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> What is this vaccine called, and for what other purpose has it been approved? The GlaxoSmithKline version is called Bexsero, but Pfizer has the patent on Tru

> What is this vaccine called, and for what other purpose has it been approved? The GlaxoSmithKline version is called Bexsero, but Pfizer has the patent on Trumenba, which is functionally the same thing. Both are used against bacterial meningitis serogroup B. Note that this is different from the standard meningitis vaccine required in most public schools and universities. Isomeone says they've been vaccinated against meningitis, they almost certainly are referring to the vaccine for serogroups A, C, Y, and W-135, which is different and not effective against gonorrhea. There are tons of studies demonstrating the effectiveness of both against gonorrhea - it's almost a running joke that every 3-6 months a new one gets published, prompting a slew of articles expressing surprise and amazement, as if this hasn't happened so many times over the last decade that we've lost track. Pretty much all of them point to the range of 40% real-world effectiveness, which is actually quite good from a public health standpoint. Knowing about it isn't really the main hurdle, though. Even if you know it exists, it's incredibly difficult logistically to get it, because your insurance company won't pay for it unless you've been provably in the vicinity of a MenB outbreak (which is rare in the US), and pharmacies will order it but generally not administer it, so even if you are fine paying for it yourself and manage to get your doctor to prescribe it to you, you'll end up in a weird logistical catch-22 where you can obtain it from a pharmacy but have to self-administer it (do not do this, unless you are trained) or find a not-so-kosher way to get it administered.

kungfufrog 4y ago
Interestingly, in Australia for young children, Bexsero is part of a recommended vaccine schedule (not compulsory). Both my kids have had it!
- chimeracoder 4y ago
  > Interestingly, in Australia for young children, Bexsero is part of a recommended vaccine schedule (not compulsory). Both my kids have had it! That's not surprising. New Zealand had a massive outbreak of MenB about ten years ago, resulting in a massive vaccination campaign, which is one of the reasons we actually found out about its effectiveness against gonorrhea in the first place.
mzs 4y ago
tier 3 on most formularies: https://www.goodrx.com/bexsero/medicare-coverage https://www.goodrx.com/bexsero/medicare-coverage
- chimeracoder 4y ago
  Note that insurance will likely only cover it for on-label use.
  - sgent 4y ago
    This is mostly not true unless it is subject to a prior authorization. There are 100's of drugs used off label dispensed from every pharmacy every day. For instance most drugs used in pediatrics aren't approved for anyone under 12.
    - chimeracoder 4y ago
      > This is mostly not true unless it is subject to a prior authorization. It is true. I used to work in this field and have helped many people navigate this exact issue. > There are 100's of drugs used off label dispensed from every pharmacy every day. Vaccines are treated differently than drugs by insurance, often covered by completely different networks under the same brand. Most people don't know this, because there's no reason for them to encounter the difference, because the situation of having to obtain a vaccine that isn't part of the standard schedules from a pharmacy is very uncommon.
DennisP 4y ago
Can't a doctor administer it, if you self-pay?
- chimeracoder 4y ago
  > Can't a doctor administer it, if you self-pay? A doctor doesn't have the vaccine in their office, because it's not part of their standard schedule. Most won't order it for you (or even be able to), for the same reason. They can send it to the pharmacy as a prescription, but the pharmacy (depending on both state law and pharmacy policy) often won't administer the vaccine to you, as it's not one of the "standard" ones that pharmacies do (e.g. flu, COVID-19). If the pharmacy gives it to you, you can bring it to your doctor's office, but most providers won't administer any medicine that they didn't source themselves, because technically they have no way of verifying the provenance. This isn't hypothetical - I used to work in this field, and I frequently help people navigate the logistics of obtaining this vaccine. It's really not simple, even if you're insured and willing to pay out-of-pocket and have a good relationship with a competent PCP.
  - inglor_cz 4y ago
    "most providers won't administer any medicine that they didn't source themselves, because technically they have no way of verifying the provenance." Interesting. In Czechia, a doctor will send you to buy a vaccine against tick meningitis into a pharmacy and when you come back, will administer it. It is up to you as an adult not to mess up.

kungfufrog 4y ago

Interestingly, in Australia for young children, Bexsero is part of a recommended vaccine schedule (not compulsory). Both my kids have had it!

chimeracoder 4y ago
> Interestingly, in Australia for young children, Bexsero is part of a recommended vaccine schedule (not compulsory). Both my kids have had it! That's not surprising. New Zealand had a massive outbreak of MenB about ten years ago, resulting in a massive vaccination campaign, which is one of the reasons we actually found out about its effectiveness against gonorrhea in the first place.

mzs 4y ago

tier 3 on most formularies: https://www.goodrx.com/bexsero/medicare-coverage https://www.goodrx.com/bexsero/medicare-coverage

chimeracoder 4y ago
Note that insurance will likely only cover it for on-label use.
- sgent 4y ago
  This is mostly not true unless it is subject to a prior authorization. There are 100's of drugs used off label dispensed from every pharmacy every day. For instance most drugs used in pediatrics aren't approved for anyone under 12.
  - chimeracoder 4y ago
    > This is mostly not true unless it is subject to a prior authorization. It is true. I used to work in this field and have helped many people navigate this exact issue. > There are 100's of drugs used off label dispensed from every pharmacy every day. Vaccines are treated differently than drugs by insurance, often covered by completely different networks under the same brand. Most people don't know this, because there's no reason for them to encounter the difference, because the situation of having to obtain a vaccine that isn't part of the standard schedules from a pharmacy is very uncommon.

DennisP 4y ago

Can't a doctor administer it, if you self-pay?

chimeracoder 4y ago
> Can't a doctor administer it, if you self-pay? A doctor doesn't have the vaccine in their office, because it's not part of their standard schedule. Most won't order it for you (or even be able to), for the same reason. They can send it to the pharmacy as a prescription, but the pharmacy (depending on both state law and pharmacy policy) often won't administer the vaccine to you, as it's not one of the "standard" ones that pharmacies do (e.g. flu, COVID-19). If the pharmacy gives it to you, you can bring it to your doctor's office, but most providers won't administer any medicine that they didn't source themselves, because technically they have no way of verifying the provenance. This isn't hypothetical - I used to work in this field, and I frequently help people navigate the logistics of obtaining this vaccine. It's really not simple, even if you're insured and willing to pay out-of-pocket and have a good relationship with a competent PCP.
- inglor_cz 4y ago
  "most providers won't administer any medicine that they didn't source themselves, because technically they have no way of verifying the provenance." Interesting. In Czechia, a doctor will send you to buy a vaccine against tick meningitis into a pharmacy and when you come back, will administer it. It is up to you as an adult not to mess up.