Meningitis shots are urged for kids, but few know it

Chicago Tribune

(KRT)

CHICAGO - No one mentioned anything about a meningitis vaccine when Tommie Colonna, 12, of Park Ridge, Ill., visited his pediatrician this month for his annual exam. Nor did his school include meningitis information in material sent to Tommie as he entered 7th grade.

As students head back to school this fall, relatively few parents may know that the federal government now recommends that children ages 11 to 12 and incoming high school freshmen be vaccinated against bacterial meningitis, a rare but potentially deadly disease.

It's the first time public health officials have targeted adolescents for such a vaccine, but experts say low awareness and tight supplies mean few of the 8 million children covered by the recommendation are likely to get shots in time for the school year.

Publicizing the new recommendation carries a built-in challenge, given the ever-growing list of required childhood vaccinations for diseases such as chickenpox and hepatitis B. But Tommie's mother, Lisa Colonna, said she would have liked to have heard something - anything.

"I would have thought that we would have gotten something from school for the summer saying, `You're going to the doctor; here's what's new,'" said Colonna, a stay-at-home mom.

Both the health facilitator for Tommie's school district and his pediatrician said they had not heard of the new recommendation, formally issued in May by the federal Centers for Disease Control and Prevention.

Many school officials said they would not raise the vaccine issue with students and their parents unless the state required it. The Illinois legislature has not passed a law regarding meningitis shots for students younger than college age.

"We are not allowed to recommend something that the state has not yet mandated," said Jaime Dircksen, coordinator of school health for the Chicago Public Schools.

In the meantime, education and health officials said school districts are free to provide information on the vaccine if they wished.

Dircksen said school officials are trying to encourage outside health providers to offer the vaccine to children. But even that has been difficult this year because the CDC's recommendation has strained supplies of the vaccine, a new product called MCV4 and sold under the trade name Menactra. It only became available in March.

"It's literally just rolling off the production line," said Jennifer Morcone, a CDC spokeswoman.

Many colleges have recommended in recent years that freshmen be vaccinated against meningitis, which can spread easily in dorms. The students get an older vaccine that is not suitable for children because its effectiveness wears off after a few years and cannot be fully renewed with a booster shot.

Now, Morcone said, parents of adolescents are seeking meningitis shots just as this year's crop of college freshmen also are ordering the newest version. That has created a shortage.

"It's hard to recommend (getting vaccinated) when we do not have supplies," Dircksen said.

Last month the vaccine's maker, Sanofi Pasteur, issued a statement saying health-care providers could get a maximum of 20 doses at a time. The company emphasized that the older vaccine should be considered an option, especially for college students.

Pediatricians said few parents object to immunizing their children - once they are aware of the vaccine.

"As soon as we mention it is for meningitis, most parents are eager," said Dr. Karen Goldstein, a professor of pediatrics at the University of Chicago. "We have started receiving some stock but do not have an adequate supply. We have told the parents to call back to see when we have it available."

Bacterial meningitis is a rare disease - about 3,000 cases are reported each year nationwide - but the consequences can include brain damage, limb loss and, in 10 percent of cases, death. The disease strikes most commonly in infants and in young people ages 11 to 19.

Outbreaks at schools can be devastating for a community, officials said, especially in unusual cases when the disease strikes more than one child.

"All diseases are not created equal, and with this one, it is so severe that a few cases can cause substantial burden, and it also causes a lot of panic," said Dr. Dan Fishbein, a medical epidemiologist with the CDC.

The CDC issued recommendations on meningitis because of the disease's severity and its public impact - each case requires a public health response and administration of antibiotics to those in close contact.

Since 2000 the health agency has recommended that information about meningitis shots be provided to college freshmen, particularly those living in dorms. But the agency did not suggest that younger children be vaccinated.

The reasoning was that if an 11-year-old child got the older vaccine, the effects would wear off by the time he or she entered college, a crucial period.

Because Menactra lasts longer and can be administered as a booster shot in later years, the CDC this year expanded its recommendation to include adolescents, Morcone said.

The vaccine offers protection against four strains that cause about 70 percent of bacterial meningitis cases in the United States. It does not protect against viral meningitis, usually a less severe disease.

Bacterial meningitis is spread through contact with saliva or mucus, such as through kissing, coughing or sharing of kitchen supplies like cups and utensils.

The disease can be treated with antibiotics if diagnosed early, but the symptoms - including high fever and a headache - often are mistaken for lesser diseases. To positively diagnose it, doctors must perform a spinal tap.

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(c) 2005, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.