It's been 10 years since medical student Zachary Gravatt died of meningococcal disease, and not enough has been done to eradicate the "preventable scourge" from New Zealand, his dad says.
Monday marked a decade since the 22-year-old was taken to Auckland City Hospital on suspicion he had swine flu.
Zac, a fourth-year medical student, went to his GP with fevers, rigors, headaches and groin pain around lunchtime on July 8, 2009, before being admitted to hospital around 1.43pm.
Over the afternoon he quickly deteriorated but was not transferred to the Department of Critical Care Medicine until 6.40pm. He died 35 minutes later.
It was "the blackest of days" and had marred the family's lives forever, Zac's father Dr Lance Gravatt wrote in a letter to the Herald (read the full letter at the bottom of this story).
"We told ourselves that Zac didn't die in vain, though, and that some good for others would come of his death and the deaths of many other young people who have died of meningococcal disease over the years. We look back and ask ourselves: what has changed?"
Two inquests into Zac's death looked at whether he could have been better cared for while in hospital. The Coroner recommended several improvements, some of which are being implemented.
But Gravatt feels things are moving too slowly.
Meningitis and meningococcal septicaemia are caused by infection with the bacteria Neisseria meningitidis, of which there are five identified strains - A, B, C, Y, and W.
While vaccines are available for all five strains, Pharmac is still deciding whether to fully fund them for children and young people.
Last year 10 people died of meningococcal disease in New Zealand, with 120 cases reported. Incidence of the disease has been trending upward since 2014 - though still well down from the 2001 peak of the last epidemic.
"One of the recommendations made by the Coroner following Zac's death was for Pharmac to conduct a cost-benefit assessment of funding meningococcal vaccination as part of the childhood programme," Gravatt wrote.
"It took nine years for the assessment to be done but still meningococcal vaccine is not routinely funded as part of the childhood vaccination programme. With several deaths every year and roughly twice that number permanently disabled, we can only wonder at the maths that says saving these lives is not value for money."
Pharmac said it had looked at funding the vaccines several times and had expanded availability to high-risk populations since it took over the decision-making job from the Ministry of Health in 2013.
High-risk groups included people with compromised immunity and those in close contact with an infected person.
Two vaccines covering all five strains of meningococcal bacteria are still being actively considered for funding, Pharmac director of operations Lisa Williams said.
Funding was being looked for vaccinating children as well as high-risk groups such as young people in close living situations like boarding schools.
There is no timeframe for the decision, she said.