A Gonococcal Vaccine Has the Potential to Rapidly Reduce the Incidence of Neisseria gonorrhoeae Infection Among Urban Men Who Have Sex With Men

Ben B Hui; Thilini N Padeniya; Nic Rebuli; Richard T Gray; James G Wood; Basil Donovan; Qibin Duan; Rebecca Guy; Jane S Hocking; Monica M Lahra; David A Lewis; David M Whiley; David G Regan; Kate L Seib

doi:10.1093/infdis/jiab581

A Gonococcal Vaccine Has the Potential to Rapidly Reduce the Incidence of Neisseria gonorrhoeae Infection Among Urban Men Who Have Sex With Men

J Infect Dis. 2022 Mar 15;225(6):983-993. doi: 10.1093/infdis/jiab581.

Authors

Ben B Hui¹, Thilini N Padeniya¹, Nic Rebuli¹, Richard T Gray¹, James G Wood², Basil Donovan¹, Qibin Duan^{1

3}, Rebecca Guy¹, Jane S Hocking⁴, Monica M Lahra^{5

6}, David A Lewis^{7

8

9}, David M Whiley¹⁰, David G Regan¹, Kate L Seib¹¹

Affiliations

¹ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
² School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
³ School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
⁴ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
⁵ Microbiology Department, New South Wales Health Pathology, The Prince of Wales Hospital, Randwick, New South Wales, Australia.
⁶ School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.
⁸ Westmead Clinical School, Faculty of Health and Medicine & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
⁹ Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
¹⁰ Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia.
¹¹ Institute for Glycomics, Griffith University, Gold Coast, Queensland, Australia.

Abstract

Background: A gonococcal vaccine is urgently needed due to increasing gonorrhea incidence and emerging multidrug-resistant gonococcal strains worldwide. Men who have sex with men (MSM) have among the highest incidences of gonorrhea and may be a key target population for vaccination when available.

Methods: An individual-based, anatomical site-specific mathematical model was used to simulate Neisseria gonorrhoeae transmission in a population of 10 000 MSM. The impact of vaccination on gonorrhea prevalence was assessed.

Results: With a gonococcal vaccine of 100% or 50% protective efficacy, gonorrhea prevalence could be reduced by 94% or 62%, respectively, within 2 years if 30% of MSM are vaccinated on presentation for sexually transmitted infection (STI) testing. Elimination of gonorrhea is possible within 8 years with vaccines of ≥ 50% efficacy lasting 2 years, providing a booster vaccination is available every 3 years on average. A vaccine's impact may be reduced if it is not effective at all anatomical sites.

Conclusions: Our study indicates that with a vaccine of modest efficacy and an immunization strategy that targets MSM presenting for STI screening, the prevalence of gonorrhea in this population could be rapidly and substantially reduced.

Keywords: Neisseria gonorrhoeae; gonococcal vaccine; gonorrhea; individual-based model; mathematical model; men who have sex with men (MSM); sexually transmitted infection.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Bacterial Vaccines
Gonorrhea* / epidemiology
Gonorrhea* / prevention & control
Homosexuality, Male
Humans
Incidence
Male
Neisseria gonorrhoeae
Sexual and Gender Minorities*

Substances

Bacterial Vaccines

Grants and funding

U19 AI144182/AI/NIAID NIH HHS/United States