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More than five years ago, Alicia Stillman’s daughter, Emily, called her complaining of a headache.

Her mother urged the Kalamazoo College student to take some medicine and head to bed.

But 36 hours later, Emily was dead. She didn’t have a migraine but the beginning symptoms of serogroup B of meningococcal disease, or meningitis B, which is considered rare in the United States. The Centers for Disease Control and Prevention has estimated there are fewer than 300 cases in the country per year.

Alicia Stillman and her foundation, the Emily Stillman Foundation, are now part of the campaign that is lobbying major universities across the country to require the meningitis B vaccine -- which few institutions currently do.

Beware the B” officially launches next week. Medical professionals and immunization experts from different states have signed a letter asking the 14 institutions that are a part of the Big Ten Conference, some of the most prominent universities in the country, to mandate that their students be vaccinated against meningitis B.

“We’re proud of the traditions that run long and true for all the schools in the Big Ten Conference,” the letter reads. “And we’re proud of the leadership that student athletes and coaches exhibit, both on and off the playing field. We ask that you join together as a conference to once again be a leader, this time in the field of your students’ health and safety.”

Among the Big Ten, only Indiana University and Purdue University currently have that requirement, as Indiana state law requires that all public institutions immunize against all strains of meningitis. The “Beware the B” campaign has found only a dozen campuses nationwide require a meningitis B vaccination.

Meningitis B gained notoriety several years back with outbreaks at Princeton University and the University of California, Santa Barbara, in 2013 through 2014.

Princeton identified nine cases of meningitis, and UC Santa Barbara confirmed four cases. One student died and another lost limbs to the disease. To treat it at the time, the Food and Drug Administration gave special approval to use a vaccine that had not been licensed in the United States but was eventually authorized here.

Most institutions require students to receive the vaccine that protects against meningitis strains A, C, W and Y, which can be covered with a single shot.

Given its relative rarity in the United States, though, meningitis B does not receive the same attention. In a college setting, the disease can spread quickly given that it’s passed by coughing, sneezing and kissing, and those who drink alcohol frequently are particularly susceptible to it.

The Advisory Committee on Immunization Practices (ACIP), which provides the government advice on vaccinations, states that traditional college-age students or teenagers may be immunized against meningitis B. That's unless they’re already at risk for it, for instance, if they suffer from asplenia (abnormal spleen function) or if they’re exposed to an outbreak, then they should. 

Rachel Mack, a spokeswoman for the American College Health Association, said the group does not advocate for colleges to require the meningitis B vaccination. She said that it includes the ACIP recommendations on the vaccine in the organization’s guidelines.

Stillman, in an interview with Inside Higher Ed, said she sees no downside to institutions requiring the vaccination. When she’s talked with colleges and universities, Stillman said, she heard concerns about the cost of record keeping to monitor if students had been vaccinated. But she said that most institutions already have a similar system in place.

She said just because ACIP gives a “softer” recommendation on being vaccinated -- which Stillman called a “disservice” -- doesn’t mean that colleges shouldn’t take the lead and require the vaccine. Few institutions want to go above and beyond the ACIP recommendation, she said.

Not all doctors educate incoming college students about or offer the vaccination, either, Stillman said; she questioned how students and families are supposed to know about their options if it’s not even mentioned during a doctor visit. She said she was unaware of the dangers of meningitis B, which can present similarly to a cold or flu, until her daughter's death.

Stillman said she’s optimistic about the new campaign, an iteration of which first helped Indiana pass the law on meningitis the last legislative session.

“I have to believe that for any of these schools, their No. 1 priority is to create a safe and healthy learning environment,” she said.

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