Vaccination with 4CMenB (Bexsero) in children under 14 years of age could have a major impact in reducing new gonorrhea infections among adolescents. A study carried out in the United Kingdom concludes that this vaccine could additionally protect (31 percent efficacy) against the pathogen Neisseria gonorrhoeae.
gonorrhea is the second most prevalent sexually transmitted bacterial infection worldwidehe. Currently, it has become a major public health problem as it has developed, in a short time, resistance to the available antibiotics used up to now.
Until recently, the combination of ceftriaxone and azithromycin it was the treatment of choice for multidrug-resistant strains. However, data in the United Kingdom and the United States have suggested that resistance to these antibiotics continues to increase. In 2021, the US Centers for Disease Control and Prevention (CDC) recommended to administer uon a double dose of ceftriaxone in an effort to overcome the bacteria’s resistance to this antibiotic. However, they caution that monitoring is essential to ensure the continued efficacy of the recommended regimens.
N. gonorrhoeae shares between 80-90 percent homology of its primary sequences with N. meningitidisa bacterium that can cause meningitis and sepsis
N. gonorrhoeae y N. meningitidis
The study published in BMC Public Health points out the obstacles that have hindered the development of a possible vaccine against this infection, caused by the highly antigenically variable surface of N. gonorrhoeae and the lack of suitable animal models. However, N. gonorrhoeae shares between 80-90 percent homology of its primary sequences with N. meningitidisa bacterium that can cause meningitis and sepsis.
Highlighting previous research, a retrospective control study among people aged 15 to 30 years who attended sexual health clinics in New Zealand, and who were vaccinated with MeNZBfound that vaccination provided partial protection (31 percent efficacy) against gonorrhea infection. two studies more, using 4CMenB, also showed impact on gonorrhea in New York City and Philadelphia
It is currently being carried out a proof of concept essay of the 4CMenB vaccine in adolescents and adults against gonorrhea.
Over 10 years, 50,000 (10 percent) of incident gonorrhea infections in heterosexuals could be prevented
Impact of the 4CMenB vaccine
The current study has found that vaccinating a cohort of 14-year-old boys in the UK with 4CMenB against gonorrhea—assuming 31 percent efficacy and 85 percent acceptance— could lead to a substantial reduction in new gonorrhea infections, particularly among adolescents. For example, for 10 years, you could avoid 50.000 (10 percent) of incident gonorrhea infections in heterosexuals, increasing to 25 percent or 849,000 cases for 70 years.
In the short term (10 years), about one 54 percent more infections with the addition of catch-up vaccination. Meanwhile, booster vaccination could help prevent around 61 percent more infections in the long term (70 years) and could help mitigate the short duration of vaccine protection.
Methodology
Researchers developed a deterministic, compartmental, and dynamic model of transmission of gonorrhea infection among people aged 13-64 in the UK, using the susceptible-infected-susceptible (SIS) model framework, stratified by sex, age, number of sexual partners per year, HIV infection status N. gonorrhoeae and vaccination status.
The default (primary) scenario was selected to be an adolescent vaccination cohort at age 14 (since the age range for MenACWY vaccination is 13-15 years) with 85 percent uptake and 31 percent of vaccine efficacy. The indication of 4CMenB in adolescents against group B meningococcus is a regimen of 2 doses with an interval of 1 month; In this model, the vaccine protection was modeled from the first dose.
