Health Secretary Jeremy Hunt under pressure on meningitis vaccine

Doctors say children's lives at risk because Nice formula is inadequate

Health Secretary Jeremy Hunt is facing demands to ditch a medical funding formula that has prevented a life-saving vaccine from reaching children.

Approved by the European Medicines Agency last year, the Bexsero vaccine would prevent child deaths and devastating limb amputations caused by meningitis B (MenB), but its use has been halted by a mathematical, rather than a medical, evaluation.

Health academics believe that had the same cost-driven formula been applied to other vaccines already in use, such as the meningitis C vaccine, they would not be protecting families in the UK today.

The calculation used by government health economists includes a discounted valuation of a child's life, at only 27 years. The figure is linked to a "quality-adjusted life years" and takes into account the financial implications of medical intervention, the subsequent quality and quantity of years lived. Also not taken into account are the severe effects of the disease on parents' lives, and the millions in NHS litigation costs linked to meningitis, leading to underestimations of the potential economic benefits.

An October meeting of the Joint Committee on Vaccination and Immunisation (JCVI), an advisory body to the Department of Health, decided against recommending the MenB vaccine for the UK-wide immunisation programme. But leading physicians who gave evidence to the committee claim that the raw value-of-life calculations used to reject the vaccine on cost-efficiency grounds "[discriminate] against children and effectively [punish] them for being a child".

The JCVI is scheduled to re-evaluate the vaccine over the next month but no U-turn on the October decision is expected. Mr Hunt is under pressure to veto the advisory body and accept that the lives of children are at stake.

If the Bexsero vaccine, produced by the Swiss multinational Novartis after 20 years of research, is shelved because of the Department of Health's controversial efficiency formulation, the development of other future vaccines is likely to suffer.

David Cameron is said to be aware of the potential damage to the Government's NHS record if the MenB vaccine is available only privately. Details of alleged spending excesses by officials at the health guidance authority Nice, including bills for luxury hotel rooms, will also do little to demonstrate where health priorities lie.

Over the past decade there have been more than 10,000 cases of meningococcal B diseases recorded in England and Wales. The death rate for these has been 5 per cent, and those who survive often face neurological damage, the surgical removal of limbs and severe damage to the skin. Although vaccines and immunisation programmes for other strains of the disease have been successful, MenB remains a major source of parental fear because of its speed when it attacks children and adolescents.

Official minutes of the October JCVI meeting at the Department of Health's Skipton House, in south London, show wide-ranging concerns from many of the leading doctors and scientists attending.

One clinical researcher, who asked not to be named for professional reasons, told The Independent on Sunday that there was "a sense of unease that science and health issues were being overwhelmed by government health economists. Costs and saving dominated. Everything else was ruled less important".

The official record acknowledges concern from attending experts and observers that "quality of life losses of IMD [invasive meningococcal disease] had not been fully captured within the cost-effectiveness analysis". The minutes also note that leading researchers wanted the "impact of IMD on close family members" to be taken into account, as well as "the considerable cost of litigation to the NHS following diagnosis or misdiagnosis of IMD".

Part of the Department of Health's efficiency algorithm for the vaccine involved a "discounted" value for the quality and quantity of life of a child who had survived MenB, measured against the cost of the vaccine's introduction.

Health professionals consulted by the JCVI are said to be angry that a manipulated figure of 27 years for a child's "life" is being used. Despite years of analysis for parallel adult measurement, there is still no stand-alone paediatric evaluation.

One leading physician said: "This is nothing more than pseudo-science; a pretence at cost-efficiency. It is a political and economic decision."

Although the JCVI is currently re-examining the decision to reject the MenB vaccine, many in the UK medical research community fear that unless Mr Hunt personally intervenes over the next few weeks, the efficiency calculation will simply deliver a repeat conclusion.

Recent health statistics estimate that an annual 1,200 cases of MenB result in 120 deaths. However, the JCVI's calculations were roundly criticised for not taking into account "significant non-cyclical fluctuations" and the "unpredictability" of MenB disease rates in the UK. A longer-term average, taking into account the historically high peaks resulting from MenB outbreaks, rather than the current relatively low rates, would have substantially altered the Department of Health's sums and its decision to reject a life-saving immunisation programme.

The Bexsero vaccine is estimated to cover 88 per cent of MenB disease in the UK. Although it is available privately from NHS GPs, with doses costing £75 each, bills for parents of children aged between two and six months would be £300 or £225 for children aged from six months to two years. However, without the vaccine being available to all young children in the UK, any "herd immunity" will be absent.

A recent letter to The Lancet by Dr Matthew Snape of the Oxford Vaccine Group at Oxford University said: "There seems little doubt that the public will react strongly to the continuing deaths and disabilities from meningococcus B that will occur in the absence of immunisation."

At the end of last year, the Bexsero vaccine, which is not yet licensed in the United States, was offered to thousands of students at Princeton University after a string of meningitis B cases hit the Ivy League institution.

With the formal blessing of the US Center for Disease Control and Prevention in Atlanta, about 5,500 vaccines were made available to all graduate and undergraduate students living in the college's dorms and annexes.

As well as young children, young adults have an increased risk of contracting meningitis, especially when they live and work close to each other. The first dose of the vaccine was given in December last year. The second will be administered at the beginning of February.

