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Princeton agrees to meningitis vaccine to fight outbreak

Princeton University students could get an imported vaccine as early as December to stop the spread of a potentially deadly meningitis outbreak that has sickened seven since March, school officials said Monday.Under the plan, all undergraduate students, graduate students living in dormitories, and members of the university community with certain vulnerable conditions would be advised to receive va

Princeton University students could get an imported vaccine as early as December to stop the spread of a potentially deadly meningitis outbreak that has sickened seven since March, school officials said Monday.

Under the plan, all undergraduate students, graduate students living in dormitories, and members of the university community with certain vulnerable conditions would be advised to receive vaccinations to protect against serogroup B meningitis, which is missing from the shots already recommended for U.S. college students. 

The move follows a request by the Centers for Disease Control in October to import emergency doses of the vaccine Bexsero, made by Novartis, and approved in Europe and Australia, but not in the U.S. 

"Pending final CDC approval, the University is prepared to accept these recommendations and make arrangements to provide access to this vaccine as soon as possible," Princeton officials said in a statement. 

School officials said they hoped to make the first of two doses of the vaccine available in early December, with a second dose in February. Six Princeton students and a student visitor have contracted the infection since March, including a male student who was hospitalized on Nov. 10. All have recovered or are recovering, officials said. 

The announcement Monday, which coincided with email notifications to the campus community, offers more complete information to parents and students, who say they were worried about the outbreak and wondering what to do. 

“It’s hard,” said Damon Prenovitz of Erie, Pa., whose 18-year-old son, Michal, is a Princeton freshman. “You take all the normal stuff that you think about and then you have this on top of it and it makes it that much worse.”

On one hand, parents say they’re concerned about an outbreak of a deadly disease that hits college-age kids particularly hard and kills at least 1 in 10 who contract it. On the other hand, it’s rare — only 500 cases in the U.S. last year — and the vaccine is unproven in the U.S.

“Trust me, it’s a tough one to think about,” Prenovitz said. 

Students have heard a lot about the outbreak since it began last March, said Luc Cohen, a senior who is editor of the Daily Princetonian, the school newspaper. They've taken precautions such as avoiding sharing drinking cups, but haven't stayed away from school dances, football games or other gatherings.

"As early as Frosh week, everyone was aware," Cohen said. "I wouldn't say there ever was hysteria."

NBC News first reported that CDC officials had asked for the unprecedented access to the vaccine through an IND, or investigational new drug application after becoming alarmed at five cases of the rare infection in the closed community. Food and Drug Administration officials approved the request last week. 

“The thing that pushed us over the edge was the licensure in Europe,” said Dr. Tom Clark, the CDC’s acting director for the branch of meningitis and vaccine-preventable diseases. “Meningococcal disease is potentially devastating. People worry about meningitis.”

Bacterial meningitis is a dangerous infection of the protective membranes that cover the brain and the spinal cord, known as the meninges. It is spread through respiratory droplets or secretions exchanged through close contact such as coughing or kissing. 

Teens and young adults are especially vulnerable to the disease because they spend a lot of time together in close quarters such as dorms, coffee shops and bars, with plenty of potential to swap germs. At any one time, 5 percent to 10 percent of the population may carry the bacteria in their throats, but only a small proportion develop infections. Exposure to smoke and getting a respiratory illness, like a cold, can increase the chance of infection, CDC says. 

Cases have dropped sharply in the U.S. in recent years, but between 800 and 1,200 are typically reported annually. Most cases in America are caused by the C or Y strains of bacteria, CDC says.

The worry is that between 10 percent and 12 percent of those who get the fast-moving infection die, and about 20 percent of those who recover can wind up with severe side effects including deafness, mental retardation and limb amputations, according to the CDC.

Four meningitis vaccines are licensed for use in the U.S., including Menveo, made by Novartis and Menactra, made by Sanofi Pasteur. But they protect against only four of the strains that cause illness: A, C, Y and W-135. Scientists have been worked for two decades to produce a vaccine to combat the B strain, which is tougher to target.

Bexsero is generally regarded as safe, Clark said. But it has yet to meet the standards to be licensed in the U.S. 

Under Princeton's plan, nearly 5,300 undergraduates would receive the shots, plus any of the 2,600 graduate students who live in dormitories, and members of the campus community who have conditions including sickle cell disease, no spleen, or a spleen that doesn't work. People who have immune problems called late complement component deficiencies would also receive the vaccine. 

"The vaccine would be made available only to these groups, and it would not be administered anywhere else," Princeton officials said. 

Prenovitz, like other Princeton parents, said he was surprised that seven cases of any disease is cause for such worry. He said he would advise his son to heed advice about not sharing cups and using good hand hygiene. His wife is researching the vaccine, but he thought he'd be inclined to let Michal get the shot. 

"It's a university with a lot of smart people," he said. "If they think it's appropriate, they probably know what they're doing."