Meningitus B (MenB) is a frightening illness. It can overtake and kill in 24 hours. College-age students who live in close quarters are the usual victims.  If it doesn’t kill, it often causes grievous injury—especially to the extremities—including loss of fingers, toes, feet, or parts of the face. While vaccines against other strains of meningitis have long been available, those for MenB have only been approved in the U.S. for a few months. Thanks to Pfizer and Novartis, we now have two effective FDA approved vaccine choices to protect against this terrible MenB strain. Unfortunately, neither is required on the routine schedule of vaccinations. 

In February, I joined with a group of advocates at the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) in Atlanta to change that. At the top of ACIP’s agenda was a vote on MenB’s inclusion on the routine vaccine schedule for persons at increased risk. While the ACIP discussed various topics such as the, “Economic evaluation of vaccinating US adolescents and college students against serogroup B meningococcal disease” or “Considerations for routine use of MenB vaccines in adolescents,” ACIP wasn’t scheduled to vote on including MenB vaccines on routine schedule for adolescents. That was unfortunate, as those who came to Atlanta with personal experience about the horrors with MenB told the committee – many in graphic terms. 

Dr. Mary Ferris, student health director at the University of California Santa Barbara, a campus of 30,000 students, faculty and staff led off. In November 2013, her campus experienced an outbreak of four cases of the MenB disease. A 19-year-old lacrosse team member suffered amputations of both legs and extensive skin grafts and scarring to his arms and face. Every word she said resonated. I have excerpted her comments here:

 “I know you’re well aware of the devastating consequences of this terrible disease, but you may not know the impact it has on a university when an outbreak occurs. National news outlets camped out on the campus. There was widespread fear and even panic among students, faculty, staff, and the surrounding city. The local school district initially prohibited our student teachers from their sites, and parents drove in to remove their children from the campus. Our campus childcare center asked student volunteers to stay away. Parents demanded that we close the campus, and others did not want their students to come home for Thanksgiving holidays. Our local public health department and CDC had to establish special phone lines to handle the large volume of incoming distress calls. We greatly appreciate all the help they gave us, including handling even international media attention, but we would have much rather avoided this disaster completely by protecting our students in advance with a vaccine that covers MenB. Outbreaks WILL happen again at other colleges, and in fact is happening right now at the University of Oregon, where they are struggling to find a source to pay for the vaccines. Even ONE CASE in a college setting has major repercussions on the institution, and most colleges will not have the resources to pay for vaccines when the outbreaks occur.

We need the ACIP to establish MenB vaccine as part of routine adolescent immunizations, so that our entering students can be protected before they arrive on campus and are exposed to meningococcus, not just after an outbreak occurs. We also need your recommendation for vaccination before college entry so that we can enforce it as an entrance requirement along with MCV4 coverage. The majority of our students are the first generation in their families to attend college, and they come from low income families that will not be able to afford this vaccine unless it is included in their health insurance coverage.” 

That is exactly NCL’s position.

The father of a young boy who tragically died of MenB last year spoke of his grief at this terrible event and asked the ACIP why MenB is not on the routine schedule. Andy Marzo, who contracted MenB as a college student in Kansas, described what it felt like to spend weeks in intensive care, his family not knowing whether he would live. And how it felt to lose all of his fingers—he has one remaining thumb—and portions of both feet. His care cost $2 million. Andy has no idea how he contracted MenB. That’s a universal theme among patients. Most are healthy and active. Andy had never spent a day in the hospital and was a healthy and happy journalism student when the infection struck. He gave me a signed copy of his book ,which is a riveting account of his ordeal. 

Frankie Milley lost her only child, Ryan, 18 years old, to MenB. She turned tragedy into action by forming the Meningitis Angels. Their mission: Meningitis Angels educates the public, health professionals, child care facilities, schools and universities on not only meningitis but other vaccine preventable diseases and the preventions including vaccines, through personal stories, our educational brochures, posters and videos.

The Angels’ video details the tragedy of menB. She implored the Committee to include the MenB vaccine on the routine schedule. 

NCL applauds the Meningitis Angels for their advocacy on vaccines and for mobilizing their members to lobby state legislatures and Congress, to educate consumers on the importance of vaccines and to attend meetings at the CDC and advocate for widespread vaccination.

Adding a vaccine to the recommended schedule is not without controversy. All vaccines cost money—MenB is around $130 a dose. Novartis’ vaccine is two doses spread out over a few months. Pfizer’s is three.  Requiring these on the routine schedule means health plans have to cover them. 

CDC, like other government agencies, does a cost benefit analysis to determine whether the expense is justified. But after I listened to the director of health in Santa Barbara, to patients, and to parents of deceased children talk about the ravages of this terrible disease, the cost of vaccinations is tiny compared to the cost of treatment, which in many cases exceeded $2 million per patient.

