GP alert for MenACWY vaccine is finally activated

An automated emergency vaccine alert for GP’s is being activated on agreement from the Department of Health and Social Care after young people who were eligible for a meningitis vaccine died because the alert was issued in a default ‘off’ setting.

Over a million people could be unaware they should get the lifesaving vaccine.

A type of meningitis vaccine (MenACWY) was introduced in August 2015 for teenagers and young people to stop a rapid rise in a new and particularly deadly strain of meningococcal meningitis (MenW) - a rise that was identified by a genome library funded by Meningitis Research Foundation.

Teenagers who left school year 13 in 2015, 2016 or 2017 needed to get their free vaccine from their GP, but uptake among that group has been worryingly low. Latest data from May 2018 shows that only around 40% of this cohort have taken up the vaccine.

A family from Tunbridge Wells, Kent, whose son tragically died from meningococcal sepsis (MenW), discovered that the software provider EMIS, used by most GP practices across the UK, has an alert that should flag to staff when a patient who attends an appointment is eligible for the MenACWY vaccine, but this alert was released inactive.

Fiona and Gavin Mason’s son Tim, an apprentice electrical engineer, died aged 21 in March 2018. Fiona said, “Tim had seemed a little unwell in early March but felt better and returned to college and work. On the 15th of March, although at work, he felt sufficiently unwell to go to the doctor, who advised him to take a few more days off and rest.

“In the early hours of the morning on 16th we were woken as Tim was violently vomiting and very unwell. My instinct told me something was seriously wrong so we took him to hospital.

“By the time we got to Tunbridge Wells Hospital he had a high temperature and could barely walk. After a long wait he was misdiagnosed with gastroenteritis and sent home at about 8:45am.

“At about 2:30pm his condition got worse and he said he felt like he was dying so I rushed him back to hospital. This time doctors began treatment but it was too late to save his life. He died that evening. It was 21 hours and 15 minutes from visible first symptoms to death.” 

“The system failed Tim in more than one way. He should have received a letter from the GP calling him in for his vaccine which would have prevented him getting MenW in the first place, but no letter was ever received. Tim had attended several GP appointments during the years after the vaccine was introduced in the UK. Had the EMIS alert been activated, he would have been flagged to staff at those appointments as a patient eligible for the vaccine. This didn’t happen.

“Having contracted the disease, the symptoms he was displaying should have triggered a sepsis alert when we first took him to hospital.

“All we can do now is try to raise awareness of these issues and make sure improvements are made to stop this happening to other families.”

Fiona and Gavin have been working with Meningitis Research Foundation to investigate the issues with the vaccination programme further.

EMIS told the charity that the alert for the MenACWY vaccine was released as inactive to avoid ‘alert fatigue’.

A letter from Seema Kennedy MP to the charity stated that, “The protocol was not activated by default, but instructions were sent out for local activation. In response to your letter, it has been agreed that this alert will be enabled for all EMIS users in England.”

NHS Digital has now confirmed that the EMIS alert was enabled for GP Practices in England in the week commencing 1 April.

Vinny Smith, Chief Executive at Meningitis Research Foundation said, “It’s a tragedy for a young person to die from an illness that they should have been protected against through vaccination.

“It seems absurd to us that an emergency vaccination programme to protect young people against a lethal disease had systems in place that were switched off.

“Practices needed to activate the MenACWY alert protocol in order to use it but this would rely on them knowing how to do so. Practices told us they did not know how to activate the alert and we know deaths from MenW disease have occurred in young people who should have been offered the vaccine.

“We admire the courage of the Mason family as they have raised awareness and triggered change within the NHS that will help avoid further deaths from this preventable, treatable disease.”

“It’s positive news from government that the alert has now been activated across England and that patients attending GP appointments opportunistically will now be made aware if they are eligible for the vaccine. It is vital that systems are improved so that this never happens again.”

Meningitis Research Foundation estimates that over a million young people have not yet got their free MenACWY vaccine from their GP.

The vaccine is routinely offered to teenagers in around school year 9 in England and Wales. Anyone born between 1 Sept 1996 and 31 August 1999 remains eligible for the vaccine from their GP practice up until their 25th birthday. Anyone starting university for the first time and aged under 25 is also eligible. It’s easy for anyone to check their eligibility at www.meningitis.org/oneshot.