When Louisiana state lawmakers in 2026 considered a bill to drop requirements for the meningitis vaccine in schools, Baton Rouge pediatrician Mikki Bouquet, MD, gave expert testimony against it. The bill failed in the House education committee. If it had gone on to become law, it likely would’ve raised the risk of bacterial meningitis outbreaks, with disastrous consequences for children, families, and whole communities, Bouquet says.
Bacterial meningitis is a rare, vaccine-preventable disease that can spread fast, kill within hours, or lead to devastating complications like brain damage and loss of limbs. Along with individual tragedies, outbreaks can “lead to school closures, strain the healthcare infrastructure, and create widespread community anxiety,” Bouquet says.
School vaccine requirements in the majority of states help keep the danger low because more people get vaccinated. Secondary schools, such as middle and high schools, in 35 states and the District of Columbia require students to get at least one dose of a routine vaccine for bacterial meningitis called MenACWY. Typically you get one dose at 11 or 12, with many states requiring a second dose at 16 or older.
But if a state rolled back its meningitis vaccine requirement in secondary schools, some serious, wide-ranging problems could follow, according to Bouquet and other experts.
More Meningitis Outbreaks
When a vaccine recommendation for a disease gets removed, fewer people get vaccinated, Bouquet says. Group immunity from the disease — known as “herd immunity” — falls, and the number of people who become sick rises. Outbreaks become more likely.
With bacterial meningitis, an outbreak usually means that three or more people have confirmed or probable cases of the same strain of the disease, she says. But that seemingly small number can grow fast.
“Outbreaks are scary and highly disruptive,” says Lori Handy, MD, associate director of the Vaccine Education Center at Children’s Hospital of Philadelphia.
More Children in the Hospital
Children who become sick with bacterial meningitis often need urgent treatment in a hospital’s intensive care unit, says Ashlesha Kaushik, MD, president of the Iowa chapter of the American Academy of Pediatrics and a national spokesperson for the AAP. “Most of these kids can get very, very sick very, very fast.”
Sick children need quick treatment with the right antibiotics to have a fighting chance to survive and avoid long-term complications. Some need other types of critical care, such as a ventilator to help them breathe, Kaushik says.
Along with the physical and emotional pain the disease causes, treatment can create a big financial burden. One analysis of hospitalizations from 2014 to 2020 found that treating children for bacterial meningitis cost an average of more than $120,000 per hospital stay.
Widespread anxiety over an outbreak can also lead to more emergency room visits in general, since some people worry that they or a family member has meningitis, Bouquet says. That could play a role in taking up hospital beds and overtaxing healthcare professionals.
Quarantines and School Closures
Students who become infected with bacterial meningitis need to stay out of school while contagious (just as infected adults need to stay away from work). Typically, you’re considered contagious until you’ve started antibiotic treatment for at least 24 hours.
Schools that shut down to keep an outbreak from growing might not be quick to reopen their doors. Public health officials likely would need to craft and apply stricter safety guidelines that allow students to return to classrooms, Bouquet says.
Also, after-school activities like sports or dances would need to be canceled to limit close physical contact, she says. That’s because meningitis spreads through things like sneezes, coughs, and kisses.
Other Disease-Control Measures
During meningitis outbreaks, mass vaccination sites often need to be set up to immunize people who haven’t received a meningitis vaccine, Bouquet says.
Public health offices also typically do an infection-control measure called contact tracing, which involves finding, notifying, and tracking the health of people who’ve had close contact with a person who’s confirmed or likely to be infected. Contact tracing helps public health workers find out who needs drugs called prophylactic antibiotics to help prevent an infection. These medicines are costly and often need to be given to a large number of people, Kaushik says.
Economic Damage
The combined costs of treating, preventing, and containing meningitis during an outbreak mean financial fallout for families, hospitals, state health departments, and the whole society, Kaushik says. “How will we be able to afford all this?”
Local businesses also pay a price when community members change their daily habits to stay away from crowded indoor places, like bars and restaurants, where meningitis could spread.
“This would also put a strain on the economy and workforce similar to what occurred during the COVID-19 shutdown,” Bouquet says.
The Power of School Rules
States where high percentages of people (more than 85% to 90%) get the meningitis vaccine have a good barrier of protection against the disease, and those high numbers are often a testament to school vaccine requirements, Kaushik says. On the most basic level, the rules help create “a worry-free environment” for parents and children.
Handy agrees: “School requirements help families recognize the importance of vaccines and also make the school a place where children are safe to learn without the fear of infection.”
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Mikki Bouquet, MD, board-certified pediatrician, Our Lady of the Lake Children’s Hospital, Baton Rouge, Louisiana.
Ashlesha Kaushik, MD, president, American Academy of Pediatrics Iowa chapter; national AAP spokesperson.
Lori Handy, MD, associate director, Vaccine Education Center, Children’s Hospital of Philadelphia; associate professor, clinical pediatrics, University of Pennsylvania Perelman School of Medicine.
Louisiana State Legislature: “HB737 by AMEDEE.”
Meningitis Research Foundation: “About Meningitis.”
American Society for Meningitis Prevention: “Meningococcal Meningitis Vaccination Requirements & Recommendations Tracker.”
Mayo Clinic: “Meningitis.”
Iowa Health and Human Services: “Controlling the Spread of Meningococcal Infection.”
Colorado Department of Public Health and Environment: “Bacterial Meningitis.”
