State Law Requires Meningitis Vaccine OR Waiver

April 2005

Dear Student:

In June 2002 the Pennsylvania legislature passed a law requiring colleges and universities to inform all students about meningitis. The law states all students are required to either receive the meningitis vaccine, OR sign a waiver stating they have read the information but have decided not to receive the vaccine. The law further states that colleges and universities “shall prohibit a student from residing in a dormitory or housing unit” unless the student has either shown proof of being immunized or signed a waiver. If you are a First Year or Transfer student and have already received the meningitis vaccine, please have your doctor’s office document the date on the Medical Record form sent to you in May.

On page one of the Medical Record form there is a waiver section for you to sign if you have not received the vaccine. If for some reason you need an additional waiver form you may download and print the form from the link at the end of this document.

If you are unable to receive the vaccine from your doctor’s office, it is available at the Health Center. Simply call for an appointment once on campus. If this is the case, you must sign the waiver form until you can get the vaccine, this will allow us to comply with the current law, and not delay your housing.

Please read the following information before printing the waiver form.

What is Meningitis?

Meningitis is an inflammation and infection of the lining of the brain and spinal cord caused by either a virus or bacteria.

Viral Meningitis is more common than bacterial meningitis and usually occurs in late spring and summer.  Signs and symptoms of viral meningitis may include stiff neck, headache, nausea, vomiting and rash.  Most cases of viral meningitis run a short, uneventful course.  Since the causative agent is a virus, antibiotics are not effective. Persons who have had contact with an individual with viral meningitis do not require any treatment.

Bacterial meningitis occurs rarely and sporadically throughout the year, although outbreaks tend to occur in late winter and early spring.  Bacterial meningitis in college aged students may be due to an organism called meningococcal bacteria.  Because meningococcal meningitis can cause grave illness and rapidly progress to death, it requires early diagnosis and treatment.  Persons who have had intimate contact with someone who has been diagnosed with meningococcal meningitis should seek immediate medical attention so they may get preventive therapy, which is a course of antibiotics. 

Where does it come from and how is it transmitted?

The meningococcal bacterial is  found in nasal and oral secretions.  People may harbor this organism, but never become ill, others get quite ill with meningitis or meningococcemia (bacterial infection of the blood) and  may die.  This organism can be transmitted through close personal contact such as:

• sharing drinking utensils (cup, bottle, glass, can, jug,)
• sharing the mouthpiece on a musical instrument
• sneezing or coughing on someone
• kissing on the lips
• sharing eating utensils
• sharing lipstick or chap stick
• sharing cigarettes, cigars or pipes

Other risk factors include those habits which decrease ones immune system such as:

•  smoking
•  alcohol
•  lack of sleep
•  lack of proper nutrition
•  stress

Most people who become infected simply carry the organism harmlessly, without illness, and eliminate it from the nose and throat within a short time by developing natural immunity.  At any one time, up to 10% of the normal population may be found carrying meningococcus without illness or symptoms.

Very rarely, an individual may develop an illness with signs and symptoms of  fever, headache, and stiff neck, sometimes with a rash or vomiting, and sometimes with fatigue or change in consciousness or awareness of their surroundings.  If you experience these symptoms, you should seek immediate medical evaluation. 

Preventative Measures

• Avoid contact with the nasal and oral secretions of others.

• Avoid coughing or sneezing on others and properly dispose of nasal and oral secretions.
• Avoid sharing eating or drinking utensils, the mouthpieces of musical instruments, lipsticks, chap sticks, cigarettes, cigars or pipes.

• Wash your hands frequently.
• Get lots of sleep, exercise, and good nutrition which will boost your immune system.
• If you drink, do so responsibly and in moderation.  Excessive alcohol consumption is believed by some health authorities to increase susceptibility to meningococcal meningitis.
• Do not smoke

Vaccine

On February 10, 2005, the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) voted to recommend that all incoming college freshmen living in dormitories be vaccinated against meningococcal disease. The ACIP also recommended vaccination for all adolescents at high school entry and during pre-adolescent health care visits (11-12 years old).

The American College Health Association (ACHA) issued similar immunization recommendations for all first-year students living in residence halls. The ACIP and ACHA recommendations further state that other college students under 25 years of age may choose to receive meningococcal vaccination to reduce their risk for the disease.

Pennyslvania law mandates all students either receive the vaccine or sign a waiver.

Five predominant strains or serogroups of N. meningitis account for most cases of meningococcal disease, these are A, B, C, Y and W-135.

Currently available vcaccine protects against four of the five strains (A,C, Y, and W-135).

Evidence shows approximately 70 - 80 percent of cases in the college age groups are causaed by serogroup C, Y, or W-135, which are potentially vaccine-preventable.

No vaccine is available for widespread vaccination against serogroup B.

The vaccine is between 98% and 100% effective against subtypes A, C, Y, and W-135, however the vaccine may not protect 100% of individuals who are vaccinated.

Vaccine will not protect against other bacteria that cause meningitis.

The effectiveness of the vaccine (production of antibodies) decreases markedly during the first 3- 5 years following vaccination.

Revaccination may be considered for first year students who were vaccinated more than 3-5 years earlier.

Routine revaccination of college students who were vaccinated as first year students is not indicated.

As with any vaccine, the meningitis vaccine may not protect 100% of susceptible individuals.

· If a student who has had the vaccine is exposed to meningococcal meningitis, the experts recommend the exposed person still seek medical attention and have antibiotics to protect them against the disease despite the vaccine. 

Adverse effects and contraindications to the vaccine

• Localized redness in the injection site for 1-2 days, headache, fatigue, fever, and chills
•  Vaccine should not be given if the patient has a fever.
•  Vaccine should not be given to those allergic to Thimerosal (a preservative used in the vaccine) or to latex.
•  Women who are pregnant should not receive the vaccine.
•  Persons receiving immunosuppressive therapy will not receive the full benefit of the vaccine.
• As with all vaccinations there is a chance of allergic reaction or anaphylactic shock which may lead to death.
  
  

Price

· The  vaccine price varies depending on your doctor’s office. Currently it is available at the Health Center for $65.00, however, if the company raises their prices, we will have to adjust ours as well.  The student may charge this amount to their account, use their declining balance, or pay in cash.

· If you decide to sign the waiver now, but in the future you decide to have the vaccination, simply call the office for an appointment.  With all injections given at the Health Center, the student will need to wait thirty minutes after the injection before leaving the facility.

Please link to the waiver form (below) if you have not already signed the wavier section on page one of the Medical Record form.

Please print and complete the Meningitis Vaccine Waiver form or call the Health Center for further information.

If you would like more information on meningitis and the vaccine, please visit the Center for Disease Control (CDC) web sites for general information.

If you are unable to access the internet for this purpose, please e-mail health@dickinson.edu and we will be happy to send you a hard copy.

Sincerely,

Mary Arthur, CRNP, MPA
Director, Student Health Services

MeningitisLawWithLink
Monday, April 25, 2005 5:26 PM