Meningococcal ACWY vaccine recommendations by PTAC in 2019
8 October 2021
Dear [name and contact details withheld]
Request for information
Thank you for your request dated 10 September 2021 under the Official Information Act 1982 (OIA) for information relating to the recommendations made by the Pharmacology and Therapeutics Committee (PTAC) at its meeting of 21 & 22 February 2019. You requested:
- The Immunisation Sub-committee documents or presentations that PTAC ‘agreed’ with.
- The criteria that PTAC used to decide that there was ‘no direct evidence of benefit’.
- At what point (earlier meeting minutes or other) did PTAC make the aim of ‘universal adolescent vaccination’ to be ‘herd immunity’, (cf reduction in morbidity and mortality)
I note that your requests relate to the recommendations made by PTAC specifically for the funding application for the meningococcal A, C, Y and W-135 vaccine (meningococcal ACWY conjugate vaccine/meningococcal C conjugated vaccine).
Full details of this funding application can be found on our online Application Tracker.(external link)
Additionally, I note requests 2 and 3 relate to discussion note 14.16 (copied below) of the record of the PTAC meeting held on 21 & 22 February 2019 [PDF, 796 KB].
The Committee agreed with the Immunisation Subcommittee that adolescents in close living situations (such as university halls of residence, boarding schools) would likely benefit the most from Men ACWY vaccination. Members noted that universal adolescent vaccination in New Zealand would aim to achieve high rates of vaccination to achieve the herd immunity observed in the UK, but there was no direct evidence of benefit. The Committee considered that there was no direct evidence of benefit for universal childhood vaccination.
The full record of this meeting can be found on our website: www.pharmac.govt.nz > About > How we get expert advice > Pharmacology and Therapeutics Advisory Committee (PTAC) > Records of PTAC meetings.
1. Immunisation subcommittee documents or presentations that PTAC ‘agreed’ with
Please find attached a combined copy of the documents provided to PTAC to assist them with making recommendations about the funding application for the meningococcal ACWY vaccine in 2019.
Please note, we approach our assessment of requests for information under the OIA on the basis that once we release the information to you it becomes available to any other party in that exact form (whether by you distributing it to others or by virtue of us receiving the same request from a different third party).
We have provided a list at the end of this letter of the clinical abstracts and/or papers (Appendix 1) that were provided to PTAC. We have not released copies of these documents as they are already publicly available (section 18(d) of the OIA) and may be subject to copyright restrictions.
Additionally, we have redacted a small amount of information from the documents as we consider this is necessary to:
- protect information where the making available of the information would be likely to unreasonably prejudice the commercial position of the person who supplied or who is the subject of the information (section 9(2)(b)(ii))
- protect information which is subject to an obligation of confidence or which any person has been or could be compelled to provide under the authority of any enactment, where the making available of the information would be likely to prejudice the supply of similar information, or information from the same source, and it is in the public interest that such information should continue to be supplied (section 9(2)(ba)(i))
- enable PHARMAC to carry on, without prejudice or disadvantage, negotiations, including commercial negotiations (section 9(2)(j)).
As required under the OIA, we also considered whether withholding information under section 9 was outweighed by other considerations which render it desirable, in the public interest, to make this information available. In this case we did not consider that the public interest outweighed the reasons for withholding the information.
2. Criteria that PTAC used to decide that there was ‘no direct evidence of benefit’
This note reflects PTAC’s opinion on the strength and quality of the evidence it reviewed at this meeting. PTAC’s opinion at the time was that there was only indirect clinical evidence of benefit from using meningococcal ACWY vaccine (Menactra) for universal adolescent or childhood vaccination programmes. For example, PTAC reviewed evidence for using meningococcal C vaccine in adolescents in the UK, from which it might be indirectly inferred that meningococcal ACWY vaccine would provide similar benefits in adolescents.
3. At what point did PTAC make the aim of ‘universal adolescent vaccination’ to be ‘herd immunity’
PTAC members noted that universal adolescent vaccination in New Zealand would aim to achieve high rates of vaccination to achieve the herd immunity observed in the UK.
This reflected PTAC’s opinion at the time that, having reviewed evidence that the UK had used herd immunity as a key strategy for meningococcal disease control (reducing morbidity and mortality) in the UK, a similar approach could be adopted for New Zealand.
Please note you have the right, by way of complaint under section 28(3) of the OIA to an Ombudsman, to seek an investigation and review of our decision.
We trust that this information answers your queries. We are making our information more freely available, so we now publish selected OIA responses (excluding personal details) on our website. Please get in touch with us if you have any questions about this.
Manager, Policy and Government Services
Helen Findlow, H. C. (2019). Serogroup C Neisseria meningitidis disease epidemiology, seroprevalence, vaccine effectiveness and waning immunity, England, 1998/99 to 2015/16. Euro Surveillance, 24(1). doi:10.2807/1560-7917.ES.2019.24.1.1700818
Paolo Pellegrino, V. P. (2014). Immunogenicity of meningococcal quadrivalent (serogroup A, C, W135 and Y) tetanus toxoid conjugate vaccine: Systematic review and meta-analysis. Pharmacological Research. Retrieved from http://dx.doi.org/10.1016/j.phrs.2014.10.006
Paul Balmer, C. B. (2018). Impact of Meningococcal Vaccination on Carriage and Disease Transmission: A Review of the Literature. Human Vaccines and Immunotherapies. Retrieved from https://doi.org.10.1080/21645515.2018.1454570
Public Health England. (2017, October 27). Invasive meningococcal disease in England: annual laboratory confirmed reports for epidemiological year 2016 to 2017. Health Protection Report, 11(38).
Scott Vuocolo, P. B. (2018). Vaccination strategies for the prevention of meningococcal disease. Human Vaccines & Immunotherapeutics, 14(5), 1203-1215. doi:10.1080/21645515.2018.1451287
Shamez N Ladhani, M. R. (2016). Enter B and W: two new meningococcal vaccine programmes launched. Archives of Disease in Childhood (ADC), 101, 91-95.