Sunday, October 12, 2008

Health

USN Current Issue

Children's Health: Preteens Should Now Get Their Meningitis Vaccination

By Adam Voiland
Posted 11/8/06

Invasive meningococcal disease is a nasty strain of bacterial meningitis that kills up to 14 percent of people who get it and leaves 19 percent of survivors with severe disabilities such as deafness, retardation, and limb loss. So, many parents were irked by summer shortages of a new vaccine that federal officials have recommended for kids ages 11 and up. Older teens heading off to college typically had access to the vaccine, Menactra, while their younger brothers and sisters generally didn't. Last week, the Centers for Disease Control and Prevention announced that the shortages have ended, and renewed the call for 11-and-12-year-olds to be vaccinated.

But now parents may be wondering if it's such a good idea after all. In recent weeks, both the Food and Drug Administration and the CDC have raised red flags about a potential link between the vaccine and Guillain-Barre Syndrome (GBS), a rare neurological disorder that usually begins with a tingling sensation in the legs and can spread to the upper body and arms, sometimes increasing in intensity until a person is completely paralyzed and in need of a respirator. With treatment, most people recover, but some are left with permanent disability and a few die of the condition. Concern about the possible link first arose in October 2005, when researchers reported five cases of GBS among Menactra recipients. Since then 10 additional cases have been reported.

"If the connection is real, it would mean there is one extra case of GBS for every 1 million vaccines given," says Dr. Robert Davis, Director of the CDC's Immunization Safety Office. He said the CDC is monitoring the situation closely and that a study led by a Harvard researcher should reveal more concrete answers in about two years.

Meantime, experts say, parents shouldn't worry. CDC officials point out that GBS is so rare and poorly understood that scientists don't even know its background incidence in the population yet, and that because some of the 15 affected people got GBS as much as a month after receiving the vaccine, other factors may have been the trigger. A major reason for publicizing the connection at all is to encourage doctors and the public to report any other cases. So far, says Davis, there's been no spike in reports. "We're looking at it very closely. Obviously we're very concerned about reports of any adverse reactions, but at this point we just don't have the information that there is a direct link," says Donna Cary, a spokesperson for sanofi pasteur, the vaccine's manufacturer.

For now, the CDC, FDA, and American Academy of Pediatrics think all 11- and 12-year-olds should get the vaccine unless they have a family history of GBS. All point out that a small risk of developing GBS, if it exists, hardly compares to the devastating effects of bacterial meningitis. Says Henry Bernstein, a pediatrician at the Children's Hospital at Dartmouth and a member of AAP's Committee on Infections Diseases: "I am encouraging all of my patients to get the vaccine. The benefits far outweigh the risks."

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