Why don’t we have equitable access to meningococcal vaccines yet?

Invasive meningococcal disease remains a serious and life-threatening infection in Australia.

Is it fair that some Australian children are protected from a rare but serious, life-threatening infection and others are not?

After a long career in paediatric medicine, I am frustrated at the great divide that continues to be a hallmark of our health system — especially when it comes to invasive meningococcal disease (IMD).

This rare but potentially fatal infection poses an ongoing threat to babies, toddlers and adolescents across the country. Australia continues to see cases of IMD¹, with meningococcal serogroup B (MenB) responsible for approximately 80% of cases in 2022 and 2023.²

This nuance is important. At the moment, all Australian children are routinely vaccinated at 12 months of age against meningococcal strains A, C, W and Y via the National Immunisation Program. There is a vaccine to help protect against the most common strain, MenB, but only Aboriginal and Torres Strait Islander children and those with certain high-risk medical conditions, have funded access via this system.³

Some state governments — South Australia and Queensland — have chosen to fund state-based programs for children under two and teenagers between 15 and 19 years old.^4,5 In addition, it now looks like the Northern Territory government will also come on board and fund a state-based program, after a commitment from the incumbent Country Liberal Party prior to taking office last weekend.^6,7

I applaud those jurisdictions for taking the initiative to prioritise public health and help to protect the most at-risk community groups from MenB.

But it makes the national inconsistency even more glaring. It leaves families in several important states in the country — NSW, Victoria, Tasmania and Western Australia — having to privately fund vaccination against meningococcal B. Unfortunately, this is an expense that many families simply cannot absorb in the current cost-of-living crisis.

Recent postcode data from VIC and NSW compiled by pharmaceutical company GSK provides an insight into what is really happening. It clearly shows that families in typically wealthy suburbs are far more likely to vaccinate their children against MenB. In lower-income pockets, children and adolescents are far less likely to be vaccinated against the disease.⁸

What this means is we have a two-tier system, where the ‘haves’ have access and the ‘have nots’ are going without — not because they don’t care about their family’s health, but because it might be considered a ‘nice to have’ not a ‘must have’ when household budgets are already so stretched.

Some GPs have admitted they would be loath to even mention the availability of a privately funded vaccine, because they know a family may not be able to meet an additional cost.

A level playing field would prioritise the health and well-being of all children, as well as providing broader public health protection.

We can begin by raising our voices again. I now urge all healthcare professionals who want to see equitable access to the MenB vaccine for all children and adolescents to contact their local Member of Parliament or the Australian Medical Association.

It is simply too dangerous to play ‘postcode lottery’ when it comes to diseases like meningococcal B.

References:

^{1    National Notifiable Disease Surveillance System (NNDSS), https://nindss.health.gov.au/pbi-dashboard/ [Accessed August 2024]
2    Communicable Diseases Intelligence 2024;48 (https://doi.org/10.33321/cdi.2024.48.23)
3    National Immunisation Program Schedule. https://www.health.gov.au/resources/publications/national-immunisation-program-schedule?language=en
4    Queensland Health. Queensland MenB Vaccination Program. Last updated 18 July 2024. https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/meningococcal-b [Accessed August 2024]
5    SA Health. Meningococcal B Immunisation Program. Last updated: 06 July 2023. https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/immunisation/immunisation+programs/meningococcal+b+immunisation+program [Accessed August 2024]
6    Country Liberal Party. Free MenB vaccine for Territory babies and teens. July 22 2024. https://www.clp.org.au/news/free-menb-vaccine-for-territory-babies-and-teens [Accessed August 2024]
7    Northern Territory Electoral Commission. 2024 Territory Elections. [Accessed August 2024] https://ntec.nt.gov.au/elections/current-elections/2024-territory-election/results
8    GSK internal data on file. REF-243901.}

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