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Teens should get 2d meningitis shot, US panel says

By Mike Stobbe
Associated Press / October 28, 2010

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ATLANTA —Teenagers should get a booster dose of the vaccine for bacterial meningitis, because a single shot does not work as long as expected, a federal advisory panel said yesterday.

The vaccine was initially aimed at high school and college students, because the disease is more dangerous for adolescents and can easily spread in crowded places, such as dorm rooms. Three years ago, the Advisory Committee on Immunization Practices said the vaccine should be offered to 11- and 12-year-olds. Panel members believed the shot was effective for at least 10 years.

But the panel was told yesterday that studies show the vaccine works for less than five years.

The panel debated whether to add a booster shot or simply push back the timing of the single dose to age 14 or 15. It decided that teens should get a booster dose at age 16.

The vote for a second shot was 6 to 5, an unusually close tally for the panel. The panel majority concluded that a booster shot after five years would be easier and less confusing to implement than changing the age for the first shot.

The group provides vaccine advice to the Centers for Disease Control and Prevention. The CDC and the US Department of Health and Human Services usually adopt the panel’s recommendations and send the advice to doctors and the public.

However, the new recommendation may not be adopted quite so easily. A Food and Drug Administration official, Norman Baylor, said more studies about the safety and effectiveness of a second dose are needed.

Some wondered if it was necessary to make such a decision. Cases of bacterial meningitis are at historic lows, and a survey of more than 200 colleges and universities — representing more than 2 million students — in the last academic year found 11 cases of bacterial meningitis and three deaths.

“I’m not terribly worried about emergent disease,’’ said Dr. James Turner, head of student health at the University of Virginia. He is a liaison to the panel for the American College Health Association.

But during a public comment session, several people made passionate pleas to keep an initial dose at 11 and 12, and add a booster if necessary. A 25-year-old man told of how his legs and hands were amputated after he suffered a bacterial meningitis infection when he was 14.

“Why would we want to go backward?’’ said Nicholas Springer of New York City.

A CDC specialist , Dr. Amanda Cohn, told the panel that some studies have shown the vaccine’s effectiveness dropping off significantly within a few years. A small study of one vaccine, Menactra, found that the vaccine was about 95 percent effective the first year, but that it dropped to under 60 percent effective in patients two to five years after they were vaccinated.

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