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Health Panel Recommends Cautious Approach to Meningitis B Vaccine

Jenna Wright administered a meningitis B vaccine earlier this year to Drew Russert at the University of Oregon. The disease drew attention following outbreaks in 2013 at the University of California, Santa Barbara, and Princeton.Credit...Brian Davies/The Register-Guard, via Associated Press

A panel of health experts stopped short of recommending that all American adolescents and young adults be vaccinated against a dangerous strain of meningitis that has caused outbreaks at Princeton University and the University of California campus in Santa Barbara, opting instead to let doctors decide whether to give the vaccine.

A committee of outside medical and public health experts convened by the Centers for Disease Control and Prevention voted, 14 to 1, to recommend the more limited use of the vaccine in people ages 16 to 23. The vaccine is new and relatively costly and the illness is rare, a combination that seemed to tip the balance toward a more cautious approach.

Some on the committee also said they were not comfortable with what was known about the vaccine’s safety.

“There are some red flags with safety for this vaccine,” said Dr. Edward Belongia, the director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Foundation in Wisconsin.

The recommendation will take effect in the coming months. Such recommendations constitute guidelines for health practice in the United States and the basis of the childhood immunization schedule.

“These recommendations are now what guides clinical practices,” said Dr. Bruce Gellin, the director of the National Vaccine Program Office at the Department of Health and Human Services.

Many patients and family members testified tearfully at C.D.C. headquarters in Atlanta about the urgent need for broad use of the vaccine. Though they did not prevail, patient groups and the companies that make the vaccine said the decision was an improvement over current policy. Until now, the vaccine has been recommended only for people at high risk of the illness.

Meningitis B is a bacterial infection that inflames the linings of the spinal cord and brain, and can be hard to diagnose. There were fewer than 300 cases a year from 2009 to 2013, and only five to 10 deaths annually, according to the disease agency.

The strain drew attention in 2013 when it infected four students at the University of California, Santa Barbara, and seven students and a visitor at Princeton. At the time, there was no approved vaccine available in the United States, so the Food and Drug Administration agreed to allow the use of one approved in Europe and Australia.

Since then, two companies have won approval in the United States for vaccines against meningitis B. Bexsero, made by GlaxoSmithKline, costs about $320 for a complete series, and Trumenba, made by Pfizer, costs about $345.

Five strains cause a majority of cases of bacterial meningitis in the United States. Meningitis B is the most prevalent, accounting for about a third of all reported cases in 2013. Vaccines already covered the other four main serogroups: A, C, Y and W.

Wednesday’s vote will also help determine whether the vaccine will be covered by insurance, a critical factor given its price. A representative from the trade association for the insurance industry, America’s Health Insurance Plans, said that even though the vaccine received a lower-level recommendation, health insurance plans would still cover it.

The vaccine will also be included in the C.D.C.’s federally funded Vaccines for Children program, which provides vaccines free to children whose families cannot afford them.

A version of this article appears in print on  , Section A, Page 13 of the New York edition with the headline: Panel Recommends Cautious Approach to Meningitis B Vaccine. Order Reprints | Today’s Paper | Subscribe

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