Male1: This time of the year, pediatricians are filling in a lot of forms for kids to go to college and there is a little question in the air. Did your kid get this vaccine against meningococcal meningitis. Why are they insisting a point? Is this is a conspiracy?
Male2: Meningitis is probably the scariest word that any parent can hear. Meningitis is a bacterial infection that invades the spinal cord and can go up to the brain. Meningitis is actually an infection of the brain and meningococcal disease which is a specific type of bacteria is very, very common in teenagers and young adults. In fact, there is about 3000 adolescents and young adults that develop meningococcal disease every year. There is a fairly new vaccine, naturally it has been helpful for quite a while. We have known about meningococcal disease for many, many years, but we finally have a vaccine that could prevent it from getting meningococcal disease. The vaccine only protects against four types of meningitis, four types of meningococcal disease, so it is not a hundred percent, but the recommendation right now is for all teenagers at eleven or 12 and certainly, for teenagers who are going off to college specifically those who are living in dormitories receive this vaccine to decrease the likelihood that they are going to get meningococcal disease—meningitis.
Male1: Is this vaccine safe?
Male2: It is very, very safe. It is costly, but most insurance companies do pay for this vaccine. The trade name is called Menactra, but it is safe. You can get some local irritation at the inoculation site.
About two years ago, there was a question about a disease called Guillain Barre Syndrome, which is a disease that can have devastating complications like paralysis. Since the American Academy of Pediatrics and pediatricians have been looking at this issue, we now know that Menactra or the meningococcal vaccine does not necessarily lead to the Guillain Barre Syndrome.
Male1: But there is a pocket of benign cases.
Male2: However, there have been reports of kids developing this disease, but we believe that the vaccine is still safe, but parents need to discuss with their pediatrician the risk of Guillian Barre Syndrome and make sure that that vaccine is appropriate for them. It should not necessarily be given to everybody. In fact, there are some patients, teenagers and young adults that they should not receive this vaccine.
Male1: And Guillain Barre cases, at least the impression that most people have now, they are sporadic and it seems, it was not really increased if you took a hundred thousand kids vaccinated and the adults and kids that were not vaccinated, the number of cases were probably about the same, but there was a little pocket, I think around Maryland or some place.
Male2: That is absolutely true. If you look at the incidence of Guillain Barre Syndrome in the general population, there probably is no higher incidence in those kids who received the vaccine, but I think this is an important discussion that every parent has to have with their pediatrician. To determine if they want to have this vaccine for their teenager or young adult, especially those going off to college who are going to be living in dormitories or those who are in the military. It is real important to have that discussion to determine if you want to have that vaccine.
Male1: Well, New York State if the kid goes to overnight camp for several days, the State of New York wants the kids to have that vaccine?
Male2: That is absolutely true. If you are going to a camp, a sleep away camp where you are going to be spending more than seven days, you need to have this vaccine, however, if you and your pediatrician decide that there is a contraindication or the parent refuses, there are many camps that will still allow the child to participate in the overnight camp.
So again, I think that the discussion is important to have with your pediatrician.
Male1: And you should talk about the cost factors a little bit. It is about $85.00 to $90.00 to buy the vaccine, so it is not an expensive--
Male2: It is not cheap, as I said, most of the insurance companies will pay for it for those people who do not have insurance or those people who cannot afford it, there are programs like in New York State, the vaccine for children’s program will pay for the vaccine for those kids who are eligible.
Male1: But I would say, the cost of one child’s life, you cannot put a figure on that.
Male2: Absolutely, $85.00, the truth is, as mothers and fathers who will spend millions to protect our children and $85.00 is a drop in the bucket.
Male1: The newer vaccines seems that if you culture it—3% or 4% of kids might have a little meningococcal in the nose and they live in dorms, I heard that some say that it could be 30% after a few months.
Male2: That is absolutely true. Sometimes, kids actually harbor this bacteria and are living perfectly fine with it. What we are particularly concerned about is if those kids will actually expose others to this disease and that is why we are suggesting that the meningococcal vaccine be given to all teenagers and young adults who are living in closed quarters, some military recruits for example, kids who are in college dorms. Those would be the kids who it would be appropriate for, but again, there are medical contraindications, so for example if an adolescent or young adult is immunosuppressed for whatever reason, whether they have a malignancy, they are on chemotherapy, if they HIV or AIDS those will be medical contraindications, so those kids should absolutely not have the vaccine.
Male1: But before someone gets it, they really should go over the literature and fully understand it.
Male2: Absolutely, I do not think that anybody, no recommendation should be followed blindly. This is where the pediatrician is the expert in children and adolescents and young adults and a good discussion really needs to occur in the office with your pediatrician.
Male1: But the CDC, the American Academy of Pediatrics most good medical groups are strongly advocating the vaccine.
Male2: Absolutely.
Male1: So that really, after you review all the information, most people are not going to be against it, but there seems to be a little resistance, we are not sure about vaccines. As far as we know, this vaccine is of all of them, it is one of the safest ones that we have.
Male2: Absolutely. In fact, I have never had a patient refuse the vaccine after I have had the conversation with them and discussed the pluses and minuses, the pros and cons of vaccination. The pros clearly outweigh the cons. It is a safe vaccine and if your child does get meningococcal disease and meningitis, the disease itself is devastating.
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