Frankie told me that she has been accused of being in the “pocket of industry” by the very destructive anti-vaccination groups that—in my view—traffic ignorance and fear.

Supporting the efforts by companies that develop these critical vaccines to get these lifesaving products out into the community makes sense. How someone could say to a mother who lost a child to a very preventable disease is to be faulted as too close to industry is beyond me. 

Dr. Ferris from Santa Barbara notes that other outbreaks will and have happened at other schools and that is critical to know. I worked with my own son’s health office at Oberlin College to order the vaccine for him. He lives in a dorm and plays on a sports team. He’s in the demographic that is susceptible to this disease. I’d like the see his college inoculate every student on campus and have encouraged them to do so. Until that happens, I’m going to make sure he is protected.

Vaccines have all but wiped out diseases like polio, German measles, diphtheria, influenza, mumps, small pox, measles, and many others that in previous generations caused the death and disability of millions of children and adults. They are safe and they are very effective. We join with the Meningitis Angels in asking ACIP to include MenB on the routine schedule. NCL’s letter and statement at the ACIP meeting are attached.

 

This week marks our nation’s annual celebration of Martin Luther King Jr. day. As we honor a truly great American icon we keep in mind two parallel and pertinent events that are occurring in America. One is the increasing awareness of the epidemic of police killings of black men (and black women too, though not as frequently). “The Root” enumerates 20 unarmed African Americans and the stories surrounding their killings by police.

The killing of Tamir Rice, is particularly troubling. Tamir, 12, was killed by a Cleveland cop as he waved a toy gun around in a park – this very officer had been fired from a suburban Cleveland police force for being too impulsive and lacking in good judgment. The Cleveland police department hired him without doing a background check.

As protests have sprung up across the country, with proclamations like “Black Lives Matter,” surely King would have led the marchers across America to protest these terrible killings and seek solutions.

The second event revolves around the movie “Selma.” The film, currently in theaters and directed by a black woman, stars a black actor and focuses on MLK’s campaign for voting rights in America.

While the reviews are positive, neither the director – an African American woman – nor the actor who vividly portrays Dr. King’s struggle to achieve the right to vote for African Americans – have received an Oscar nomination.

In the movie, King’s political skills are in sharp relief: he refused to be cowed by President Lyndon Johnson. He led his followers through a phalanx of dangerously racist cops and locals wielding nightsticks nail studded clubs, whips and guns. These scenes are depicted so graphically I could hardly watch.

The tense phone conversations between King and LBJ have viewers on pins and needles. LBJ capitulates and eventually passes the Voting Rights Act, because he has to. He accuses King of reckless opportunism, but the civil rights leader triumphs because he makes the case that without voting rights, blacks are denied power to throw out white office holders who deny them the right to vote, the right to march, the right to be free of harassment and discrimination.  Martin Luther King, a disciple of Mahatma Gandhi, wins the day,

There’s something else – something troubling – being played out on another totally different stage: neither the African American female director nor the actor playing King were nominated for Academy Awards.

So how important is an Oscar nomination anyway? Very important, and for a variety of reasons. Over the weekend CNN featured two men debating whether the Academy was racist. The white commentator said no, absolutely not, The Help and 12 Years A Slave, the first about black maids in the South as the civil rights movement unfolded and the latter, about a free black man in the 1850s kidnapped and sold into slavery, both won major awards in the last few years . The African American commentator laughed. “I thought you were kidding. The Academy is only comfortable acknowledging black actors playing servants or slaves. But in a film like Selma, black actors and directors don’t get any recognition.”

The director of “Selma,” Ava DuVernay, is a black woman who for years sought studio backing to make the movie. And, as David Carr wrote in the New York Times this week, “No club in the United States — over the last several years, the academy has been around 93 percent white, 76 percent male and an average of 63 years old — is in more need of new blood than Hollywood.”

Carr further argues for the importance of Oscar recognition. He says the Oscars, “convey recognition at the highest level of a craft that is seen by millions.”

These two seemingly vastly different issues are not so different after all. They are both focused on the value of African American life in America and African American contributions, social, political, and cultural. Yes, we have an African American president and that is a milestone, but America still suffers from the ugly legacy of slavery and I fear that we continue to minimize the value of African American life and African American achievement in America.

2015 is a historic year  – it marks the 50th anniversary of both the Selma marches and the Voting Rights Act. We could recognize these events by acknowledging the risk black men face every day at the hands of the police – and that police officers have a hard job – and supporting campaigns like “Black Lives Matter.” We need also to recognize the talent and achievement of black directors, actors and producers at the Oscars. Martin Luther King would have been very proud, I think, of Selma, and especially its directors, actors, and producers. Happy MLK celebration to all.