There are two types of meningitis infection, viral and bacterial. The viral infection is not particularly serious and is usually self-limiting. The bacterial version is quite a different story. Although uncommon — due largely to the 1999 approval of a vaccine for children aged 11–18 years — bacterial meningitis is very dangerous: It has a 15 percent mortality rate, and approximately another 15 percent of those who contract it will suffer severe, long-term neurological damage, such as loss of hearing, seizures, and strokes.
Fortunately, recent research in this area has resulted in the approval of one vaccine for children as young as nine months of age — and another vaccine that could be used for children as young as two months is under FDA review. This is good news.
Following approval by the FDA, vaccines are routinely placed on the Centers for Disease Control and Prevention’s (CDC) schedule of recommended vaccines. Once a vaccine is on this list, it is covered by virtually all insurance policies and the federal Vaccines for Children program. However, this summer, the CDC has taken the unprecedented step of scheduling four public hearings across the U.S. — “a listening tour” — ostensibly to determine whether the infant vaccines should be endorsed by the CDC for inclusion in the standard vaccination regimen of infants and young children.
Since when does the general public have the medical expertise required to evaluate the risks or benefits of a new vaccine? The mere fact that the CDC is delaying an addition to the children’s schedule of new vaccines, pending public input, has raised concerns within the medical community. And these concerns have nothing to do with medicine.
Rather, disturbing signs indicate that this is a new tactic designed to control health-care costs by suddenly adding a cost-effectiveness component to the normal decisionmaking procedure. Some medical professionals and health-care economists believe that we are seeing the early encroachments of the Patient Protection and Affordable Care Act (a.k.a. Obamacare) — the insertion of a government-based bureaucracy between the patient and physician.
If that scenario sounds far-fetched, just consider the evidence pointing to the path ahead. In addition to the unprecedented and puzzling public hearings, the summary of the CDC Vaccine Decision Making Stakeholder Meeting on May 25 contains the following questions: “How many people would it help; what are the costs (to society and to individuals); and what are the benefits (what do I get and what do we all get for the cost)?” Similarly, the agenda for the first regional meeting, in New Hampshire, on June 15 asks: “Does or would the cost of the vaccine matter? If so, how so? Does the cost of the immunization effort matter? If so, how so?”
There have been two regional meetings so far; neither was publicized, and attendance was low. So, what does the CDC get from this? Is it possible that these hearings are a sham, held merely to cover the CDC’s position in the event it decides not to add the vaccine to the recommended schedule? In that case, the CDC panel will be able to claim that the “public” was either indifferent to or against the vaccine — and point to the supposed “transparency” of the process. Based on these clues, we may be seeing how Obamacare will cut health-care costs — by deflecting responsibility to the few citizens who actually attend public meetings.
While the inoculation of older children has cut down on the incidence of meningitis, it has not been eradicated: Infants and toddlers remain vulnerable. According to the CDC, there are about 2,000 cases of bacterial meningitis each year in the U.S., and unvaccinated children bear the brunt of the infection. Vaccines typically cost about $100 apiece, but on average, treatment for a surviving child costs about $1 million. This means that vaccinations, in addition to saving lives and preventing severe illness, pay for themselves, at least in part.
There are other potential consequences of these public hearings. Inevitably, they will provide a forum for anti-vaccine zealots to continue to promote their irresponsible and thoroughly disproven claims that autism is connected to vaccination. And by adding an extra hurdle after FDA approval, which is already burdensome, hearings will also have a chilling effect on the companies currently conducting vaccine research.
It is clear that our government needs to find effective ways to cut spending — but this is not the way to do it. Saving money by denying life-saving vaccines to children is unconscionable.
— Josh Bloom is director of chemical and pharmaceutical sciences at the American Council on Science and Health.