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Nova Scotia doesn’t vaccinate against most common meningococcal meningitis strain

HALIFAX – A vaccine is available for the most common strain of meningococcal meningitis, but it isn’t being offered in Nova Scotia.

On Tuesday, the province announced it will begin offering vaccinations against the A, C, Y and W strains of the disease starting in the fall. It previously had only been vaccinating against the C-strain.

However, the B-strain of the disease of the most common. Figures from the Public Health Agency of Canada show there were 111 cases involving the B-strain between 2007 and 2011. Of those cases, 12 were from Nova Scotia.

READ MORE: Lower Sackville student dies after meningococcal meningitis diagnosis

“Now the most common type is B and there is a vaccine for that,” said Dr. Joanne Langley, a vaccine researcher with the Canadian Centre for Vaccinology. “Quebec is using that and those were the outbreaks in the United States. I think is the next question to ask [is] should we provide B protection?”
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MORE: What vaccinations do provinces and territories offer? (external link)

The Public Health Agency of Canada reports 62 per cent of reported invasive meningococcal disease (IMD) in 2011 were a result of the B-strain. The same year, only two per cent of reported IMD cases were due to the C-strain.

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The Canadian Pediatric Society said the mortality rate for children under the age of 19 years from the B-strain is between four and six percent. The estimate is based on data from 12 children’s hospitals from around the country, including the IWK Health Centre in Halifax.

MORE: Read the Canadian Pediatric Society statement on the B-strain vaccine (external link)

So why doesn’t Nova Scotia offer vaccination against the B-strain in its current routine immunization schedule?

A vaccine for that specific strain was only approved in 2013, and no provinces or territories currently cover the cost of the vaccine, according to the Canadian Pediatric Society.

MORE: Report from National Advisory Committee on Immunization on the B-strain vaccine (external link)

Top health officials in the province said they are looking into it.

“What I can assure [you] is we are going to review and look at it,” said Nova Scotia Health Minister Leo Glavine. “Cost will not be the paramount consideration. We have to see again the efficacy and so forth. It is a relatively new vaccine.”
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Nova Scotia Public Health Officer Dr. Robert Strang said several factors need to be taken into consideration before the province offers the vaccine.

“Is the disease important enough that we include those in our publicly funded program? And if so, how do we then go about making the case to get funding to do that?” he said.

“We’re actively in the process of looking at that and looking at how we can move that forward.”

READ MORE: Nova Scotia to vaccinate against meningitis strain that killed Sackville teen

The National Advisory Committee on Immunization makes recommendations about the use of vaccines in Canada, but it appears to be on the fence about whether the vaccine should be publicly offered across the country.

“Currently it is not recommended to include the multi-component meningococcal serogroup B vaccine in routine immunization programs for Canadian infants, children, adolescents and adults,” it said in statement.

It cites the lack of evidence, uncertainly over how long protection will last and possible adverse effects of the vaccine.

Whether Nova Scotia will offer the vaccine is not yet known, but doctors said the disease is rare and can be prevented through means other than vaccination.

“We can all prevent transmission of meningococcal meningitis [and] other bugs by not sharing water bottles, food and cigarettes,” said Dr. Robin Taylor, medical officer of health for Capital Health and the IWK.. “Especially the age group that tends to share things — kids and teens — now is a good time to use your own water bottle and not share with anybody else.”
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