Govt delay over vaccine led to deaths

02:03, Oct 18 2011

Government delays in introducing a vaccine against meningococcal B during an epidemic in the 1990s led to "unnecessary and potentially avoidable deaths", new research says.

Research led by the University of Auckland says although the Health Ministry was fully briefed from 1996, it took another eight years for the MeNZB immunisation campaign to begin - at a point when the epidemic was already declining.

The effectiveness of the campaign was also not monitored properly, meaning it was impossible to know how much it contributed to the epidemic's end, the researchers said.

The research has been released weeks after a catch-up campaign was launched in Northland to vaccinate people against meningococcal C, which has killed three people in the region.

Two Wellington teenagers have also died of meningococcal C but a vaccination campaign in the region has been ruled out so far by health officials.

However, many public health workers support funding a universal meningococcal C immunisation.

An epidemic of meningococcal B - which often leads to brain damage, limb amputations and death if not treated swiftly - emerged in Auckland in 1991.

By 1996, there were more than 450 confirmed cases a year around the country - half of them in pre-schoolers - and that number continued to rise in subsequent years.

However, the research says the Health Ministry's response was marked by a "lack of engagement".

A small trial of one vaccine was carried out in 1996, but not followed up as the lack of interest from the ministry was a discouragement.

In 1997, a group of Auckland doctors convinced the ministry to attend a meeting with the World Health Organisation, where a detailed proposal for a vaccination campaign was presented.

"At this meeting in late 1998, potential vaccine manufacturers were invited to discuss their interest in producing a strain-specific vaccine to attempt to control the NZ epidemic. Despite interested vaccine companies, the [ministry] did not engage."

It was not until 2000, following persistent lobbying from health workers, that work began to sign contracts with vaccine companies.

A contract to start clinical trials was finally signed in 2002.

"At the time of the signed contract, there had been 4195 notified cases and 185 deaths," the researchers wrote.

"Many more cases and deaths might have been prevented if action had been progressed earlier on in the epidemic cycle.

"The delay in progressing the vaccine strategy, despite the Ministry of Health being fully briefed from 1996, led to unnecessary and potentially avoidable deaths and sequelae, many lifelong."

That failure to act affected disadvantaged children the most, as they were the least likely to receive the vaccine.

The nationwide MeNZB campaign was launched in 2004 after trials were completed, with about a million young New Zealanders receiving the vaccine by the time the campaign was wound up in 2008.

By 2004, the number of cases was already declining after peaking at about 650 in 2001.

Proper national monitoring should have been done to see whether the vaccination campaign accelerated the epidemic's decline, but the ministry failed again, the researchers wrote.

"Unfortunately, funding was only made available for the Auckland region by the [ministry] and was withdrawn after one year of the two-year study, rendering the data collected redundant."

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