"After he died, we found out a vaccine was available and it had been recommended, but the information hadn't filtered down," said Bozof. Before Bozof began her work in 1998, there were no recommendations for vaccination.
The American College Health Association began to take notice of meningitis and in 1999 recommended immunization, according to Dr. Jim Turner, chairman of its vaccine committee.
Studies in 2000 revealed 100-125 annual cases among college students nationally, and about 6 to 12 student deaths a year, Turner said..
For the last three or four years, health officials have seen a decline in cases, according to Turner, but that could be because of natural cycles of bacteria and not immunizations efforts.
Scientists first saw outbreaks of the disease among young recruits in the military in the 1960s and they began vaccinating in 1971, according to Turner. "Living and learning in crowded conditions, drinking and smoking when they shouldn't be, it was a perfect lesson from the military."
About 10 percent to 20 percent of all people carry the meningococcal bacteria in their nose or throat, but 99.9 percent develop antibodies and never get sick, according to Turner.
Strains vary on a molecular basis from region to region, so a student exposed in Seattle might bring a different strain to a college dormitory in New York.
"Colleges have tremendous geographic diversity, and all these kids converge and live in the dorms, study together in the libraries and big lecture halls and party together in the frats," said Turner. "They spread the bacteria from one person to another."
In 2005 the CDC got on the immunization bandwagon when the vaccine Menactra was approved, according to Tom Clark, an epidemiologist at the CDC.
A conjugated vaccine, Menactra is effective for roughly eight years.
In June, the CDC expanded guidelines to recommend all children 11 to 18 and all college freshmen receive the vaccine.
As a result of grass-roots campaigns like those of the National Meningitis Foundation, public awareness efforts have taken hold.
A national college health assessment survey conducted by the American College Health Association in the spring of 2000 revealed that 24 percent of those questioned had been immunized for meningitis. By the spring of 2006, that number had more than doubled to 57 percent.
"In 1997, I bet you it was less than a half a percent," said Turner. "We've made stunning headway in terms of getting students vaccinated."
Since Evan's death and the work of Bozof's organization, 34 states have enacted legislation to require either education or vaccination. Some states ask parents to sign a waiver if their children are not vaccinated.
Still, in Vermont, where there are no state requirements for vaccination, the Middlebury College community still feels the pain of the death of 23-year-old Jason Fleishman, a neuroscience major and head of the ski patrol.
The popular student from Colorado had just skied down the "snow bowl" as part of his February 2004 graduation ceremony and was out to dinner with his parents when he complained of not feeling well, according to college physician Mark Peluso.
The next day, he had died of acute bacterial septicemia, a result of a meningitis infection.
"It came on like a lightning bolt," said Peluso. "It was so tragic. We had video of him that day going down the snow bowl smiling."