Clarity around meningitis vaccines critical to LatinX community

OPINION – The COVID-19 pandemic exposed long-standing gaps in health care access and education among communities of color and low-income neighborhoods in Los Angeles and existing health disparities continue to leave Los Angeles’ large LatinX community at a higher risk for significant health threats. But with rising rates of communicable illnesses across California and beyond, public health professionals have a critical opportunity to help improve vaccine rates by issuing clear recommendations around all new meningitis vaccines to ensure the vaccines are widely available and improve access for those who need protection most.

Meningitis is a serious bacterial disease that causes inflammation of the tissues surrounding the brain and spinal cord. In most cases, the illness spreads quickly through close contact with respiratory fluids, increasing the potential for close-knit environments like classrooms and college dorms to have a major outbreak with just one infected individual.

There are several different strains of meningitis and, historically, one vaccine has provided coverage for the majority of the strains, MenACWY, while another vaccine has provided coverage specifically for meningitis B (MenB). Several public health professionals who are part of the Advisory Committee for Immunization Practices (ACIP), a subcommittee of the Centers for Disease Control and Prevention (CDC), are responsible for making recommendations around vaccines and regulate the availability of newly FDA-approved vaccine, insurance coverage of the vaccines, and determine broad access to vaccines.

ACIP recommends a two-shot vaccine series for the majority of meningitis strains but issued a shared clinical decision making (SCDM) for MenB, which requires additional conversations about the vaccine between a doctor and a patient. The SCDM recommendation has left many providers struggling to interpret how to best implement the vaccine recommendation and many patients in the dark that another vaccine for meningitis exists. On top of that, ACIP recently met to discuss recommendations around new meningitis vaccines that provide protection against all strains of the illness, but the new vaccines did not receive a broad recommendation to administer the vaccine to all eligible populations, potentially worsening existing disparities around the MenB vaccine. In addition, ACIP’s guidance will require health care to consistently carry multiple meningitis vaccines in their offices, a significant undertaking that can overcomplicate routine vaccine administration.

While the MenB vaccine is readily available, due to the SCDM recommendation, many Californians do not know it exists or that they aren’t full protected against all strains of meningitis. A 2019 report showed that more than 80 percent of parents were not aware of the MenB vaccine And, according to the CDC in 2021, adolescent vaccination coverage of at least one dose of the MenACWY vaccine was 89%, compared to a staggering 31% for MenB.

While we’re all at risk of contracting meningitis without a vaccine, the bacteria can be particularly harmful for infants, teens and young adults, people with certain medical conditions that affect the immune system, and the LGBT community. Notably, men in the LGBT community have four times greater risk of contracting meningitis compared to those who identify as cisgender, with rates even higher among LGBT males living with HIV.

ACIP’s recommendations around meningitis vaccines that provide coverage for all strains of the illness are a step in the right direction, but I urge federal public health officials to issue easy-to-understand recommendations around these vaccines to efficiently and quickly protect communities most at risk. Improving access to new meningitis vaccines would help ensure patients are protected in just one trip to their provider – a commonsense step we should prioritize to help combat disparities in care that California’s LatinX community continue to face.

I urge the CDC to protect our community who is most at risk by routinely recommending vaccines that protect against all meningitis strains.

Richard Zaldivar is executive director of The Wall Las Memorias Project based in Los Angeles.