Decision to fund meningococcal B vaccine for close contacts of cases and people at higher risk of meningococcal disease

Medicines Decision

We're pleased to announce a decision to fund meningococcal B vaccine (Bexsero).

What we’re doing

We're pleased to announce a decision to fund meningococcal B vaccine (Bexsero) for people who are close contacts of meningococcal cases or who are at higher risk of meningococcal disease, from 1 July 2021.

In summary, vaccination will be funded for people who are:

  • close contacts of meningococcal cases of any meningococcal group (e.g. A, C, W, Y or B),
  • at higher risk of meningococcal B disease because they:
    • are pre- or post-splenectomy
    • have functional or anatomic asplenia
    • have HIV
    • have complement deficiency
    • are pre- or post-solid organ transplant
    • are post-bone marrow transplant
    • are pre- or post-immunosuppression.

Any changes to the original proposal?

This decision was subject to a consultation letter dated 3 May 2021.

The proposal was approved as consulted on, except for a change to the eligibility criteria to permit vaccination of people before they start immunosuppressive therapy, as well as after stopping immunosuppressive therapy.

We received supportive feedback regarding this proposal and really appreciate the thoughtful feedback. We would like to thank everyone who responded. We also received feedback requesting further widening of access to meningococcal vaccines. Our clinical advisors have reviewed and recommended several options for funding access for a range of different patient groups and these remain under consideration by PHARMAC for future funding.

Who we think will be most interested

  • People with reduced immune function due to certain conditions, who may be at higher risk of meningococcal disease, close contacts of confirmed meningococcal cases, and their whānau
  • Doctors in general practice, other primary care prescribers, nurses and vaccinators
  • DHB regional public health services
  • DHB oncology and haematology services and other clinical services and health professionals treating patients who are, or will become, immunosuppressed (including patients having splenectomy)
  • Suppliers and wholesalers
  • Organisations with an interest in immunisation

Detail about this decision

From 1 July 2021, meningococcal B vaccine (Bexsero) will be listed in Section I and Part II of Section H of the Pharmaceutical Schedule as follows:

Pharmaceutical

Brand Name

Formulation

Pack Size

Price and subsidy

Meningococcal B multicomponent vaccine

Bexsero

Inj 175 mcg per 0.5 ml prefilled syringe

1

$0.00*

* Vaccine prices are listed with zero cost in the Pharmaceutical Schedule as PHARMAC distributes them free of charge to vaccinators. A confidential purchase price will apply to Bexsero.

Bexsero will be listed with “Xpharm” restriction.  An Xpharm listing means that pharmacies cannot claim subsidy because PHARMAC has made alternate distribution arrangements.

The eligibility criteria for meningococcal B multicomponent vaccine will be listed in Section I and Part II of Section H of the Pharmaceutical Schedule as follows:

Section I

Either:

A) Both:

  1. Child is under one year of age; and
  2. Any of the following:
    1. up to three doses for patients pre- and post-splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre- or post-solid organ transplant; or
    2. up to three doses for close contacts of meningococcal cases of any group; or
    3. up to three doses for child who has previously had meningococcal disease of any group; or
    4. up to three doses for bone marrow transplant patients; or
    5. up to three doses for child pre- and post-immunosuppression*; or

B) Both:

  1. Person is one year of age and over; and
  2. Any of the following:
    1. up to two doses and a booster every five years for patients pre- and post-splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre- or post-solid organ transplant; or
    2. up to two doses for close contacts of meningococcal cases of any group; or
    3. up to two doses for person who has previously had meningococcal disease of any group; or
    4. up to two doses for bone marrow transplant patients; or
    5. up to two doses for person pre- and post-immunosuppression*

*Immunosuppression due to corticosteroid or other immunosuppressive therapy must be for a period of greater than 28 days.

Section H

Restricted

Initiation – Infants under one year of age

Any of the following:

  1. up to three doses for patients pre- and post-splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre- or post-solid organ transplant; or
  2. up to three doses for close contacts of meningococcal cases of any group; or
  3. up to three doses for child who has previously had meningococcal disease of any group; or
  4. up to three doses for bone marrow transplant patients; or
  5. up to three doses for person pre- and post-immunosuppression*

Initiation – Person is one year of age and over

Any of the following:

  1. up to two doses and a booster every five years for patients pre- and post-splenectomy and for patients with functional or anatomic asplenia, HIV, complement deficiency (acquired or inherited), or pre- or post-solid organ transplant; or
  2. up to two doses for close contacts of meningococcal cases of any group; or
  3. up to two doses for person who has previously had meningococcal disease of any group; or
  4. up to two doses for bone marrow transplant patients; or
  5. up to two doses for person pre- and post-immunosuppression*

*Immunosuppression due to corticosteroid or other immunosuppressive therapy must be for a period of greater than 28 days.

The Ministry of Health is responsible for supporting the implementation of changes to the National Immunisation Schedule.

The Ministry of Health’s Immunisation Handbook will be updated to reflect the addition of eligibility for meningococcal B vaccine.(external link)

Our response to what you told us

We’re really grateful for the time people took to respond to this consultation. Responses were generally supportive of the proposal. A summary of the main themes raised in feedback, our responses to the feedback received, and changes we have made after listening to you are provided below:  

Theme

PHARMAC Comment

Request to fund meningococcal B vaccine for wider groups than proposed:

  • all infants as part of the childhood immunisation schedule
  • all infants and children under 5 years of age
  • Māori and Pacific infants and young children, particularly those living in poverty
  • adolescents and young adults living in close living situations
  • NZDF recruits.

We are currently in a position to progress funding for people who are close contacts of meningococcal cases or are at higher risk of meningococcal disease due to reduced immune function. 

PTAC and the Immunisation Subcommittee have reviewed the funding of meningococcal B vaccine and recommended funding with a high priority for several different patient groups. These other groups remain in active consideration by PHARMAC, in consultation with the Ministry of Health, for future funding. 

See PHARMAC’s application tracker for information on the range of groups that have been considered and to review the clinical advice we have received.(external link)

Request that pharmacists be able to administer the meningococcal B vaccine.

Funded vaccine supply will be available through ProPharma as with other funded vaccines. As with most other funded vaccines (apart from influenza vaccine), pharmacist vaccinators will not be able to administer this funded vaccine at this time. Significant changes would be required to the current funding process and delivery of vaccines to allow pharmacists to administer all funded vaccines. We continue to consider options for changes to the funding and distribution mechanisms that would allow pharmacists to administer funded vaccines in the future.  

Request to amend eligibility criteria to permit immunisation before immunosuppression commences as well as following immunosuppression.

We have amended the eligibility criteria accordingly so that Men B will be funded for both pre- and post-immunosuppression.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.