4CMenB sustained vaccine effectiveness against invasive meningococcal B disease and gonorrhoea at three years post programme implementation

Bing Wang; Lynne Giles; Prabha Andraweera; Mark McMillan; Sara Almond; Rebecca Beazley; Janine Mitchell; Michele Ahoure; Emma Denehy; Louise Flood; Helen Marshall

doi:10.1016/j.jinf.2023.05.021

4CMenB sustained vaccine effectiveness against invasive meningococcal B disease and gonorrhoea at three years post programme implementation

J Infect. 2023 Aug;87(2):95-102. doi: 10.1016/j.jinf.2023.05.021. Epub 2023 Jun 1.

Authors

Affiliations

¹ Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
² School of Public Health and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
³ Communicable Disease Control Branch, SA Health, Adelaide, South Australia, Australia.
⁴ Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia; Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. Electronic address: helen.marshall@adelaide.edu.au.

PMID: 37268223
DOI: 10.1016/j.jinf.2023.05.021

Abstract

Objectives: To evaluate persistence of vaccine effectiveness (VE) and vaccine impact (VI) on invasive meningococcal B (MenB) disease and gonorrhoea at three years after implementation of a state funded 4CMenB programme for infants, children, adolescents and young people in South Australia.

Methods: VI was assessed using a Poisson or negative binomial regression model, and VE was estimated using screening and case-control methods. Chlamydia controls were used to estimate VE in the primary analysis to control potential confounding effects such as high-risk sexual behaviour associated with sexually transmitted infections.

Results: During the three-year programme, reductions of 63.1% (95%CI 29.0-80.9%) and 78.5% (95%CI 33.0-93.1%) in incidence of MenB disease were observed in infants and adolescents, respectively. There were no cases in infants who had received three doses of 4CMenB. Two-dose VE against MenB disease was 90.7% (95%CI 6.9-99.1%) for the childhood programme and 83.5% (95%CI 0-98.2%) for the adolescent programme. Two-dose VE against gonorrhoea in adolescents was 33.2% (95%CI 15.9-47.0%). Lower VE estimates were demonstrated after 36 months post-vaccination (23.2% (95%CI 0-47.5%)> 36 months post-vaccination compared to 34.9% (95%CI 15.0-50.1%) within 6-36 months). Higher VE estimates were found after excluding patients with repeat gonorrhoea infections (37.3%, 95%CI 19.8-51.0%). For gonorrhoea cases co-infected with chlamydia VE was maintained (44.7% (95%CI 17.1-63.1%).

Conclusion: The third-year evaluation results show persistent vaccine effectiveness of 4CMenB against MenB disease in infants and adolescents. As this is the first ongoing programme for adolescents, moderate vaccine protection against gonorrhoea with waning effectiveness three years post-vaccination was demonstrated in adolescents and young adults. The additional protection of 4CMenB vaccine against gonorrhoea, likely through cross-protection should be considered in cost-effectiveness analyses. A booster dose may need to be further evaluated and considered in adolescents due to waning protection against gonorrhoea demonstrated after 36 months post-vaccination.

Keywords: 4CMenB; Vaccine effectiveness; Vaccine impact.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Gonorrhea* / epidemiology
Gonorrhea* / prevention & control
Humans
Immunization Schedule
Infant
Meningococcal Infections* / epidemiology
Meningococcal Infections* / prevention & control
Meningococcal Vaccines*
Neisseria meningitidis, Serogroup B*
Vaccine Efficacy
Young Adult

Substances

Meningococcal Vaccines