Can you put a price on protecting your children from a potentially deadly meningitis-causing bacterial infection?
Right now, it’s about $320 per child, unless you happen to have private insurance, for a two-dose vaccine recommended by public health officials in Kingston, Ont. — one of a handful of regions in Canada seeing a spike in local cases of invasive meningococcal disease (IMD).
IMD is a rare but life-threatening bacterial infection that can infect the brain and spinal cord, causing meningitis, and the bloodstream, causing septicemia.
Up to 10 per cent of people infected with IMD die, according to Health Canada, and complications include deafness, limb amputations and permanent brain damage. There are almost 200 cases in Canada per year on average.
Most IMD cases are caused by five types of bacteria: A, B, C, Y and W-135, though in Canada, group B causes most illness, according to the health department.
Kingston, Frontenac and Lennox & Addington Public Health (KFL&A) is recommending the meningococcal B vaccine for people under age 25. It’s not a routine vaccine like meningococcal C, typically given to babies at age one, or meningococcal ACYW-135, administered in Grade 7 in Ontario, said the health unit.
Currently, no provinces or territories cover the cost of the meningococcal B vaccine for all children, according to the Canadian Paediatric Society.
Crystal Harris, 45, plans to vaccinate her two teenagers after getting letters from their schools in Kingston last week recommending the shots. She says she was surprised when she realized how much it would cost, and was grateful she has private insurance that covers it. She also knows she’s one of the lucky ones.
“I cannot imagine having to pay that money to keep your children safe and healthy,” Harris told CBC News. “It’s simply wrong.”
People with certain high-risk medical conditions are eligible for a free vaccine, as is anyone who comes in contact with a case. But at this point, the Kingston community at large isn’t eligible for publicly funded vaccination, said Dr. Piotr Oglaza, medical officer of health at KFL&A Public Health.
The cost for the general population — about $160 per dose, with two doses required — is “absolutely” a barrier, especially for someone who doesn’t have private insurance, Oglaza said.
“I fully understand and appreciate that dilemma and that struggle that individuals may face.
“But really, the best protection against this is the vaccine.”
Rare but risky
Last Thursday, KFL&A Public Health warned of an increase in invasive meningococcal disease type B activity in the region — three cases in recent months, including one pediatric case, according to Oglaza. Its last case was in 2013, he said.
Kingston isn’t the only region seeing an increase. Last month, health officials in the Eastern Townships of Quebec called for vigilance after confirming two cases of invasive meningococcal infection in the region, one of which resulted in a death. The specific type of case isn’t yet known.
Manitoba public health officials also recently warned that the province had seen 11 cases and one death between Dec. 21 and Feb. 29. The serogroup of one of those cases was identified as type B.
Manitoba typically has six cases of IMD reported in a year.
While IMD cases in Canada are rare, outbreaks do occur across the country, says a 2023 report from the National Advisory Committee on Immunization.
Most cases came from children under age five and adolescents aged 15 to 19, the report said.
“Outbreaks of meningococcal B disease are usually small and localized, and are primarily seen among adolescents and young adults, especially those living in dormitory or other group settings,” said Devon Greyson, an assistant professor at the School of Population and Public Health at the University of British Columbia.
University campuses in Atlantic Canada have had outbreaks in the last few years, including student deaths.
In May 2023, Nova Scotia began offering the meningococcal B vaccine for free to people aged 25 and under living in group settings, such as university residences. Then in January, Prince Edward Island expanded its free vaccine eligibility to all post-secondary students.
‘Multiple tiers of privilege’
There are “multiple tiers of privilege going on” in terms of vaccine accessibility, between the out-of-pocket cost, the potential for coverage by private insurance, and the fact that if you don’t have a family doctor, you may not even be having these conversations, said Ian Culbert, the executive director of the Canadian Public Health Association.
“For low-income people, it simply isn’t an option.”
Funded vaccine programs have much higher uptake rates than unfunded ones, he noted. But even the hesitancy for funded vaccines — such as the measles shot — is increasing post-pandemic, he added.
A new poll released last week by the Angus Reid Institute found that a growing number of Canadian parents say they are opposed to vaccinating their children. Among the 1,626 survey respondents, 17 per cent of parents of minors said they were “really against” vaccinating their kids, compared with about four per cent in 2019.
Given that, there’s even less incentive for provincial and territorial governments to fund some of the vaccines for diseases that are less common, Culbert said, even though the outcome of catching IMD can be much more serious than mumps or measles.
“It’s this risk-benefit that as individuals we have to think about, but that the governments need to think about, as well.”
The potential community spread of measles in several cities and an alarming rise in cases abroad has health officials warning Canadians to make sure their vaccinations are up to date. The National asks the experts to break down how we got here and what you can do to protect yourself from one of the world’s most contagious viruses.
