Abstract
Background
Neisseria gonorrhoeae is acquiring increasing resistance to available oral antibiotics, and current screening and treatment approaches have not decreased gonorrhea incidence. Although a gonorrhea-specific vaccine does not exist,
N. gonorrhoeae shares much of its genome with
Neisseria meningitidis, notably critical antigenic determina nts including outer membrane vesicles (OMV). Prior observational studies have suggested that OMV-based meningococcal serogroup B vaccines confer protection against gonorrhea.
Methods
We conducted a matched cohort study from 2016-2020 to examine the association of OMV-containing recombinant meningococcal serogroup B vaccine (4CMenB) with gonorrhea infection among teens and young adults at Kaiser Permanente Southern California. Recipients of 4CMenB were matched in a ratio of 1:4 to recipients of non-OMV-containing polysaccharide-conjugate vaccine targeting serotypes A, C, W, Y ("MenACWY") who had not received 4CMenB and were followed for incident gonorrhea. We used Cox proportional hazards regression to compare gonorrhea rates among recipients of 4CMenB vs MenACWY, adjusting for potential confounders. We conducted the same analysis with chlamydia as a negative control outcome.
Results
The study included 6,641 recipients of 4CMenB matched to 26,471 recipients of M enACWY. During follow-up, gonorrhea incidence rates per 1000 person-years (95% CI) were 2.0 (1.3-2.8) for recipients of 4CMenB and 5.2 (4.6-5.8) for recipients of MenACWY. In adjusted analyses, gonorrhea rates were 46% lower among recipients of 4CMenB vs MenACWY (HR [95% CI] 0.54 [0.34-0.86]), but chlamydia rates were similar between vaccine groups (HR [95% CI] 0.98 [0.82-1.17]).
Conclusions
These results suggest cross-protection of 4CMenB against gonorrhea, supporting the potential for vaccination strategies to prevent gonorrhea.
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