Meningococcal Vaccination May Offer Gonorrhea Protection

A new study published today in Clinical Infectious Diseases suggests that a meningococcal serogroup B vaccine may offer cross-protection against gonorrhea infection.

This new research joins recent studies from Canada, Norway, and New Zealand that also indicated that meningococcal vaccines might be protective against Neisseria gonorrhoeae.

These findings are essential since Neisseria gonorrhoeae is acquiring increasing resistance to available oral antibiotics, and current screening and treatment approaches have not decreased overall gonorrhea incidence. 

Although a gonorrhea-specific vaccine does not exist, N. gonorrhoeae shares much of its genome with Neisseria meningitidis, notably critical antigenic determinants including outer membrane vesicles (OMV). 

Published on June 1, 2022, this study was a matched cohort study from 2016 to 2020 to examine the association of OMV-containing recombinant meningococcal serogroup B vaccine (4CMenB) with gonorrhea infection among teens and young adults at Kaiser Permanente Southern California.

The study's results included 6,641 recipients of the 4CMenB (Bexsero) Meningitis B vaccine matched to 26,471 recipients of MenACWY. 

During follow-up, gonorrhea incidence rates per 1000 person-years (95% CI) were 2.0 (1.3-2.8) for recipients of 4CMenB and 5.2 (4.6-5.8) for recipients of MenACWY.

In adjusted analyses, gonorrhea rates were 46% lower among recipients of 4CMenB vs MenACWY (HR [95% CI] 0.54 [0.34-0.86]).

But chlamydia rates were similar between vaccine groups (HR [95% CI] 0.98 [0.82-1.17]).

"These results are aligned with prior observational studies and lend support to ongoing randomized controlled trials of the effectiveness of 4CMenB against gonorrhea," wrote these researchers.

"As rates of antibiotic-resistant gonorrhea continue to increase, renewed attention to vaccination strategies is paramount to preventing untreatable gonorrhea disease."

A recent observational study published in 2022 focused on New York City and Philadelphia from 2016-to 2018. Its results indicated two doses of the 4CMenB vaccine provided about 40% protection against gonorrhea.

In the USA, antibiotics have successfully treated gonorrhea for several decades; however, the bacteria has developed resistance to nearly every drug used for treatment, says the U.S. CDC. In 2020, about half of all infections were estimated to be resistant to at least one antibiotic.

In 2020, over 677,000 cases of gonorrhea were reported to the CDC, making it the second most common notifiable sexually transmitted infection. Even during the early COVID-19 pandemic shutdown period of 2019–2020, the overall rate of reported gonorrhea increased by 5.7%.

GSK's Bexsero® vaccine was initially approved in the USA in 2015. Bexsero is indicated for active immunization of individuals from two months through 17 years old against invasive disease caused by Neisseria meningitidis serogroup B strains.

Historically, MenB first-dose vaccine coverage in the US is low and even lower for a second dose, with regional variation. MenB vaccination coverage among 17-year-olds increased from 14.5% in 2017 to 17.2% in 2018 for ≥1 dose and from 6.3% to 8.4% for ≥2 doses. And coverage with two doses of MenACWY was about 54% in 2020.

The CDC's updated vaccination schedule was posted on February 17, 2022. And GSK's recommended vaccination schedule was updated in 2021.

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