Serogroup B Meningococcal Disease at University of Oregon
The university is encouraging students to take one of the newly licensed serogroup B meningococcal vaccines (Bexsero or Trumenba); so far, about 9,000 students have received one dose of the vaccine. (Bexsero is a two-dose series and Trumenba is a three-dose series.) Students were offered the vaccine at clinics on campus, and standing orders at local pharmacies allow those at risk to get the vaccine. In most cases, student’s health insurance plans are covering the cost of the vaccine.
Meningococcal vaccination is common in college students; the conjugate meningococcal vaccine they receive includes strains from serogroups A, C, W-135, and Y. The vaccine is recommended around age 11 and a booster is recommended at age 16. Many universities require students to provide proof of meningococcal vaccine receipt upon enrollment. But these outbreaks involve a serogroup of the bacteria not included in the recommended vaccine. Only recently has the serogroup B vaccine been available to those at increased risk of disease.
The fact that her daughter was vulnerable to infection with serogroup B meningococci was not clear at first to Jami Granston, mother of a first-year student at the University of Oregon. When her daughter called her to tell her about the outbreak, she assumed the student was protected. A nurse at the daughter's pediatrician's office thought so too; she reassured Granston, "Don't worry; she's covered." The student eventually understood differently based on communications from the school; she called the doctor herself to report that, in fact, she needed a different vaccine. "I was really caught off guard by this oubreak," Granston said, "and I was shocked at how difficult it was to get accurate information." Granston then tried to get the vaccine for her daughter in her hometown of Kirkland, Washington, but couldn't locate a clinic or pharmacy that stocked it. Eventually, Granston's daughter, who had been notified that she had been in a class with one of the cases, got the first dose of the vaccine at the university's clinic.
At both Providence College in Rhode Island and Acadia University in Wolfville, Nova Scotia, Canada, two cases of disease from Neisseria meningitidis serogroup B have occurred this year. One student at Acadia died. Vaccine is being offered to students at both campuses. At Providence College, the vaccine is free. However, at Acadia the vaccine is not covered by public insurance. Regardless, 84% of students at there have received one dose.
Single cases of serogroup B meningococcal disease have been reported this year at Yale University and University of California Davis. In both places, menB vaccine is available to students, but mass vaccination is not currently being planned.
As public health officials have noted, single cases of the disease do occur sporadically, and one case does not constitute an outbreak. This was the situation last year here in Philadelphia, when a Drexel student died from serogroup B meningococcal disease, but no other cases related to hers were reported. That case was epidemiologically linked to an outbreak that occurred at Princeton University.
At Princeton, whose own serogroup B meningococcal disease outbreak spanned two academic years, students have just been advised by the administration that they are no longer at increased risk of disease from meningococcal serogroup B bacteria. There, 98% of undergraduates took at least one dose of Bexsero. Effectively, the outbreak is over and the level of community protection is high.