Intended for healthcare professionals

Letters Universal meningitis vaccination

Authors’ reply to Rappuoli and colleagues, Black, and Glennie and colleagues

BMJ 2014; 349 doi: (Published 13 November 2014) Cite this as: BMJ 2014;349:g6758
  1. Hannah Christensen, research associate1,
  2. Caroline L Trotter, senior lecturer2,
  3. Matthew Hickman, professor of public health and epidemiology1,
  4. W John Edmunds, professor of infectious disease modelling3
  1. 1School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK
  2. 2Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
  3. 3London School of Hygiene and Tropical Medicine, London, UK
  1. hannah.christensen{at}

We do not believe our analyses adopted a set of singularly vaccine unfavourable conditions.1 A University of Warwick team commissioned by the Department of Health to independently review the modelling and parameters found “no major defects with the model,” recommending changes that would have led to vaccination appearing less cost effective than in our base case.2 We agree with Rappuoli and colleagues and Black that models and cost effectiveness analyses should be viewed as tools to aid decision making rather than as “gate keepers.”3 4 Indeed, in our discussion we stated that, because of the substantial uncertainty about the …

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