Two doses of the vaccine are 33% effective against gonorrhea in adolescents and young adults.
A new study of the health records of 16-23 year olds in New York City and Philadelphia, USA from 2016 to 2018 found that taking two doses of the meningitis vaccine 4CMenB provides 40% protection against gonorrhea.
According to the results of three linked research papers published in the Lancet Infectious Diseases Journal, meningitis vaccines may help improve protection against gonorrhea in a growing number of cases worldwide and in increasing the bacterial resistance of drugs used to treat infections.
Gonorrhea is a sexually transmitted infection (STI) that, if left untreated, can lead to serious health conditions, including infertility in women, infections in newborns, and increased risk of HIV. By 2020, more than 80 million new cases of gonorrhea have been recorded worldwide.
The efficacy of drug treatments for the responsible bacteria is declining – Neisseria gonorrhoeae – and the lack of a licensed vaccine to prevent infection has raised concerns about the possibility of future gonorrhea becoming more resistant or even incurable.
The meningitis vaccine has been recommended as part of the WHO’s roadmap to reduce the global burden of meningitis. This includes getting the meningitis vaccine as part of a routine childhood immunization strategy.  Since the meningitis vaccines have become more widely available, studies have shown that they also provide some protection against gonorrhea and may even significantly reduce the risk of partial protection against infections. However, questions remain about the effectiveness and efficacy of using the meningitis vaccine against gonorrhea.
In 2016, the WHO set a goal of reducing gonorrhea outbreaks by 90% by 2030, but no effective vaccine has yet been developed. Three studies have suggested that the 4CMenB vaccine may provide significant protection for young adults and that men who have sex may have a higher risk of infection.
The meningitis vaccine 4CMenB provides 40% protection against gonorrhea
An observational study led by Dr. Winston Abrar of the US Center for Disease Control and Prevention used health records to identify laboratory-confirmed cases of gonorrhea and chlamydia – another leading STI, among 16-23 year olds in New York City, NY. And from Philadelphia, PA, 2016-2018. These cases were compared with immunization records to determine the vaccine status of humans with 4CMenB – licensed for use against meningitis – during infection.
Of the approximately 110,000 people, there were more than 167,000 infections (18,099 gonorrhea, 124,876 chlamydia and 24,731 co-infections). A total of 7,692 people received the 4CMenB vaccine, of which 4,032 (52%) received one dose, 3,596 (47%) two doses and 64 (less than 1%) two doses higher. The complete 4CMenB vaccine – two doses – was estimated to provide 40% protection against gonorrhea. A single vaccine dose provides 26% protection.
Dr. Winston Abra says: “Our findings suggest that the meningitis vaccines, which are effective even moderately effective in protecting against gonorrhea, may have a significant effect on the prevention and control of the disease. It also provides insight into the need for understanding and, in particular, the development of a vaccine for gonorrhea. “
The author acknowledges some limitations. The results may not be generalizable to a larger group because the data used were from 16-23 year olds in two large urban settings in the United States. Additionally, the use of surveillance data means that some participants’ infection and vaccination status have been incorrectly classified, affecting the analysis.
4CMenB two-dose course 33% effective against gonorrhea in adolescents and young adults
South Australia’s ongoing 4CMenB immunization program is one of the most comprehensive in the world, involving an ongoing state-funded program for children and adolescents, primarily children, adolescents and young adults. In an observational study led by Professor Helen Marshall of the Women and Children’s Hospital in Adelaide, researchers evaluated the effectiveness of 4CMenB against meningitis and gonorrhea as part of an immunization program for infants, children and adolescents.
The authors analyzed data on meningitis and gonorrhea infections held by the Communicable Disease Control Branch and the 4CMenB vaccination record from the Australian Immunization Register. To estimate the efficacy of 4CMenB against gonorrhea, patients diagnosed with chlamydia act as controls because similar sexual behavioral risks are reported in patients with both infections.
More than 53,000 adolescents and young adults have received at least one dose of 4CMenB in the first two years of the immunization program. In addition to being highly effective against meningococcal B meningitis and sepsis, a two-dose course of 4CMenB in adolescents and young adults was 33% effective against gonorrhea.
Professor Helen Marshall said: “Although recent research has shown that the 4CMenB vaccine is associated with a reduced risk of gonorrhea, the vaccine is only given to adolescents and young adults. It provides valuable real-world evidence of the effectiveness of the vaccine against gonorrhea in adolescents. This information is important to inform global meningitis vaccination programs and policy decisions. ” 
The author acknowledges some limitations. Although a significant reduction in the rate of gonorrhea in adolescents and young adults was not observed, it was probably due to the small number of cases at this age. The reported efficacy of 4CMenB against gonorrhea is consistent with other studies. Co-infections of gonorrhea and chlamydia may play an important role in the spread and severity of the disease, but the factors associated with the rate of co-infection are not well understood. However, the analysis showed that 4CMenB efficacy was the same whether co-infection was included or not.
Professor Jason Wong, Dr. Magnus Unemo, Annabelle Chung, Victor Zhao, and Dr. Eric Chao, who were not involved in the study, wrote in a linked commentary on both observational studies, highlighting key gonorrhea vaccine development efforts. : “In the meantime, we must intensify prevention efforts, improve access to early diagnosis and evidence-based treatment (in the case of indicators and sexually transmitted diseases), ensure quality-assured global surveillance of treatment guidelines, and prompt, reliable investment. Point-of-care testing (for the detection of gonorrhea and its antimicrobial resistance) and the development of innovative therapeutic antimicrobials.
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