Parents rush to check meningitis vaccines after deadly Kent outbreak

Parents have scrambled to doctors to check for meningitis vaccines, sending images of their children’s ‘baby books’ to ensure they are protected prior to holiday trips to the UK, following the deadly disease outbreak in Kent.

Paediatrician Robert Cassar said this was the case especially among parents of older children, born pre-2020, when the MenB vaccines for the bacteria that caused the outbreak started to be provided by the State for free.

The ones born after 2020 know they are covered, he said, adding that the meningococcal disease linked to the University of Kent and Canterbury could serve as a wake-up call for the MenB immunisation of children aged over six.

This would have to be done privately, however, as the State started offering it to those born six years ago, although it was already available in Malta on payment in 2017.

“Vaccines are always important,” Cassar said.

“Without wanting to set alarm bells ringing, yes, a good proportion of kids over six would be at risk here if there were to be an outbreak of the disease,” he continued, acknowledging that while “we have it good”, the more susceptible remained unprotected.

The Kent outbreak last month, characterised as “unprecedented” due to its rapid, “explosive” spread, resulted in two deaths, around 20 confirmed laboratory cases of invasive meningococcal disease (Group B), and numerous hospitalisations, primarily among students.

It is now reported to have passed its peak, with no new confirmed cases for several consecutive days.

But parents locally rushed to their paediatricians, or sent shots of children’s health guidebook, which includes an important immunisation record.

Cassar said Maltese children in general were well covered for the disease, referring to a local “obsession” with meningitis.

“I never had a single patient who refused that vaccine,” he said, even when he encouraged it before the government started paying for it.

The MenB vaccine (Bexsero) was already available privately in Malta nine years ago. Once it was offered for free in 2020, there was a big uptake, Cassar maintained.

Babies born in Malta after 2020 are very well covered – “probably the best in Europe” – he noted. Locally, they get every available vaccine, meaning MenB and Men ACWY, and a booster for the latter at age 14.

“Malta is also one of the very few countries that gives the meningitis ACWY under the age of one. Now, it is paid by the state at three months. While most other countries, like the UK or Italy, do it as teenagers, we do it as babies.”

Cassar explained that in the UK, the NHS started the vaccine programme against the bacterium Neisseria meningitidis Type B – the cause of the Kent outbreak – in 2015, five years before Malta.

So, children over 11 in the UK were not vaccinated, and that was why it was not the younger ones that were affected, he said.

MenB is spread through close contact with respiratory and throat secretions (saliva and spit) from someone who carries or has the infection. Typical routes include prolonged close contact, with transmission generally requiring living in the same household and crowded shared accommodation, as well as coughing, sneezing, kissing, or sharing drinks, vapes or cigarettes, Cassar explained.

Being an infection that is transmitted from saliva and respiratory fluids, it peaked in babies who put things in their mouths and sneezed without covering, for example, and in teenagers for other reasons.

Investigations strongly linked the outbreak to a nightclub, where “close and prolonged contact” occurred, similar to outbreaks seen in student populations historically.

Club Chemistry in Canterbury, identified as the centre of the outbreak in early March, is now set to reopen after undergoing deep cleaning.

The UK Health Security Agency called the outbreak unusual due to its rapid pace, with 15 cases emerging within 48 hours, when typical MenB outbreaks involve two to four cases over a longer period.

Since the outbreak, over 10,000 preventative antibiotic courses have been administered, and thousands of doses of the Bexsero vaccine have now been given to students and those linked to the affected venues in a targeted programme at the universities in the area and pupils at local secondary schools.

Living in our noses but rarely causing disease

Meningococcal bacteria are not as contagious as measles or COVID-19. Brief, casual contact, like walking past someone, carries very little risk, Cassar said.

In fact, a significant proportion of people carry the bacteria, including Group B, harmlessly in the back of the nose and throat without ever becoming sick, he said, adding that 10% to 20% of the population might have it there but it causes no problems at all.

One out of four people may be carriers at any given time, with higher carriage rates among adolescents and young adults in settings such as universities.

These carriers can still spread the bacteria to others, but only a very small minority of their close contacts go on to develop invasive disease, Cassar said.

Replying to questions regarding a MenB booster that parents were asking about, he said that back in 2017, anyone over two years got two vaccines, but now it is being recommended that those in high-risk groups get three.

In Malta, the vaccination programme is similar to most of Europe. However, rotavirus and chickenpox are private-only vaccines.

The new baby book ‘bible’ lists all immunisations required, including the private-only vaccines, although they are not indicated as free on it.

For the national immunisation schedule, visit here.