Meningitis B vaccine and the cost of life

The BBC reports today (here) that agreement has been reached between the Health Secretary, Jeremy Hunt (the one-time ‘Hulture’ Secretary, as James Naughtie nearly described him) and the suppliers of the Meningitis B vaccine. No exact date has been set for the introduction of the vaccine, though it will be added to the schedule of vaccinations (available here).

The introduction of a vaccine against the B-strain has been delayed by a year while the Health Secretary and the suppliers discussed the price.

The Daily Mail reported on the human cost of the delay in introduction of vaccination nine months ago, here.

Meningitis is an inflammation of the coverings of the brain, the meninges; it may be caused my many differing germs, and by other causes (much more here). It typically presents with headache, fever, photophobia (an aversion to light), neck stiffness (called meningism) and a petechial rash. This rash is pathognomonic of infection with Neisseria meningitidis. This rash does not blanch, that is when pressed upon by a glass it does not loose its colour. There are a number of strains of N meningitidis for which vaccines are already available; the B-strain is one of the most dangerous, and can lead to the loss of limbs, persisting brain damage, and it can be fatal.

A suspected case of meningitis is a medical emergency of the utmost importance and urgency. Treatment should be begun even before the diagnosis is clearly established.

Suzanne Moore wrote an op-ed in the Guardian a few days ago, describing her own experience, and fulminating against the market; until the announcement today, I had intended to do the same. You can read her article here. And let me entirely reassure you that the extreme rapidity of the treatment her daughter had, and the extreme measures that had to be undertaken are entirely representative; for this is a disease that, in a matter of a few hours can claim the life of a previously healthy infant or toddler.

Public health measures such as a supply of clean drinking water and proper sanitation, and vaccination programmes are called, entirely justifiably, an ‘epidemiological revolution’. Yes, it costs money to supply clean water, to build proper sewers, to develop vaccines, to immunise the population. But these costs fade into triviality compared to the savings in human life, human disability and emotional distress.

What then is the price of a life? How much should be paid to save a single life? You might think such a calculation is something only the most hard-hearted bean-counting Scrooge of an actuary could countenance, though it is often used as the basis for, say, road improvements. Such a figure might be £100,000, easily the cost of Suzanne Moore’s daughter’s treatment.

And for those children who recover but are very severely damaged what are the lifetime costs of support, special services, carers, respite? A course of vaccine might be £220 and would prevent this disaster. A good financial investment, one worth the upfront cost?

You might well think so.

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