'Outrage' at vaccine delays

Zachary Gravatt died in 2009 and his parents, Jenny and Lance, back mass vaccination.

The parents of a young man who died of meningococcal C are "outraged with grief" at the many deaths that could have been prevented if the Government had introduced mass vaccination of children against the disease.

After medical student Zachary Gravatt died in Auckland City Hospital of the disease in 2009, when he was 22, a coroner recommended the Ministry of Health urgently review the costs and benefits of mass C-strain vaccination.

That was in 2011, the year in which an outbreak of the disease swept through Northland, taking three lives.

One was 18-year-old Ben Brown, whose case went before the same coroner, Brandt Shortland, in Whangarei this week.

The ministry's vaccine evaluation role passed to Pharmac last year and Mr Gravatt's father, Lance, told the Herald the only progress was a sub-committee's request for a cost-utility analysis to be done.

"To the best of our knowledge no such cost-benefit analysis has been undertaken," Dr Gravatt writes in today's New Zealand Medical Journal, in a letter in which he also reports on his own preliminary cost-effectiveness study.

Pharmac said it was considering funded access to a C-strain vaccine and was "progressing" a cost-utility analysis, which would go to a sub-committee next year.

After plugging some New Zealand data into a British C-strain vaccine study, Dr Gravatt, an owner of a small pharmaceutical company, said mass vaccination would be highly cost-effective here. Medicine cost-effectiveness studies assess drug costs against years of life saved, quality of life and savings from health care avoided.

Dr Gravatt estimated the net cost of vaccinating children at 12 months and again at 18 years would be zero for each "quality-adjusted" year of life saved at a vaccine price of $25 to $40 per dose. The listed prices were around $43 to $87, but discounts would be likely in a bulk contract.

He added that his calculations indicated C-strain vaccination would be much better value for money than rotavirus vaccine, which Pharmac's vaccine advisers want to be funded.

Over the past five years, 118 cases of meningococcal disease, including 19 fatalities, have been lab-tested as C strain. The Northland District Health Board offered free C-strain vaccination to young people to combat the region's 2011 outbreak, but the ministry hasn't funded the vaccine nationally because the rate of the disease in New Zealand is lower than it was in Australia and Britain before they introduced mass vaccination.

Dr Gravatt said, "Jenny [his wife] and I ... are simply outraged with grief to think that Zachary and dozens of young people like him could easily have been saved at no net cost to the nation, and that is without assigning any value to their lifetime of productivity that they would have given the country in return. All because of an ingrained dogma and an apathy to do the analysis. New Zealand can do better than this."

Mr Brown's father, Darren, said New Zealand should "definitely" introduce state-funded C-strain vaccination. "A lot of people are confused. They think our kids have been vaccinated; it's only from B and it is not effective on C."

Waikato specialists Drs Graham Mills and Anita Bell noted in April that the diagnosis of meningococcal disease was often fraught with difficulties. "Vaccine prevention is a pivotal part of the answer to prevent more lives being lost," they said in the journal.

Britain introduced mass C-strain vaccination in 1999 and Australia in 2003.