OBJECTIVESTo systematically review and synthesis the evidence of vaccine effectiveness (VE) and impact (VI) of meningococcal vaccines in preventing gonorrhoea.METHODSWe systematically evaluated studies. Literature searches were conducted in PubMed, Embase, Cochrane Library, CINAHL, Google Scholar, clinical trial registries, and major health and immunisation conferences. Meta-analysis was performed with the DerSimonian-Laird random-effects model to estimate the pooled VE.RESULTSTwelve studies met the criteria for inclusion. VE of meningococcal B (MenB) outer membrane vesicle (OMV) vaccines was evaluated in nine studies, with one study evaluating a non-OMV vaccine, MenB-FHbp. The majority of studies targeted individuals aged 15-30 years. Adjusted VE for OMV vaccines against gonorrhoea ranged from 22% to 46%. MenB-FHbp did not show protection against gonorrhoea. The pooled VE estimates of OMV vaccines against any gonorrhoea infection following the full vaccine series were 33-34%. VI was assessed for 4CMenB in Canada and Australia, for VA-MENGOC-BC in Cuba; and for MenBvac in Norway. VI ranged from a 30% to 59% reduction in gonorrhoea incidence.CONCLUSIONS4CMenB and other MenB-OMV vaccines show moderate effectiveness against gonorrhoea. Further research is required to explore the factors associated with vaccine protection, informing more effective vaccination strategies for the management of gonococcal infections.

2022-11-01·Vaccine

Estimating the population level impact of a gonococcal vaccine candidate: Predictions from a simple mathematical model

Article

作者: Spicknall, Ian H ; Newman, Lori M ; Carey, Kelly A

BACKGROUNDNeisseria gonorrhoeae cross-protection was suggested in a New Zealand meningitis B vaccine. We modeled the potential impact of similar vaccines on gonorrhea prevalence in heterosexuals in the United States.METHODSOur mathematical model incorporated infection, behavior, and vaccination dynamics. Approximate Bayesian Computation calibrated our model to US prevalence. Primary analyses assumed New Zealand vaccine characteristics: 30% efficacy and 2-year duration of protection. We estimated impact under two vaccine coverages (20%, 50%).RESULTSReduction in gonorrhea prevalence ranged from 4.8 to 39.4%, depending on vaccine coverage. Vaccine impact was correlated with both size of the highly sexually active subpopulation and sexual mixing between high and low activity subpopulations.CONCLUSIONSA meningitis vaccine providing low efficacy cross-protection against gonorrhea acquisition and short duration of protection could result in a large reduction in gonorrhea prevalence in the United States. Potential dual protective effects can be considered when making vaccine recommendations.

2022-07-06·Clinical Infectious Diseases1区 · 医学

Infection With the USNeisseria meningitidisUrethritis Clade Does Not Lower Future Risk of Urethral Gonorrhea

1区 · 医学

Article

作者: Bazan, Jose A ; Retchless, Adam C ; Carter, Alexandria M ; Stephens, David S ; Wang, Xin ; Brown, Morgan A ; Turner, Abigail Norris ; Tzeng, Yih-Ling ; Snyder, Brandon M

AbstractBackgroundCross-protective immunity between Neisseria meningitidis (Nm) and Neisseria gonorrhoeae (Ng) may inform gonococcal vaccine development. Meningococcal serogroup B (MenB) outer membrane vesicle (OMV) vaccines confer modest protection against gonorrhea. However, whether urethral Nm infection protects against gonorrhea is unknown. We examined gonorrhea risk among men with US Nm urethritis clade (US_NmUC) infections.MethodsWe conducted a retrospective cohort study of men with urethral US_NmUC (n = 128) between January 2015 and April 2018. Using diagnosis date as the baseline visit, we examined Ng status at return visits to compute urethral Ng risk. We compared these data to 3 referent populations: men with urethral Ng (n = 253), urethral chlamydia (Ct) (n = 251), and no urethral Ng or Ct (n = 255). We conducted sensitivity analyses to assess varied approaches to censoring, missing data, and anatomical site of infection. We also compared sequences of protein antigens in the OMV-based MenB-4C vaccine, US_NmUC, and Ng.ResultsParticipants were primarily Black (65%) and heterosexual (82%). Over follow-up, 91 men acquired urethral Ng. Men with urethral US_NmUC had similar Ng risk to men with prior urethral Ng (adjusted hazard ratio [aHR]: 1.27; 95% CI: .65–2.48). Men with urethral US_NmUC had nonsignificantly increased Ng risk compared with men with urethral Ct (aHR: 1.51; 95% CI: .79–2.88), and significantly increased Ng risk compared with men without urethral Ng or Ct (aHR: 3.55; 95% CI: 1.27–9.91). Most of the protein antigens analyzed shared high sequence similarity.ConclusionsUrethral US_NmUC infection did not protect against gonorrhea despite substantial sequence similarities in shared protein antigens.

100 项与 Meningococcal vaccine group B OMV (NZ) (GlaxoSmithKline/NIPH) 相关的药物交易

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