Editor - It is now a year since the new conjugated meningococcal
group C vaccine was introduced to the UK.1 Higher education students are
known to be at a higher
risk of meningococcal disease, and were targeted in the government
vaccination campaign. Due to the limited supply and late licensing of the
new vaccine, the pre-existing polysaccharide vaccine was used.
In order to determine the implementation of the policy, we performed a
cross-sectional study of 3028 first year undergraduate and overseas
postgraduate students at the University of Birmingham in Autumn 1999.
Only 51% of UK students had been vaccinated before arriving at the
University. The main reason for this was a shortfall in supply of the
vaccine to General Practitioners. Uptake of the vaccine was not uniform;
significantly more students reading health-related subjects were
vaccinated than other arts and science students (p<_0.001. p="p"/>Fortunately
this academic year, most first year undergraduate University students from
the UK will have been vaccinated as
part of the school programme.
However, an alarming finding from our study was that only 4% of overseas
students had been vaccinated before arrival. This left both the students
and those they came into contact with at higher risk of meningococcal
infection.
This group of students will remain unvaccinated against meningococcal
infection in future years, whilst the countries of origin do not have a
school vaccination programme similar to that in the UK. At present there
appears to be no policy for vaccinating this group in the future. Recent
reports of an increase in W135 serotype meningococcal disease with the
Hajj pilgrimage2 and high levels of carriage in the Gambia3 highlight the
potential for importing the meningococcus from outside the UK.
Our study also found that international students did not receive adequate
health promotion information before arriving in the UK. Since their
contact with University Health Services might be only at the point of
registration,
there may be only a small window of opportunity to target these students
during their first weeks in the country. If further vaccination
programmes are to be effective, eg if a group B vaccine becomes available,
lessons must be learnt from the failings of the group C programme. Careful
consideration of the needs of University medical practices is required,
who sometimes do not have enough staff or vaccine supplies required to
meet demand.
References
1. Wise J. UK introduces new meningitis C vaccine. BMJ 1999;
319: 278
2. Communicable Disease Surveillance Centre. Meningococcal
infection
in pilgrims returning from the Haj. Commun Dis Rep CDR Wkly 2000; 10: 129.
3. MacLennan JM, Urwin R, Obaro S, Griffiths D, Greenwood B,
Maiden MCJ. Carriage of serogroup W-135, ET-37 meningococci in the
Gambia: implications for immunisation policy. Lancet 2000; 356: 1078.
Matthew R Edmunds
4th year Medical Student
University of Birmingham
James E Davison
4th year Medical Student
University of Birmingham
Annette L Wood
CCDC
Birmingham Health Authority,
213 Hagley Road,
Birmingham B16 9RG
Vijay Raichura
Medical Officer
The University of Birmingham ,
Health Centre,
Elms Road,
Edgbaston,
Birmingham B15 2SE
Rapid Response:
Meningococcal vaccination and university students
Editor - It is now a year since the new conjugated meningococcal
group C vaccine was introduced to the UK.1 Higher education students are
known to be at a higher
risk of meningococcal disease, and were targeted in the government
vaccination campaign. Due to the limited supply and late licensing of the
new vaccine, the pre-existing polysaccharide vaccine was used.
In order to determine the implementation of the policy, we performed a
cross-sectional study of 3028 first year undergraduate and overseas
postgraduate students at the University of Birmingham in Autumn 1999.
Only 51% of UK students had been vaccinated before arriving at the
University. The main reason for this was a shortfall in supply of the
vaccine to General Practitioners. Uptake of the vaccine was not uniform;
significantly more students reading health-related subjects were
vaccinated than other arts and science students (p<_0.001. p="p"/>Fortunately
this academic year, most first year undergraduate University students from
the UK will have been vaccinated as
part of the school programme.
However, an alarming finding from our study was that only 4% of overseas
students had been vaccinated before arrival. This left both the students
and those they came into contact with at higher risk of meningococcal
infection.
This group of students will remain unvaccinated against meningococcal
infection in future years, whilst the countries of origin do not have a
school vaccination programme similar to that in the UK. At present there
appears to be no policy for vaccinating this group in the future. Recent
reports of an increase in W135 serotype meningococcal disease with the
Hajj pilgrimage2 and high levels of carriage in the Gambia3 highlight the
potential for importing the meningococcus from outside the UK.
Our study also found that international students did not receive adequate
health promotion information before arriving in the UK. Since their
contact with University Health Services might be only at the point of
registration,
there may be only a small window of opportunity to target these students
during their first weeks in the country. If further vaccination
programmes are to be effective, eg if a group B vaccine becomes available,
lessons must be learnt from the failings of the group C programme. Careful
consideration of the needs of University medical practices is required,
who sometimes do not have enough staff or vaccine supplies required to
meet demand.
References
1. Wise J. UK introduces new meningitis C vaccine. BMJ 1999;
319: 278
2. Communicable Disease Surveillance Centre. Meningococcal
infection
in pilgrims returning from the Haj. Commun Dis Rep CDR Wkly 2000; 10: 129.
3. MacLennan JM, Urwin R, Obaro S, Griffiths D, Greenwood B,
Maiden MCJ. Carriage of serogroup W-135, ET-37 meningococci in the
Gambia: implications for immunisation policy. Lancet 2000; 356: 1078.
Matthew R Edmunds
4th year Medical Student
University of Birmingham
James E Davison
4th year Medical Student
University of Birmingham
Annette L Wood
CCDC
Birmingham Health Authority,
213 Hagley Road,
Birmingham B16 9RG
Vijay Raichura
Medical Officer
The University of Birmingham ,
Health Centre,
Elms Road,
Edgbaston,
Birmingham B15 2SE
Competing interests: No competing interests