title: Reducing inequalities with vaccines: New Zealand's MeNZB vaccine initiative to control an epidemic.
abstract: Disadvantaged children of Māori and Pacific origin in New Zealand carry an inequitable burden of infectious diseases, many of which are preventable, some by vaccine. Immunisation is recognised in the developing world as a cheap, effective and efficient means of reducing inequalities. The MeNZB immunisation programme delivered in 2004-2006 towards the expected natural end of a projected 15-year epidemic appears to have had an effect (difficult to prove conclusively) on reducing the disproportionate burden of meningococcal disease carried by this group of children. It was delayed by the late engagement of the New Zealand Ministry of Health, fully briefed from 1996, leading to unnecessary and potentially avoidable deaths and sequelae, many lifelong. Further, failure to adequately assess vaccine effectiveness means that the contribution of MeNZB to the observed reduction in disease, particularly in those aged less than five years, will never be reliably known. However, the MeNZB campaign has at least left a legacy: the National Immunisation Register, which should enable New Zealand to minimise the 'vaccine inverse care law' and contribute to reducing ethnic inequity in the burden of vaccine preventable diseases.
authors: Community Paediatrics, The University of Auckland, Auckland, New Zealand. d.lennon@auckland.ac.nz
authors: Diana
authors: D
authors: Lennon
authors: Stewart
authors: S
authors: Reid
authors: Joanna
authors: J
authors: Stewart
authors: Catherine
authors: C
authors: Jackson
authors: Sue
authors: S
authors: Crengle
authors: Teuila
authors: T
authors: Percival
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D058872:Epidemics / Q000517:prevention & control*; D054624:Health Status Disparities; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D038541:Neisseria meningitidis, Serogroup B / Q000187:drug effects; D009520:New Zealand / Q000453:epidemiology / Q000208:ethnology; D035862:Vulnerable Populations / Q000208:ethnology*; D055815:Young Adult