KEY POINTS:
The cause of public health in this country has been done a serious disservice by the failure of the meningococcal immunisation campaign to make it clear that the immunity it was offering would last, for younger children, just a few months.
Only now, four years after the launch of the campaign, has a report by the Immunisation Advisory Centre at Auckland University brought the fact to light.
Had the limits of the immunity been plainly stated at the time, it may have made the campaign more difficult, but not impossible. An epidemic strain of meningococcal disease had been evident for some time and the terrible effects on children suddenly afflicted had been well publicised.
No immunisation campaign is guaranteed a unanimous response. Always, there will be opposition based on concerns about a vaccine's safety, effectiveness or even the need for it. But it does no good for the credibility of future campaigns to try to gloss over limitations.
The debilitating meningococcal disease had affected more than 5400 New Zealanders, killing 220 and leaving hundreds more seriously disabled. While the annual rate of infection was just 0.009 per cent of the population, some parents were so anxious that they were willing to pay for a new vaccine. This had been developed especially for the New Zealand B-strain of the bacteria by the California-based Chiron Corporation, in collaboration with the Health Ministry and the Norwegian Institute of Public Health.
Chiron's publicity was, as might be expected, all positive. It said trials demonstrated the vaccine had "a good safety profile and generates strong immune responses in the target age groups". Nowhere was it mentioned that immunity dropped below protective levels within months. Nor did the Health Ministry tell this to the parents of the one million children who were vaccinated. As far as those people were concerned, their children had received essentially lifelong immunity. In fact, fewer than half of the country's children are thought to be still protected against the disease.
The failure to inform parents at the time was disgraceful. It could also have severe consequences. For parents, it is hard to tell the meningococcal disease from other feverish illnesses.
If children had been vaccinated, it would be natural to think they were suffering from a less dangerous ailment. But children stricken by meningococcal disease may get worse rapidly, and must be got to a doctor quickly. Brain damage, blindness, deafness, limb amputations and death are the possible consequences of a failure to act.
There is no coherent reason for this information vacuum. The drastic need for the vaccine meant it was developed in three years, a period that Chiron boasted was just "a fraction of the time usually required". Even so, trials had revealed that immunity declined rapidly. This deficiency was the reason a fourth dose was added for babies at 10 months. But still the full picture was not disclosed. This despite the fact that parents could simply have been informed that, as with the tetanus vaccine, meningococcal vaccine boosters would be required to maintain protection.
A total of $200 million had been allotted to the campaign, and officials were determined to conceal anything that might cause unease. Four years later, however, this policy creates not only concern for parents but raises questions of whether that money would have been spent better elsewhere. It also has repercussions for future immunisation campaigns. Many parents will be more cautious and all will demand the full story. Next time, they must get it.
