventable illnesses would still however require an assessment of threat, risk and harm. I am not sure this would work. I have paid privately for our son to be vaccinated against chicken pox and for my daughter to be vaccinated against flu (my son gets flu vaccine free). We can afford it, not very badly off but it is quite hard to get private vaccinations, my dd went three years with no flu vaccine because it was not available. If my daughter or son were ill with these diseases that could be vaccinated against the NHS would pay thousands to care for my kids. So the NHS should pay the relatively small sum to keep my kids safe. Who knows, my kids could grow up to be doctors!

We also paid for our fertility treatment ourselves, BUT the key thing about vaccinations is they help to build some sort of herd immunity. So they need to be pursued.

Maybe world governments should work together on making vaccines cheaper!

There are lots of options to make and save money for medical care and prevention. In my mind, no answer to all this is to leave children vulnerable to diseases we can prevent.

Prevention is better than cure.

In the EU it is indicated from 2 months onwards Bexsero SPC

The leaflet acknowledges that the longer term efficacy has still to be established, as would be expected with a relatively new vaccine. I am in no doubt that trials are continuing in order to determine what booster regime will be implemented longer term. I have signed the petition, for one child to die because they could not have this vaccine is one too many.

Please look at my link upthread which estimates the cost to the NHS to a child who has survived MenB but with dreadful effects

My Daisy was gone in a matter of hours, oh if only..........................

NightLark that's the one I linked to up thread.

1234 it says

"The Committee noted that uncertainty remained regarding a number of key parameters associated with the impact of the vaccine in infants and adolescents, including effectiveness against disease, strain coverage and duration of protection against disease, and as each of these factors affected the impact of the vaccine, they also affected the cost-effectiveness of the vaccine."

And

"The Committee therefore concluded that an adolescent programme, though plausibly cost effective at a suitably low vaccine price, posed too high a risk of producing less overall health benefit than other current health service interventions without further investigation, particularly of the vaccine efficacy against the acquisition of carriage."

italian the point is that they don't know if it is safe and useful/effective yet.

This talks about the safety....

www.meningitisnow.org/how-we-help/campaigns/beat-it-now/faqs-on-meningitis-b-vaccine/

The main reason for not extending it seems to be cost.

The JCVI statement talks about the clinical trials and says this in relation to safety:

"Data were too limited to identify rare adverse reactions to the vaccine, however the Committee agreed that the infrastructure and expertise available in the UK would allow the acceptability and safety of the vaccine to be assessed."

So it seems that it is still being assessed.

.... but they are giving it safely to babies.