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.

Do you work for JCVI bumbley?

Does it really matter about the range of disabilities? Of course some will be less or more disabled but it will still be a shed load of money long term. Perhaps it should be factored into the whole cost benefit analysis.

No, I don't.

The extent of the disability will impact on the costs of their lifetime care which matters if you're actually trying to compare costs.

I don't think it's possible to put a price on the costs of looking after a child post meningitis. The young man I know will never live independently. He is unlikely ever to work or marry or drive a car or travel the world. His life was shattered by meningitis. His parents have the worry of what will happen to their son when they are too old to look after him. Their dreams and hopes for the future were destroyed almost overnight.

It's not just the child is affected, but the whole family. Living with a disabled child is not easy.

I wonder if that's what they're referring to when they say 'quality of life losses to family members'. (Last point on the below list)

"The changes requested by the Committee were generally, but not exclusively positive towards the impact of the vaccine, the Committee considered it important these were modelled to ensure the robustness of the model. The changes made were:
• Revision of quality of life losses to include additional quality of life losses associated with the short term phase of IMD
• Inclusion in the base case model of a quality of life adjustment factor agreed by the JCVI in June 2013 (as opposed to this being accounted for in an additional analysis as had been done previously)
• An increased incidence of disease, considered by the Committee more representative of average incidence over a longer period
• Inclusion of new data on the rate of minor and severe sequelae following IMD
• Inclusion of a proportion of litigation costs associated with meningococcal disease in
the NHS
• Inclusion of quality of life losses to family members."

Almost impossible to calculate lost future earnings of child, the tax they would have paid, the loss of family earnings..... Must be a huge figure.

If we're looking at costs, then we need to consider the costs of the care for children who are damaged by vaccine. I'm not anti-vax by any stretch of the imagination but acknowledging that some vulnerable children will be permanently disabled by vaccinations is important.

Meningitis can cause brain damage that mimics autism. I would far rather have a child with autism than have a child suffer meningitis. Vacinne damage doesn't usually kill.

Thats true Zariyah.

I don't envy the JCVI having to make these decisions.

I agree with everything you've said reallytired. Also sugar I am so sorry about your baby

I find it really depressing that with all medical advance elsewhere healthy children often seem to be the lowest priority. 30 preventable deaths per year is too many, not to mention the children who survive but whose lives are ruined. But yet we get the predictable 'nhs can't afford it'- type responses. On a parenting website where surely we should be standing up for this very vulnerable group (our dc) who cannot speak out for themselves.

Of course the "predictable" responses about cost to the NHS are going to come out - the thread is about cost. If the government and NHS are not going to shift on this then it would seem reasonable to try to suggest some possible solutions, which have tended to accompany those responses, such as mine. Nobody is minimising the human cost or Sugar's loss. It's a genuine discussion/ debate. For the record I've been following the interesting points raised by others, especially Italian's which I also completely take on board. I understand that the prevention of death and serious illness may well offset the cost of supporting those with life changing injuries. I have tried to phrase my points as inoffensively and objectively as possible, bearing in mind it is hard to have a discussion about such a personally emotive issue.

I understand that but 30 deaths per year plus a larger number of dc left injured for me cannot come down to cost in a developed country. If it does then quite simply the NHS is not working.

By all means yes consider efficacy ie is it actually going to work and reduce the effects or in reality does the vaccine only last a year/ not work in under 10s/ have other side effects? But to start comparing on cost to the NHS of supporting a child damaged by this terrible disease to vaccinating the whole population..... What about the human cost?

And OK perhaps it's 'what the thread is about'...... I personally find it disturbing however.

As I've said, nobody is minimising the human cost.

It hard to have a rational discussion with considering statistics. The U.K. wants a fully funded nhs without paying more tax. If we are not prepared to pay more tax then corners have to be cut from somewhere.

It's also worth considering that there may be other ways to save lives without it costing as much as rolling out a vaccine campaign to another lower risk age group e.g. introducing the new diagnostic tests that I mentioned upthread. Tbh even if the vaccine was introduced for all children, the tests would still be useful because the vaccine isn't 100% effective and doesn't cover all strains. The tests on their own may even save more lives than the vaccine in certain age groups. There are so many things to consider - we shouldn't just focus on one way of achieving the end goal.

Any diagnostic test would need to be pretty well instantaneous to really make a difference, and would need to be able to be carried out at GP surgeries as well as A&E and the technology simply isn't there, it takes days to culture samples and get an identification of strains of bacteria. If it were simple it would be happening already.

Trust me. By the time you realise what is going on (and have been sent home three times in my case) there often isn't time for a diagnostic test.

WhoKnows, the technology is available and it is happening. Eg. this one

It would be great but it doesn't exist yet and wouldn't catch every case either.
Children would still be sent home thinking that they just had flu.

Now, personally, if there are limited funds and it's a choice between making those types of tests available or vaccinating one of the lower-risk groups with a vaccine that they haven't determined the effectiveness of yet, then I would be leaning towards the tests.

Now personally if there were limited funds and it is a choice between saving these children and delaying building something like HS2 railway, I would save these kids first. I would save your child first.

Please sign and share the petition if you agree.

petition.parliament.uk/petitions/108072

Even if you know a child has meningitis it can be hard to save them from harm. We need to stop children getting meningitis in the first place.

How do you know that the vaccine would save my child 1234? You don't know if it is effective (because the experts still don't) and it doesn't cover all strains. Fair enough if they can divert funds away from something else like railways but even then, what if the diagnostic tests could actually save more lives than the vaccine? Wouldn't that be a better way to spend the money then?

Of course both would be lovely to have both the vaccine and diagnostic tests & nobody has claimed that the Men B jab is 100% effective but it still prevents a lot of cases (88%) and that is good enough for me.

This talks about the success rate - www.meningitis.org/menb-vaccine

How effective is this vaccine?

The effectiveness of a vaccine is determined by many things, including how strong an immune response it produces (its ‘immunogenicity’), and how widely it covers disease-causing strains circulating in the country. Results from the vaccine trials are very encouraging, showing that the vaccine triggers a strong immune response in infants, toddlers and adolescents. Studies looking at how well circulating MenB strains match the vaccine have predicted that it will cover approximately 88% of MenB circulating in the UK, and 78% of MenB in Europe over all.

Maybe improving A and E would save more lives. Our local A and E is completely overstretched due to lots of smaller accident and emergency units in other towns being closed and the population increasing. The fact that many GP surgeries are swamped may also cost lives.

ReallyTired I acknowledge your points. FWIW, I want my DC vaccinated against meningitis B. However, I was just stating that sadly some children do get damaged by vaccines and if we're looking at things from a purely cost perspective, then that needs to be taken into consideration. I only said this because people were discussing the costs of long-term care for children who are left disabled by meningitis and I was balancing that up against long-term care for children who are left disabled by vaccines.