Effectiveness of a serogroup B meningococcal vaccine against gonorrhea: A retrospective study

Winston E Abara; Sharareh Modaressi; Bruce Fireman; Nicola P Klein; Evan Layefsky; Kristin Goddard; Kyle T Bernstein; Robert D Kirkcaldy; Ousseny Zerbo

doi:10.1016/j.vaccine.2024.126312

Effectiveness of a serogroup B meningococcal vaccine against gonorrhea: A retrospective study

Vaccine. 2024 Sep 10;42(26):126312. doi: 10.1016/j.vaccine.2024.126312. Online ahead of print.

Authors

Winston E Abara¹, Sharareh Modaressi², Bruce Fireman², Nicola P Klein², Evan Layefsky², Kristin Goddard², Kyle T Bernstein³, Robert D Kirkcaldy³, Ousseny Zerbo²

Affiliations

¹ Division of STD Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: Winston_abara@yahoo.com.
² Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, CA, United States.
³ Division of STD Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States.

PMID: 39260056
DOI: 10.1016/j.vaccine.2024.126312

Abstract

Background: Outer membrane vesicle (OMV) meningococcal serogroup B (MenB) vaccines might be protective against gonorrhea. We evaluated the effectiveness of MenB-4C, an OMV MenB vaccine, against gonorrhea.

Methods: We identified gonococcal mono-infections, chlamydial mono-infections, and gonococcal/chlamydial co-infections among persons aged 15-30 years in the electronic health records of Kaiser Permanente Northern California during 2016-2021. We determined MenB-4C vaccination status (vaccinated [≥1 MenB-4C vaccine dose] or unvaccinated [MenB-4C vaccine naïve]) at each infection. We used log-binomial regression with generalized estimating equations to calculate adjusted prevalence ratios (APR) and 95 % confidence intervals (CI) to determine if MenB-4C vaccination was protective against gonococcal mono-infections compared to chlamydial mono-infection. We also evaluated if MenB-4C vaccination was protective against gonococcal/chlamydial co-infections. Because of concerns with small sample size of vaccinated persons, we estimated effects using a limited model (adjusting for race/ethnicity only) and an expanded model (adjusting for additional potential confounders).

Results: Of 68,454 persons, we identified 558 (0.8 %) MenB-4C vaccinated persons and 85,393 infections (13,000 gonococcal mono-infections, 68,008 chlamydial mono-infections, and 4385 gonococcal/chlamydial co-infections). After adjusting for race/ethnicity, MenB-4C vaccination was 23 % protective against gonococcal mono-infection compared to chlamydial mono-infection (APR = 0.77, 95 % CI = 0.64-0.99) in the limited model but not in the expanded model.

Conclusion: MenB-4C vaccination was protective against gonococcal mono-infection, independent of race/ethnicity. This protective effect was not observed when other potential confounders were included in the analysis. Protection against gonococcal/chlamydial co-infection was not observed. Efficacy data from clinical trials are needed.

Keywords: Gonorrhea; Gonorrhea/chlamydia co-infection; MenB-4C; STI vaccine; Vaccine effectiveness; chlamydia.

Published by Elsevier Ltd.