Californians need protection against outbreaks of vaccine-preventable illnesses

OPINION – California vaccination rates for communicable illnesses dropped during the outbreak of the COVID-19 pandemic when our health system moved to an “emergency only” system. Today, many Californians are still behind on their routine vaccines, leaving communities across our state susceptible to contracting and spreading dangerous illnesses. With breakouts of easily spreadable and vaccine-preventable illnesses happening across the country, public health professionals must take action to improve access to critical vaccines that protect against pneumococcal disease and meningitis.

Across the country, adults and adolescents missed more than 37 million routine vaccinations during COVID – vaccines that have long kept our communities safe against outbreaks of illnesses like measles, rubella, meningitis, and pneumococcal disease.

Both pneumococcal pneumonia and meningococcal meningitis are highly contagious bacterial infections that can be spread easily and quickly. It’s estimated that 150,000 Americans are hospitalized with pneumococcal disease each year and between 5-7% of those patients die from the disease – the death rate is even higher for those aged 65 and older. In addition, while deadly for all populations, meningococcal meningitis is most seen in children, teenagers, and older adults, and infections can spread quickly in places like classrooms and college dorms. Since 2021, meningitis cases have increased sharply, now exceeding pre-pandemic levels. Of those who contract meningococcal meningitis, between 10-15% will die, and among those who survive, 20% of these patients will live with permanent disabilities, such as brain damage, hearing loss, loss of kidney function, or limb amputations.

Both pneumococcal pneumonia and meningococcal meningitis are vaccine-preventable illnesses, meaning that with routine vaccinations, our communities will be safe from major outbreaks of these illnesses. That’s why improving access to these vaccines is more important than ever.

The Advisory Committee for Immunization Practices (ACIP) is a subcommittee of the Centers for Disease Control (CDC) that is responsible for determining which vaccines are widely accessible and covered by health insurers, what age people should get certain vaccines, and how often they should get them. In just a few weeks, ACIP is meeting to assess various vaccines, including those that protect against pneumococcal pneumonia and meningococcal meningitis.

There are several different strains of meningococcal meningitis, but current ACIP recommendations call for shared clinical decision making (SCDM) against meningitis B, which means the decision to vaccinate against MenB is left to providers and families. Without a strong recommendation for MenB vaccination, many providers struggle to implement the SCDM recommendation, and many Californians are left susceptible to contracting MenB due to a lack of education around this strain. In 2022, more than 70% of 17-year-olds in the U.S. had not been vaccinated against MenB. To combat this trend, ACIP should make a clear and easy-to-understand recommendation to alleviate the existing confusion and ensure more Californians are protected from all strains of meningitis.

Similarly, ACIP’s current age recommendation for pneumococcal vaccination is for children younger than 5 years and adults 65 years or older. Given how susceptible older adults are to contracting pneumococcal disease, it’s critical that communities get risk start getting vaccinated earlier. Limiting access to vaccines can increase the disease burden, worsen health inequities, and potentially lead to vaccine shortages in the future. ACIP should recommend all FDA-approved pneumococcal vaccines to adults 50 and older to protect our community against an outbreak of the illness.

Both more inclusive age recommendations and strong recommendations around meningitis vaccines would provide more clarity for both patients and healthcare providers, ensure that more Californians receive life-saving vaccinations in a timely manner, and help Californians get the right vaccine at the right time, particularly as we continue to catch up on missed vaccines as a result of the COVID-19 pandemic.

As one of the largest and most diverse states, California is especially vulnerable to the gaps in vaccination coverage. Health disparities already exist in many underserved communities across the state and any policies that hinder vaccine access can only deepen these existing inequities. By advocating for broader, more accessible vaccination policies, we can protect more adults from the harmful effects of pneumococcal disease and meningitis, reducing hospitalizations, improving public health outcomes, and alleviating pressure on an already strained healthcare system.

ACIP must act now to revise its recommendations and improve access to vaccines for pneumococcal disease and meningococcal meningitis. This is not just a matter of improving vaccine rates; it is about safeguarding public health and ensuring that no Californian is left vulnerable to preventable diseases.

Larry Bottorff, RN, BSN, MBA, CIC is executive director of Infectious Disease Association of California.