Victoria takes jab at federal government as it offers meningococcal vaccinations

Victoria’s health minister, Jill Hennessy, has criticised the federal government for not acting to fund immunisations against a particularly virulent strain of the meningococcal bacteria.

Hennessy announced that the state government would fund a free school-based vaccination program for the meningococcal W-strain for 15- to 19-year-olds, commencing in the next school term.

“This is a national responsibility and once again we are seeing Malcolm Turnbull and the Liberals vacating the space when it comes to immunisation while we step in and cover the shortfall,” Hennessy said.

The federal government does already offer a free meningococcal C-strain vaccine under the childhood national immunisation program, with the B and C strains most commonly found in Australia. Infection from the C-strain has declined significantly under the program. A federal government review of the disease is also under way, with the health department considering the vaccine program and future risk of disease strains.

A spokesman for the federal health minister, Greg Hunt, said Hennessy had “not raised the matter once” with Hunt.

The issue of meningococcal was “one of the first issues Hunt raised with the chief medical officer on his first day in the job,” the spokesman added.

“The minister has asked the chief medical officer to consider the broader Australian needs and what, if any, is an appropriate national response to meningococcal W,” he said.

The addition of new vaccines to the national immunisation program requires a pharmaceutical company to apply for approval from the independent pharmaceutical benefits advisory committee. No pharmaceutical company had applied, the spokesman said.

Victoria’s move follows an announcement by the New South Wales government on Monday that it would fund a meningococcal vaccination program targeting 17- and 18-year-olds, with those ages particularly at risk because of their physical closeness with peers. The disease is spread through respiratory secretions, such as coughing and sneezing, and prolonged contact with someone carrying the infection.

The Western Australian government announced a free meningococcal vaccination program for 15- to 19-year-olds last month. The vaccines will protect against the A, C, W and Y strains.

But it is the W-strain of the disease that prompted the programs. Meningococcal W has become a prominent strain nationally, with notifications almost tripling since 2015 in NSW and Victoria.

While it used to be rare in Australia, the W-strain is common in the UK. According to a study on the increased incidence of the strain in Victoria published in the journal Emerging Infectious Diseases, the genetic similarity of the Australian strain suggests it was originally introduced from Britain.

“There is substantial population movement between Australia and the United Kingdom; the United Kingdom is the primary source of permanent migrants and a major source and destination for short-term visits,” the study found.

“The situation is evolving, epidemiologic and molecular investigations are ongoing, and other jurisdictions are encouraged to monitor emergence of this strain.”

An infectious diseases physician and microbiologist at the Australian National University, Prof Peter Collignon, said a colleague in London had reported seeing an increasing number of Australian travellers coming into his emergency department with the W-strain.

He said it was not an easy task for the federal government to decide which strains to offer free vaccines for. Diseases and strains changed over time, he said. Australians had little immunity to the W-strain because of its rarity, allowing it to spread.

“The numbers of meningococcal infections are low in Australia, at about one case per 100,000 each year, but it does disproportionately affect young people without immunity yet as well as 18- to 20-year-olds,” Collignon said.

“The problem is the vaccine is very expensive and, at end of the day, governments have limited fundings and it’s a question of cost-benefit ratio. Do governments spend millions of dollars on a vaccine to save a small number of lives, or do they direct that health funding to a different health initiative with wider benefits?

“People say that every life is sacred but the reality is, there is only a finite amount of health money.”

While the disease is not common, it is serious, and can cause death within hours if not detected and treated early. Meningococcal bacteria live in the back of the nose and throat in about 10% of the population without causing illness, but in a small number of cases, the bacteria can penetrate the lining of the throat, entering the bloodstream and causing severe disease and a range of symptoms including red or purple splotches on the skin, fever, confusion and vomiting.