Voices
voicesGood for Lana Del Rey for helping kill that myth, writes Grace Dent
Sport
The Pipes and Drums of The Scottish Regiments perform during the Opening Ceremony for the Glasgow 2014 Commonwealth Games at Celtic Park on July 23, 2014 in Glasgow, Scotland.
Commonwealth GamesThe actor encouraged the one billion viewers of the event to donate to the children's charity
Sport
Karen Dunbar performs
Entertainers showcase local wit, talent and irrepressible spirit
Sport
Members of the Scotland deleagtion walk past during the opening ceremony of the 2014 Commonwealth Games at Celtic Park in Glasgow on July 23, 2014.
PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Arts and Entertainment
The Tour de France peloton rides over a bridge on the Grinton Moor, Yorkshire, earlier this month
film
Life and Style
fashion Designs are part of feminist art project by a British student
News
Very tasty: Vladimir Putin dining alone, perhaps sensibly
news
Life and Style
Listen here: Apple EarPods offer an alternative
techAre custom, 3D printed earbuds the solution?
Arts and Entertainment
Top guns: Cole advised the makers of Second World War film Fury, starring Brad Pitt
filmLt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a uniform
News
The University of California study monitored the reaction of 36 dogs
sciencePets' range of emotions revealed
News
Snoop Dogg pictured at The Hollywood Reporter Nominees' Night in February, 2013
people... says Snoop Dogg
Arts and Entertainment
A scene from Shakespeare in Love at the Noel Coward Theatre
theatreReview: Shakespeare in Love has moments of sheer stage poetry mixed with effervescent fun
News
Joining forces: young British men feature in an Isis video in which they urge Islamists in the West to join them in Iraq and Syria
newsWill the young Britons fighting in Syria be allowed to return home and resume their lives?
Arts and Entertainment
The nomination of 'The Wake' by Paul Kingsnorth has caused a stir
books
News
i100
Life and Style
food + drinkZebra meat is exotic and lean - but does it taste good?
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    BI Manager - £50,000

    £49000 - £55000 per annum + competitive: Progressive Recruitment: My client is...

    BI Project Manager - £48,000 - £54,000 - Midlands

    £48000 - £54000 per annum + Benefits package: Progressive Recruitment: My clie...

    VB.Net Developer

    £35000 - £45000 per annum + competitive: Progressive Recruitment: If you're pa...

    SAP Business Consultant (SD, MM and FICO), £55,000, Wakefield

    £45000 - £55000 per annum + competitive: Progressive Recruitment: SAP Business...

    Day In a Page

    Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

    Screwing your way to the top?

    Good for Lana Del Rey for helping kill that myth, says Grace Dent
    Will the young Britons fighting in Syria be allowed to return home and resume their lives?

    Will Britons fighting in Syria be able to resume their lives?

    Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
    Beyoncé poses as Rosie the Riveter, the wartime poster girl who became a feminist pin-up

    Beyoncé poses as Rosie the Riveter

    The wartime poster girl became the ultimate American symbol of female empowerment
    The quest to find the perfect pair of earphones: Are custom, 3D printed earbuds the solution?

    The quest to find the perfect pair of earphones

    Earphones don't fit properly, offer mediocre audio quality and can even be painful. So the quest to design the perfect pair is music to Seth Stevenson's ears
    US Army's shooting star: Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform

    Meet the US Army's shooting star

    Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform
    Climate change threatens to make the antarctic fur seal extinct

    Take a good look while you can

    How climate change could wipe out this seal
    Should emergency hospital weddings be made easier for the terminally ill?

    Farewell, my lovely

    Should emergency hospital weddings be made easier?
    Man Booker Prize 2014 longlist: Crowdfunded novel nominated for first time

    Crowdfunded novel nominated for Booker Prize

    Paul Kingsnorth's 'The Wake' is in contention for the prestigious award
    Vladimir Putin employs a full-time food taster to ensure his meals aren't poisoned

    Vladimir Putin employs a full-time food taster

    John Walsh salutes those brave souls who have, throughout history, put their knives on the line
    Tour de France effect brings Hollywood blockbusters to Yorkshire

    Tour de France effect brings Hollywood blockbusters to Yorkshire

    A $25m thriller starring Sam Worthington to be made in God's Own Country
    Will The Minerva Project - the first 'elite' American university to be launched in a century - change the face of higher learning?

    Will The Minerva Project change the face of higher learning?

    The university has no lecture halls, no debating societies, no sports teams and no fraternities. Instead, the 33 students who have made the cut at Minerva, will travel the world and change the face of higher learning
    The 10 best pedicure products

    Feet treat: 10 best pedicure products

    Bags packed and all prepped for holidays, but feet in a state? Get them flip-flop-ready with our pick of the items for a DIY treatment
    Commonwealth Games 2014: Great Scots! Planes and pipers welcome in Glasgow's Games

    Commonwealth Games 2014

    Great Scots! Planes and pipers welcome in Glasgow's Games
    Jack Pitt-Brooke: Manchester City and Patrick Vieira make the right stand on racism

    Jack Pitt-Brooke

    Manchester City and Patrick Vieira make the right stand on racism
    How Terry Newton tragedy made iron men seek help to tackle their psychological demons

    How Newton tragedy made iron men seek help to tackle their psychological demons

    Over a hundred rugby league players have contacted clinic to deal with mental challenges of game