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Hervé Haas (pediatric infectious disease specialist)
The High Authority for Health recommends extending vaccination against meningitis to other serogroups. The point of view of Dr Hervé Haas, head of the pediatric neonatology department at the Princess Grace Hospital Center in Monaco.
Invasive meningococcal infections (IIM) are increasing in 2023 in France, with 560 cases recorded in 2023, an increase of 72% compared to 2022. Figures higher than those observed before the Covid pandemic, a pandemic which has elsewhere allowed a drop in cases in 2020 and 2021, due to barrier gestures and different confinements. Faced with this situation, the High Health Authority takes stock of its vaccination recommendations.
Meningitis, a fatal disease in 10% of cases
Meningitis are particularly serious infections of the brain and spinal cord. They are fatal one time in ten and cause, when they are not, significant neurological sequelae. Meningitis is caused by viruses but also bacteria, called meningococci. These meningococci are divided into different serogroups: A, B, C, Y and W.
Vaccination made compulsory for infants, against all serogroups
Currently, vaccination is only compulsory for those under one year of age for group C meningococci, even if it is also strongly recommended for group B. However, “serogroups W and Y have progressed significantly, particularly among infants and young people” describes the High Authority of Health (HAS), highlighting in particular the very deadly nature of meningococcal W infections.
Based on this observation, the health authority now recommends making vaccination of children under one year of age compulsory against meningococci A, B, W and Y, as well as C. It also considers it useful to make vaccination against strain B, for infants under one year old, “as a replacement for vaccination directed against serogroup C alone, according to a two-dose vaccination schedule“.
Vaccination would thus be carried out with a single vaccine – in two doses – for the four strains A, C, W and Y, and another for strain B.
No changes for adults and adolescents regarding serogroup B
In these recommendations from Wednesday March 27, the HAS also recalls its recommendations for older children. Currently, only vaccination against serogroup C meningococci is recommended up to the age of 24, if it did not take place when the patient was an infant. From now on, a new injection against meningococci A, C, W and Y is recommended for 11-14 year olds, even if they were vaccinated as babies, under the age of one year.
For the B strain, on the other hand, the health authority is not changing its recommendations for adolescents and young adults, because infections linked to this type of meningococcus would remain “too rare” in this age group. Frédéric Valletoux, Minister responsible for Health and Prevention, has already indicated that the “government will follow this opinion” and that it will specify “in the coming days the modalities for implementing this recommendation”.
Reimbursement of vaccination would be a good thing, according to Dr Haas
Questioned on the subject, Dr Hervé Haas, head of the pediatric neonatology department at the Princess Grace Hospital Center in Monaco, believes that “the conclusions of the High Authority of Health are positive for the Pediatric Infectious Pathology Group (GPIP). This is going in the right direction, this is what we wanted for the protection of infants but also adolescents“.
He continues by stating that “reimbursement of vaccination against meningococcal B in adolescents would be an excellent thing because we know that these infections occur in particular among the most deprived.”.
Before adding: “It will now be necessary to inform professionals and the public in order to move forward quickly, with questions remaining regarding the impact that the Paris 2024 Olympic Games on the circulation of meningococci” he concludes.