Wednesday 28 September 2016

How to defend against meningitis and shingles

Nina Byrnes

Published 15/03/2016 | 02:30

The introduction of a meningitis B vaccine in the early 2000s in Ireland greatly reduced the incidence of the condition. Photo: PA
The introduction of a meningitis B vaccine in the early 2000s in Ireland greatly reduced the incidence of the condition. Photo: PA

Advice from our GP on vaccinations for meningitis B and shingles.

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Question: I have heard a lot about the meningitis B vaccine and I would like to get my children vaccinated. Is this available free in Ireland or how do I get it done?

Dr Nina replies: Bacterial meningitis B is a disease that is universally feared for good reason. Up to one-in-10 children will die from the condition, with many others left with lifelong disability having survived the disease.

The introduction of a meningitis B vaccine in the early 2000s in Ireland greatly reduced the incidence of the condition.

Meningitis B is by far the most common type of meningitis and so, the arrival of a vaccine for this is warmly welcomed. The NHS introduced routine vaccination for meningitis B for all babies born in the UK after May 2015.

Doses are given at two, four and 12 months of age. In recent times, there has been a call for a catch-up programme of vaccination, extending immunity to children born before the May 2015 introduction. This was recently rejected as not cost-effective by British parliament, but the debate goes on. A number of high-profile cases of meningitis B have led to many people seeking to pay for vaccination privately and as such, there is now a global shortage of vaccine supplies.

The National Immunisation Advisory Committee in Ireland has recommended introduction of a meningitis B programme here. The Department of Health recently announced that a deal has been struck with the manufacturer and that it is planned to introduce vaccination to babies aged two, four and 13 months from late 2016. It does not seem likely at this stage that a catch-up programme to older children will be offered.

The vaccine available in Ireland and the UK is Bexsero. This protects against approximately 80pc of the strains of meningitis B in circulation.

Over a million doses of meningitis B vaccine have been given globally to date and it is considered to be a safe and effective vaccine.

Many children under the age of 12 months will experience redness or soreness at the site of vaccination and a fever. It is therefore recommended that paracetamol be given at the time of vaccination to prevent this febrile reaction. Depending on the age of the child, two to three doses are required to maximise immune cover.

GPs across the country have been receiving enquiries about the possibility of private vaccination. In the case of adequate supplies, it is possible to pay for the vaccine and administration. GPs either order the vaccine or issue a prescription, which allows this to be purchased at a pharmacy. Some travel clinics have also been offering vaccination.

Bexsero costs between €100 and €120 per dose to buy. Administration is not covered by the medical card and most clinics charge a fee to administer the vaccine.

Due to the global shortage of availability, the vaccine is proving difficult to source. The manufacturers have requested that available doses are used to complete vaccine courses that have already commenced, rather than starting new courses. It is hoped the vaccine shortage will ease this summer.

Meningitis B is rare, affecting five-in-100,000 under the age of four, even less in the older age group.

Question: I am worried about getting shingles and have heard there is a vaccination available. I’m interested in getting it. At 65-years-old, will it suit me? Can you tell me more about it? Is it free and where can I go to get it?

Dr Nina replies: Shingles is an infection that causes a painful blistering rash. It affects about three-in-1,000 people annually in the UK, with similar numbers expected in Ireland.

Shingles primarily affects those over the age of 50. Once a person has had chicken pox, the virus remains in the body.

Shingles occurs due to a reactivation of the chicken pox virus. The exact triggers are unclear. The rash itself eases over five to 10 days, but a post-infectious nerve pain may be prolonged and uncomfortable complication.

The shingles vaccine may reduce the chance of developing this painful rash by over 50pc and, more importantly, reduce the chance of post-infective complications by over 60pc. Even if the vaccine doesn’t provide a 100pc cover, those who have been vaccinated are much more likely to experience a mild infection.

Vaccination has been available since 2006 and is recommended to all those over the age of 60 by the Centers for Disease Control and Prevention in the US. It was introduced in the UK for those aged 70 to 78 in 2015.

In Ireland, vaccination is available privately through your doctor.

A single does of vaccination is required. The vaccine itself costs between ¤180 and ¤200 and most clinics charge an administration fee. It is not covered on the medical card.

The shingles vaccine is a live vaccine, therefore, it should not be given to those who are immunocompromised, those who are pregnant or planning to become pregnant. It is well tolerated.

Common side effects are a sore arm or headache after vaccination. A small percentage of people develop a transient chicken pox-type rash in the days or weeks post vaccination.

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