Meningococcal C vaccine could increase relapse for children with kidney disease

Withholding meningococcal vaccine could be the best strategy for children with the kidney disorder nephrotic syndrome, according to authors of a research letter in this week's issue of THE LANCET.

In November, 1999, all children under 18 years of age in the UK were offered immunisation with the newly introduced meningococcal C conjugate vaccine (MCCV). Richard Trompeter from Great Ormond Street Hospital for Children NHS Trust, London, UK, and colleagues report how a 30% increase in relapse of nephrotic syndrome occurred after meningococcal C vaccination was introduced. There were 63 relapses during the 12 months before vaccination, and 96 during the equivalent period postvaccination.

The investigators propose that the conjugated vaccine influences processes in the immune system that could promote production of proteinuria (protein in the urine, one of the main features of nephrotic syndrome).

Richard Trompeter comments: "Our results indicate a causal relation between administration of MCCV and relapse of nephrotic syndrome. The risk of relapse after vaccination might be greater for this group of patients than the risk of meningococcal C infection, so the decision to vaccinate should be carefully considered."

Contact: Dr. Richard Trompeter, Great Ormond Street Hospital for Children NHS Trust Renal Unit, LONDON, WC1N 3JH UK; T)/F) +44-0-20-7829 8841; E) TROMPR@gosh.nhs.uk

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