Provinces urged to offer students free vaccines for rare but deadly meningitis strain

In this file photo, Allen Smith gets a free vaccine against bacterial meningitis in West Hollywood, Calif., Monday, April 15, 2013. (Damian Dovarganes/AP Photo)

Nova Scotia and Prince Edward Island are the only provinces that offer post-secondary students free vaccination against meningitis B, a rare but deadly bacterial infection.

With Canadian universities and colleges about to welcome thousands of freshmen in September, more provinces are being urged to cover the vaccines, which can cost $300 or more for two required doses.

"Meningococci can kill within hours," Meningitis Foundation Canada medical adviser Dr. Ronald Gold told CTVNews.ca. "The best protection is vaccination."

Meningitis B, or MenB for short, is caused by Group B meningococcus bacteria. While most Canadian children receive a vaccine that covers four other strains of meningitis – groups A, C, W and Y – the comparatively new shots for group B are not part of any routine vaccination program in Canada.

Meningitis bacteria can cause a rare and severe illness known as invasive meningococcal disease, which affects less than one in 100,000 Canadians. It is fatal in up to 10 per cent of cases, according to Health Canada, while 10 to 20 per cent of survivors experience life-altering consequences such as hearing loss, neurological disabilities or amputated digits and limbs.

Gold previously headed the infectious disease division at Toronto's Hospital for Sick Children. He says teens and young adults are more likely to carry the dangerous bacteria for reasons that are not fully understood.

"And behaviours in this age group promote the spread of the bacteria," Gold added. "Meningococci spread from person to person through close contact: coughing, sneezing, singing, kissing, sharing glasses and utensils, being in crowded rooms such as bars."

That's why Gold would like to see meningitis B vaccines offered free to all post-secondary students in Canada.

"I believe that because of the severity of the disease and the increased risk of disease in first-year university students living in dormitories and residences, the MenB vaccine should be made available at no cost to the students," Gold said. "I would prefer to cover it for all post-secondary students, to be given before the start of their first year."

Student deaths lead to changes in Atlantic Canada

Kai Matthews had just finished his first year at Acadia University in Nova Scotia when he suddenly developed a high fever and body aches.

"He was started on antibiotics in a race against time to fight and slow down the infection, which they suspected to be meningitis," his father Norrie Matthews told CTVNews.ca. "Only 30 hours had passed from his first sign of symptoms until we had to make the impossible decision of taking him off life support."

Following Kai's sudden death in 2021, his family launched the non-profit BforKai to raise awareness about meningitis B and advocate for vaccination.

"We had no idea that Kai wasn't protected for MenB," Matthews said. "Most parents believed their children were fully protected against meningitis with the routine provincial vaccine program and were unaware that MenB was not included in that program."

After two more Nova Scotia students died from meningitis B the following year, in 2023 the province began offering free vaccines to new post-secondary students ages 25 and under living in dormitories and residence, as well as to new military recruits living in congregate settings like barracks.

Prince Edward Island announced a similar program in 2023 and has since expanded eligibility to all post-secondary students, including those studying out-of-province.

Other provinces and territories typically only cover the costly vaccine for those who have been in close contact with a confirmed case, or to children at high risk of severe disease, such as those with immune system disorders. The first meningitis B vaccine was approved for use in Canada in 2013.

"The most common reason why MenB vaccines are not publicly funded is that the 'cost-benefit' analysis does not meet the threshold required by ministries of health," Matthews said. "This is what I've heard from government officials and health policy makers over and over again. That response is a hard pill to swallow for a father that lost his 19-year-old son who was in the prime of his life."

Group B strains most common in Canada

The Public Health Agency of Canada says there were about 115 cases of invasive meningococcal disease per year between 2010 and 2022, with most occurring in winter and spring.

"In Canada, U.S.A. and western Europe, group B strains cause about 50 per cent of the cases, especially in countries where children are routinely vaccinated against the other main groups of meningococci – A, C, Y and W," Gold explained. "The predominance of B strains is partly the result of vaccination against the other groups of meningococci and also because of the greater genetic variability of B strains."

Group B remains the most dominant strain in Canada, accounting for 40 per cent of invasive meningococcal disease cases since 2012, or about 43 cases annually, according to Meningitis Foundation Canada. Group B is even more common in Quebec and Atlantic Canada, where it accounts for 50 per cent of severe cases. That number drops to less than 25 per cent in Western Canada, where group W is the most prevalent.

Despite periodic and localized outbreaks, the Public Health Agency of Canada says incidence of invasive meningococcal disease has generally decreased over time. While it was unable to provide recent national data to confirm this, some provincial figures are available.

Ontario, for example, saw 30 confirmed cases and three deaths from invasive meningococcal disease in 2023, with most – 36.7 per cent – linked to group B. Meningitis B was also the most common strain in Ontario in 2022, at 38.5 per cent of 26 confirmed cases.

Initial symptoms can include headache, fever, nausea, vomiting, light sensitivity, stiff neck and later a dark purple rash. Anyone with symptoms should seek immediate medical attention. About 10 per cent of people who carry the bacteria don't get sick.

Both Gold and Matthews agree that the high cost for meningitis B vaccines remains a major barrier.

"In the absence of public funding, individuals seeking meningitis B vaccination must pay out-of-pocket for the cost, which individuals may be hesitant to do because of the perception that if a vaccine isn't covered by the government, it isn't worth getting," Matthews said. "Nova Scotia and P.E.I. have led the way for other Canadian provinces and territories by implementing a MenB program for post secondary students. I hope to see that type of policy change spread across Canada."