Meningococcal B vaccination: update

Meningococcal B (MenB) is a very serious disease that can lead to meningitis and sepsis, and ultimately result in death. These are grounds to consider offering children and adolescents a vaccine through the National Immunisation Programme (RVP). As new data has emerged since the previous advisory report was issued in 2018, the Health Council of the Netherlands has carried out a new assessment. The Council has established that the number of cases is relatively low. In the first half of 2022, there were 6 cases in young children and 15 in adolescents. To reduce this number, 175,000 children would need to receive the vaccine every year. It is difficult to say precisely how effective the vaccine is, because the disease is rare. The vaccine is estimated to be 70 to 80% effective in the Dutch context. Vaccination does not result in herd immunity. The vaccine also has a highly unfavourable cost-effectiveness ratio, due to the low number of cases, the high price of the vaccine, and the fact that several doses are needed. Compared to other vaccines, the MenB vaccine causes a relatively large number of temporary adverse events such as high fever, particularly in young children. This often leads to hospital admission and medical intervention. The Council therefore recommends against the inclusion of the MenB vaccine in the RVP for the time being. The MenB vaccine is already currently offered to certain medically at-risk groups. Outside the RVP, individuals may have reason to opt for the MenB vaccine. It is therefore vital that the vaccine is well-known and accessible, to ensure that people can make their own decision. There may be reason to reconsider this recommendation in the future, for example if the number of cases grows, the price of the vaccine falls considerably, or a new vaccine is developed.