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First-year college students in Georgia pondering which major to pursue and which club to join have a new decision to make this year: whether to be vaccinated against a rare but often deadly disease.
A new law requires freshmen and transfer students in dorms to receive a bacterial meningitis vaccine or sign a waiver saying they are aware of the risk of meningococcal disease. The disease, fatal nearly 15 percent of the time, is somewhat more common among students in communal settings, in part because they share food and drink.
The law doesn't take effect until Jan. 1. But campuses already are increasing attention to the vaccine, and some are forcing a decision before classes begin this month.
For several years, most colleges have offered the vaccine and sent letters about meningitis to parents. In 2000, the Centers for Disease Control and Prevention said campuses should inform students about the vaccine, but the CDC stopped short of recommending the shot.
This year, Georgia passed a law requiring the vaccine or a waiver, as 13 other states have done. Ten other states say students must be educated about the shot and the disease.
"We weren't given the chance to make any decision at all," said Lynn Bozof of Marietta, whose son Evan, 20, died from bacterial meningitis in 1998 while attending Georgia Southwestern University in Americus. Bozof and her husband, Alan, helped push for the new law in Georgia.
"What parent, knowing how deadly this disease can be, wouldn't choose to vaccinate their child?" she asked. No blanket protection
The shot is about 85 percent effective against four strains of meningococcal bacteria, including two of the three most prominent strains in the United States, according to the CDC. The disease --- much more serious than viral meningitis --- can cause inflammation of the brain or spinal cord, leading to sudden headaches, seizures and death.
But a third of the cases among college students aren't covered by the inoculation. And even though freshmen in dorms have a rate nearly five times that of the general population, they account for a small percentage of cases. The disease is most widespread in children under age 2, for whom the existing vaccine doesn't work.
"If you got rid of all cases in freshmen in dorms, it wouldn't really impact the overall disease," said Dr. Nancy Rosenstein, a meningitis epidemiologist at the CDC. Tech requires waiver
The vaccine costs $60 to $90 at area campuses, where health officials often take a publicly neutral stance on immunization while privately endorsing it.
"Some people feel more comfortable doing whatever is possible to protect against a disease, and some people just don't want to worry about it," said Becky Laurens, manager of the student health clinic at Georgia State University, where classes begin Aug. 25. "We answer questions. We don't try to make the decision for them."
At Georgia Tech, which starts Monday, students must get the shot or sign a waiver before receiving their dorm key, said Dr. Cindy Smith, director of Georgia Tech Health Services.
"We have more and more students who come now already having gotten the vaccine from their pediatrician or private physician," she said.
The housing department at the University of Georgia --- which also starts Monday --- has sent e-mails to students about the new law, but won't require the waiver forms until January, said Liz Rachun, spokeswoman for the UGA Health Center.
Emory University, which begins Aug. 28, will hold a special meningococcal vaccine clinic next month, said Dr. Michael Huey, executive director of Emory Student Health Services. The school immunized more than 300 students at a similar clinic last year.
"When parents ask me, my official recommendation is to read the material," he said. "But parent to parent, I recommend that their child be vaccinated. There's not a real long list of things that cause death or permanent disability in college students. We can't vaccinate for accidents, depression or suicide. We do have a meningococcal vaccine."
Emory has had three students with bacterial meningitis in the past 20 years. Georgia Tech had a death in 1999 and two other cases the same school year.
UGA had a death in 1997 and another case in 1998. Georgia State hasn't had a case in recent years.
Throughout Georgia, there have been 316 cases of meningococcal meningitis over the past five years, including 37 deaths --- six of those among college-aged people.
About 3 percent of the 2,500 meningococcal cases around the country each year are among college students, the CDC says. Risk factors for students include irregular sleeping patterns, alcohol consumption, intimate contact and shared utensils.
To Bozof, one meningitis death is too many.
Her son Evan, a pre-med student and avid baseball player, came down with a migraine during spring break in 1998. By the next day, he was in critical condition.
He spent 26 days at three hospitals and had his arms and legs amputated in an attempt to stop gangrene.
"It was only afterward that we learned there was a vaccine," said Bozof, executive director of the Maryland-based National Meningitis Association. The strain of meningitis Evan had would have been covered by the vaccine, she said.
A new meningococcal vaccine that would provide longer protection and work in young children may be available in the United States in two years, the CDC's Rosenstein said. It could be recommended for wider use.
Two other vaccines are already available for other bacteria that can cause meningitis. One is for haemophilus influenzae type b, and the other is for pneumococcal disease. Both vaccines are among the shots routinely given to young children, who are most susceptible to those causes of bacterial meningitis.
Copyright 2003 The Atlanta Journal-Constitution
