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Three months after the Centers for Disease Control and Prevention formally recommended that all freshmen living in dormitories be vaccinated for meningitis, college officials seem to be taking the recommendations to heart -- and that response is contributing to a shortage of the vaccine around the United States.

For years, the CDC urged colleges to educate students and parents about the risks of the rare but potentially fatal bacterial infection that affects the brain and spinal cord but stopped short of actually recommending the vaccination, mostly because the existing vaccines were viewed both as too expensive and not effective enough. But the U.S. Food and Drug Administration's approval in January of a newly formulated vaccine called Menactra prompted the CDC in May to formally recommend that all freshmen living on campuses (as well as some younger children) get vaccinated.

The American College Health Association and other groups of health officials quickly followed suit and altered their own policies to more aggressively push vaccination. 

Although it is early to say through formal surveys or other conclusive data, campus health experts say the change in policy has persuaded more campuses to promote, if not require, vaccination for their students.

"I would characterize it as significant movement rather than a sea change," says James Turner, chairman of the college health association's vaccination committee and executive director of student health at the University of Virginia. "From anecdotal reports, being a listener of what's going on around the country, many, many, many more schools now are aggressively recommending the vaccination based on the new CDC policy, rather than just providing education about the vaccine."

Alderson-Broaddus College, in West Virginia, is one such institution. Allen Withers, vice president for student services and enrollment management, says the recommendations by the CDC and the college health association -- "two respected sources" -- persuaded the institution to recommend the vaccine this year for the first time. "We had been looking at this area for a number of months, and when the CDC and ACHA changed their policies, I said, 'Okay, time to really go for this,' " Withers says.

Students seem to be responding, he adds. "I think people are paying attention, just from the calls that have come in," says Withers. "We're hearing from some folks that they're having a hard time finding" the vaccine.

Alderson-Broaddus students are not alone. In fact, one tangible sign that Turner and others point to as evidence of colleges' new approach to meningitis vaccination is the fact that demand for Menactra has far outstripped the supply that its manufacturer, Sanofi Pasteur, has made available. The health association issued an alert last month letting its members know that the company was limiting the number of doses of the vaccine it was making available to college clinics. 

The ACHA said that the crunch was expected to ease later in the fall, but that in the meantime, another medication, tetravalent polysaccharide, known as Menomune, "remains a very acceptable alternative while the conjugate vaccine remains difficult to secure."

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