Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. Vaccination programs for ten selected pathogens will have averted an estimated 69 million deaths in 98 low- and middle-income countries between 2000 and 2030. Most of this impact has been concentrated in a reduction in mortality among children younger than 5 years (57% reduction), most notably from measles. These public health gains are predicted to increase in coming decades if progress in increasing vaccine coverage is sustained.
The breastmilk of mothers in Bangladesh who received the meningococcal vaccine during pregnancy had anti-meningococcal antibody levels at 3-6 months after delivery of four to five times higher than that of mothers who did not receive the vaccine.
Although this study was published in 2002, the data on this topic are sparse as it is methodologically difficult to conduct studies to evaluate the relationship between anti-meningococcal antibodies in breastmilk and protection.
A systematic literature review of studies of the long-term effects of invasive meningococcal disease in high-income countries found that children who survived the disease had a greater incidence of hearing loss and psychological problems, including attention-deficit/hyperactivity disorder (ADHD) than control groups or the general population. In addition, they had increased odds of death – one study showed more than a 25% greater mortality rate in this population than did the general public up to 30 years after having the disease.
During a meningococcal meningitis epidemic in Burkina Faso, households spent, on average, US$90 for treatment and other direct costs for family members with the disease. These costs, the equivalent of one third of the country’s annual GDP per capita, were in addition to the loss of income and assets from family members caring for patients.
Two meningococcal meningitis outbreaks in Brazil resulted in US$128,000 (9 cases, 2007) and US$34,000 (3 cases, 2011) in direct costs to the health system to investigate cases and manage the outbreak (including emergency vaccination). The investigation and response activities related to the 2011 outbreak alone cost $11,475 per case, and an additional $6,600 overall for supplemental disease surveillance activities.
A large meningococcal meningitis epidemic in Burkina Faso cost the health system an estimated US$7.1 million, representing nearly 2% of the country’s entire annual health budget.
In this study of a 2007 outbreak, 86% of the health system cost covered a reactive vaccination campaign using older polysaccharide vaccines. Routine vaccination with new, conjugate vaccines are expected to prevent or limit future outbreaks and thus reduce these costs.
Meningococcal meningitis epidemics in Burkina Faso “… disrupted all health services from national to operational levels,…” according to a 2011 study. Impacts included a shortage of available hospital beds and medicines, a reduction or delay in routine lab analyses for other diseases, longer wait times, and an increase in misdiagnoses by overtaxed health workers.
A 2006-07 meningococcal meningitis epidemic in Burkina Faso cost households an average of US$90 for each case of meningitis that occurred. These costs — representing nearly 2.5 months of the average per capita income for that year — included direct and indirect costs of treatment and lost income to caretakers.