Princeton to Offer Students Meningitis-B Vaccine After New Case

Princeton University will offer students, pending federal approval, a meningitis vaccine not currently available in the U.S., after a seventh case was reported this year on the Ivy League campus.

The U.S. Centers for Disease Control is preparing to recommend that all undergraduate students, as well as graduate students living in dormitories, get the vaccine, the Princeton, New Jersey-based college said yesterday in a statement. Costs would be covered for students who receive the vaccine, it said.

“The University is prepared to accept these recommendations and make arrangements to provide access to this vaccine as soon as possible,” Princeton said.

All seven cases -- six students and one campus visitor -- developed infections with meningococcus B. Because the strain of the bacteria isn’t covered by vaccines available in the U.S., federal health officials approved importation of the immunization Bexsero, made by Novartis AG. Princeton expects to make the first of two doses of the vaccine available in early December. The second dose would come in February, according to the statement. Two doses are required for maximum protection, the school said.

The danger may increase in the winter, when the bacteria tends to spread more rapidly, said Andrin Oswald, head of Novartis vaccines and diagnostics, in a phone interview from Basel, Switzerland. Since the first patient was diagnosed in March after spring break, it’s crucial to closely monitor residents through the cold months, he said.

‘So Important’

“That’s why it is so important to vaccinate and stop the spread to a lot of students,” Oswald said. “You want to make sure people aren’t carrying the bacteria if they are healthy, so it can’t spread from one to the next.”

Not everyone gets sick from the bacteria, which may be carried by as much as 10 percent of the Princeton population, Oswald said. The number of cases is occurring in about 1 out of 1,000 students there. That’s significantly higher than most other vaccine-preventable diseases, and 100 times the 1 to 2 in 100,000 seen with other forms of meningitis, he said.

Kelsey Kane-Ritsch, a sophomore from La Canada, California, said she plans to get the vaccine.

“I know it isn’t approved here, but it’s already been approved in Europe,” Kane-Ritsch said in an interview. She’ll accept the shots “just to be cautious,” she said.

The university has been working with the U.S. Centers for Disease Control and Prevention and the New Jersey Department of Health since the first case was reported in March. The CDC requested and received permission last week from the Food and Drug Administration to bring in the vaccine, Barbara Reynolds, a CDC spokeswoman, said Nov. 16 in a telephone interview.

No Guarantees

Students shouldn’t waver about getting the vaccine because even if diagnosed early, there isn’t a guarantee of survival, said Lynn Bozof, president of the National Meningitis Association, a nonprofit group.

Her son, Evan, died from meningitis at age 20 while a college student at Georgia Southwestern University in 1998. She said young people think they are invincible.

“I’m really concerned that kids are going to miss this opportunity,” Bozof said in a telephone interview. “I would be first in line there to get that vaccine. You can’t think that, ‘I’m going to catch it early.’ This is a disease you can’t fool around with.”

Vaccines exist for four of the five common strains of meningitis. The vaccine against the B strain has been difficult to develop because of its makeup, Oswald at Novartis said.

Dominant Strain

The outer coating of the bacteria is similar to something found naturally in the body, making it harder to attack, he said. Bexsero, the first vaccine against the strain, is based on a protein found on the surface of about 80 percent of the circulating B strains, including the one found in Princeton, Oswald said.

Meningococcus B accounts for 40 percent of cases in the U.S. and as much as 80 percent in Australia and parts of Europe. Bexsero was cleared for sale in Europe in January and in Australia in August. The vaccine hasn’t been available in the U.S. because drug companies and regulators couldn’t agree on how to measure the efficacy of the injection, Oswald said.

“In many geographies B has become the dominant strain because we could vaccinate against the other” types of meningitis,’’ Oswald said.

To obtain the immunization for Princeton, the CDC asked the FDA to grant the vaccine investigational new drug status, typically used to begin a clinical trial, Oswald said. The CDC would need to oversee the use of the immunization since the company doesn’t have an actual study under way, he said.

Timing Crucial

“When a child is affected and potentially dies, each case is terrible,” Oswald said. “You can’t protect each individual against everything that’s out there, so you have to look at epidemiology and the larger numbers.”

Bacterial meningitis can occur sporadically, especially in the close quarters seen on college campuses. It’s spread through respiratory and throat secretions and close contact -- such as kissing and sharing drinking glasses -- though is typically less infectious than viruses, including influenza.

By early May, three students had been diagnosed. The most recent patient developed symptoms eight month later on Nov. 8.

Meningitis can be caused by viruses, fungi and bacteria, with bacterial meningitis causing about 170,000 deaths globally each year, according to the World Health Organization. The infection is marked by inflammation surrounding the thin lining around the brain and spinal cord, causing such symptoms as stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.

Sometimes Fatal

As many as 10 percent of those infected die within 48 hours after symptoms start, according to the WHO. Brain damage, hearing loss or learning disabilities may affect as many as 20 percent of survivors.

Novartis, Sanofi and GlaxoSmithKline Plc all make shots available in Europe and the U.S. that protect against four of the five major strains of the disease, not including the B strain. Pfizer Inc., the New York-based drugmaker, has a vaccine for meningitis B that has begun the final stage of development.

Princeton is a member of the Ivy League, a group of eight selective colleges in the Northeastern U.S. It has about 7,800 students, according to its website. Chartered in 1746, alumni include First Lady Michelle Obama and Supreme Court Justices Elena Kagan, Sonia Sotomayor and Samuel Alito.