Comment: Keep kids on schedule for meningococcal vaccines

Published 1:30 am Saturday, June 8, 2024

By Christin Gilmer / For The Herald

Meningococcal disease is a serious and life-threatening illness that can strike individuals of any age, but adolescents and young adults are particularly susceptible.

The current vaccination schedule for children — which recommends an initial dose at ages 11-12 followed by a second dose at age 16 — has been carefully designed to provide immunological protection during this period of adolescent vulnerability.

At ages 11 to 12, children receive regular medical care that is often managed by a parent or guardian and their medical provider. By age 16, many teens visit health care providers less frequently according to the National Center for Health Statistics, even though there is an increased risk for invasive meningococcal disease during this time period of their lives, given the tendency to participate in high-risk behaviors like intimate contact, visiting social venues and sharing drinks. Further, vaccination coverage rates for 11- to 12-year-olds is 89 percent, but for older adolescents these rates drop to 61 percent, which is likely attributable to the fact that they are less likely to keep up with routine exams.

Since these routine recommendations were set in place in the mid-2000s, almost 90 percent of 11- to 12-year-olds have been immunologically protected against the four common strains of meningococcal meningitis. Despite the success of the current vaccination schedule, the Advisory Committee on Immunization Practices and at the Centers for Disease Control and Prevention are considering the removal of the initial dose administered to pre-teens and instead opting for a delayed schedule for the primary dose when adolescents turn 16, despite the fact that older children are less likely to attend health care appointments than their younger counterparts and thus, fewer young people would likely receive this critical vaccine.

While the effectiveness of the meningococcal vaccine wanes over time, delaying the primary vaccination age until 16 likely means tens of thousands of vulnerable teenagers would not receive any shot at all. Any protection conferred by vaccines against this virus, even at an earlier age, is significantly better than none.

We are fortunate in that there are only between 10 and 20 cases of meningococcal disease in Washington state each year, primarily because of high rates of vaccinations. Altering this schedule may jeopardize the health of our youths and compromise our collective efforts to prevent the spread of this deadly disease. Removing the initial dose at ages 11 to 12 may not only undermine public health efforts but also exacerbate existing health disparities, disproportionately impacting low-income communities and those with less access to medical care.

These communities face numerous barriers to receiving health care, including systemic inequities in access to quality care, economic disparities, and in many areas, cultural and linguistic barriers. We must consider any changes to vaccination schedules through the lens of health equity and an understanding of these disparities followed by a commitment to addressing them. Unfortunately, altering the meningitis vaccination schedule without considering the specific needs of these communities may only serve to widen the gap in health care. We need more data before any decision of this magnitude should be considered.

By removing the initial dose of the meningitis vaccine at ages 11 to 12, we may be depriving these communities of a crucial opportunity to protect their children from this disease. It is essential that public health policies and interventions are developed in collaboration with these communities, with a deep respect for their knowledge, experiences, and needs.

It may compromise the health of some of our most vulnerable youths, and it could also deepen existing health disparities, particularly among low-income communities.

As an advocate for health equity, I know how important it is to reconsider any changes to vaccination schedules that will undermine the well being of our most vulnerable communities.I urge the CDC to recognize the impact a change of this caliber would have on our communities and maintain the meningococcal vaccine recommendation for 11- and 12-year-old children.

Dr. Christin Gilmer is a doctor of public health and a global health scientist. She has led and worked on research projects and policy analyses at the World Health Organization, United Nations Population Fund, University of Oxford, Harvard University, Columbia University, the United Nations Refugee Agency, UNICEF, Special Olympics International and provided health policy advising for multiple statewide and nationwide election campaigns.