The potential public health impact of adolescent 4CMenB vaccination on Neisseria gonorrhoeae infection in England: a modelling study.

Abstract

INTRODUCTION:

Diagnoses of gonorrhoea in England rose by 26% between 2018 and 2019. Recent evidence that a vaccine against meningococcal B disease currently offered to infants in the UK (4CMenB) could additionally protect (with 31% efficacy) against gonorrhoea has led to renewed hope for a vaccine. A Phase 2 proof-of-concept trial of 4CMenB vaccination against gonorrhoea in adults is currently underway.

OBJECTIVES:

To investigate the potential public health impact of adolescent gonorrhoea vaccination in England, considering different implementation strategies.

METHODS:

We developed a deterministic transmission-dynamic model of gonorrhoea infection among heterosexual 13-64-year-olds stratified by age, sex and sexual activity. We explored the impact of a National Immunisation Programme (NIP) among 14-year-olds for a vaccine with 31% efficacy, 6 years' duration of protection, and 85% uptake. We also explored how impact might change for varying efficacy (20-50%) and uptake (75-95%), the addition of a catch-up programme, the use of boosters, and varying duration of protection.

RESULTS:

An NIP against gonorrhoea could lead to 50,000 (95% credible interval, CrI 31,000-80,000) and 849,000 (95%CrI 476,000-1,568,000) gonorrhoea infections being averted over 10 and 70 years, respectively, in England, for a vaccine with 31% efficacy and 85% uptake. This is equivalent to 25% (95%CrI 17-33%) of heterosexual infections being averted over 70 years. Vaccine impact is predicted to increase over time and be greatest among 13-18-year-olds (39% of infections 95%CrI 31-49% averted) over 70 years. Varying vaccine efficacy and duration of protection had a noticeable effect on impact. Catch-up and booster vaccination increased the short- and long-term impact, respectively.

CONCLUSIONS:

A partially-effective vaccine against gonorrhoea infection, delivered to 14-year-olds alongside the MenACWY vaccine, could have an important population impact on gonorrhoea. Catch-up and booster vaccination could be considered alongside cohort vaccination to increase impact.

• Authors: Katharine J Looker, Ross Booton, Najida Begum, Ekkehard Beck, Jing Shen, Katherine M E Turner, Hannah Christensen
• Journal: BMC public health (BMC Public Health) Vol. 23 Issue 1 Pg. 1 (01 10 2023) ISSN: 1471-2458 [Electronic] England
• PMID: 36624437 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022. The Author(s).

Chemical References

• Meningococcal Vaccines

Topics

• Adolescent
• Adult
• Humans
• Infant
• England (epidemiology)
• Gonorrhea (epidemiology, prevention & control)
• Meningococcal Infections (epidemiology)
• Meningococcal Vaccines (therapeutic use)
• Public Health
• Vaccination
• Proof of Concept Study