While there is good evidence that MeNZBTM is effective, the epidemic strain is continuing to circulate. It is important to continue to protect the vulnerable birth cohort until there is another vaccine to take the place of MeNZBTM or the risk to newborns becomes very low, as evidenced by low rates of disease in vaccinated and unvaccinated.
Careful monitoring of disease rates and vaccine breakthroughs needs to continue to inform the decision of whether a booster dose becomes warranted in the under five year age group.
Given a replacement generic vaccine is unlikely to be available within the next two to five years, a set of targets is proposed that could inform future considerations regarding stopping MeNZBTM vaccination Of paramount importance is the need to consider the impact on disease rates in the Pacific and Maori populations who have been most affected by this epidemic.
Attention needs to be given to managing the relationship with Novartis so that the vaccine supply chain is not put at risk. This may require the Ministry committing to binding orders (before vaccine may be needed and taking into account the extended shelf life to minimise wastage) to minimise the risk of an interruption to the supply.