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Urging the provinces to provide free vaccinations for students against a rare but deadly strain of meningitis.

Urging the provinces to provide free vaccinations for students against a rare but deadly strain of meningitis.

By Mounira Magdy

Published: August 18, 2024

Nova Scotia and Prince Edward Island are the only two provinces that offer students after high school a free vaccine against type B meningitis, which is a rare but deadly bacterial infection.

As Canadian universities and colleges prepare to welcome thousands of new students in September, more provinces are being urged to cover the costs of vaccinations, which may cost $300 or more for the two required doses.

The medical advisor for the Canadian Meningitis Foundation Dr. Ronald Gold told CTVNews.ca: "Meningococci can kill within hours. The best protection is vaccination."

Type B meningitis, or MenB for short, is a disease caused by group B meningococcal bacteria. While most Canadian children receive a vaccine that covers four other strains of meningitis - groups A, C, W, and Y - the relatively new vaccines for group B are not part of any routine vaccination program in Canada.

Meningococcal bacteria can cause a rare and serious illness known as invasive meningococcal disease, which affects less than one in every 100,000 Canadians. It is fatal in up to 10 percent of cases, according to the Canadian Ministry of Health, while 10 to 20 percent of survivors suffer from life-changing consequences such as hearing loss, neurological disabilities, or amputations of fingers and limbs.

Gold previously headed the Infectious Diseases Department at Toronto's Hospital for Sick Children. He says teenagers and young adults are more likely to carry the dangerous bacteria for reasons that are not fully understood.

Gold added: "Behaviors in this age group promote the spread of the bacteria. Meningococci spread from person to person through close contact: coughing, sneezing, singing, kissing, sharing cups and utensils, and being in crowded places like bars."

Student deaths have led to changes in the Atlantic Canada region.

Kay Matthews had just finished his first year at Acadia University in Nova Scotia when he suddenly experienced a high fever and body aches.

His father Nuri Matthews told CTVNews.ca: "They began administering antibiotics in a race against time to fight the infection and slow its spread, which they suspected was meningitis. It was only 30 hours after the first symptoms appeared that we had to make the impossible decision to take him off life support."

After Kay's sudden death in 2021, his family launched a nonprofit organization, BforKai, to raise awareness about meningitis B and advocate for vaccination.

Matthews said: "We had no idea that Kay was unprotected from MenB. Most parents think their children are fully protected against meningitis through the routine regional vaccination program and were unaware that MenB was not included in this program."

After two more students in Nova Scotia died from meningitis B the following year, the province began offering free vaccines in 2023 to new post-secondary students aged 25 and under living in dormitories and housing, as well as to new military recruits living in crowded places like barracks.

Prince Edward Island announced a similar program in 2023 and has since expanded eligibility to all post-secondary students, including those studying out of province.

Other provinces and territories typically cover the costly vaccine only for those who have been in close contact with a confirmed case or for children at risk of severe disease, such as those with immune system disorders. The first meningitis B vaccine was approved for use in Canada in 2013.

Matthews said: "The most common reason for public funding not being provided for MenB vaccines is that the 'cost-benefit analysis' does not meet the minimum required by health ministries. This is what I have heard repeatedly from government officials and health policymakers. This response is a deep shock for a father who lost his 19-year-old son who was in the prime of his life."

For this reason, Gold wants to provide meningitis B vaccines for free to all post-secondary students in Canada.

Gold said: "I believe that due to the severity of the disease and the increased risk of contracting the disease among first-year university students living in dormitories and housing, the meningitis B vaccine should be provided for free to students. I would rather it be provided to all post-secondary students before the start of their first year."

The most common group B strains in Canada.

The Public Health Agency of Canada says there are about 115 cases of invasive meningitis annually between 2010 and 2022, most occurring in winter and spring.

Gold explained: "In Canada, the United States, and Western Europe, group B strains account for about 50 percent of cases, particularly in countries where children are routinely vaccinated against the other major groups of meningitis - A, C, Y, and W. The predominance of group B strains is partially a result of vaccination against the other groups of meningitis and also due to the greater genetic diversity of group B strains."

Group B remains the dominant strain in Canada, representing 40 percent of cases of invasive meningitis since 2012, or about 43 cases annually, according to the Meningitis Foundation of Canada. Group B is more common in Quebec and Atlantic Canada, where it accounts for 50 percent of severe cases. This figure drops to less than 25 percent in Western Canada, where group W is the most prevalent.

Despite periodic local outbreaks, the Public Health Agency of Canada says that the incidence of invasive meningitis has generally declined over time. While it could not provide recent national data to confirm this, some regional numbers are available.

For example, Ontario reported 30 confirmed cases and three deaths from invasive meningitis in 2023, with most of them - 36.7 percent - linked to group B. Meningitis B was also the most common strain in Ontario in 2022, accounting for 38.5 percent of 26 confirmed cases.

Initial symptoms can include headaches, fever, nausea, vomiting, light sensitivity, stiff neck, and a dark purple rash later on. Anyone experiencing symptoms should seek immediate medical attention. About 10% of people carrying the bacteria do not get sick.

Both Gold and Matthews agree that the high cost of meningitis B vaccines remains a significant barrier.

Matthews said: "In the absence of public funding, individuals seeking the meningitis B vaccine have to pay out of pocket, which individuals may be reluctant to do due to the perception that if the vaccine is not covered by the government, it won't be worth getting. Nova Scotia and Prince Edward Island have paved the way for other Canadian provinces and territories by implementing the MenB program for post-secondary students. I hope to see this kind of political change spread across Canada."

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