A meningococcal B vaccine induces cross-protection against gonorrhea

Abstract

Purpose: Neisseria meningitidis and Neisseria gonorrhoeae share between 80% and 90% of their genetic sequence. Meningococcal serogroup B vaccines based on outer membrane vesicles-such as VA-MENGOC-BC-could cross-protect against gonorrhea. The aim of this study was to analyze the incidence rates of gonorrhea and other sexually transmitted diseases with respect to the use of the VA-MENGOC-BC vaccine.

Materials and methods: Health statistics between 1970 and 2017 were reviewed and the incidence of meningococcal disease and sexually transmitted diseases (gonorrhea, syphilis, condyloma acuminatum, hepatitis B and human immunodeficiency virus infection) were analyzed during the pre- and post-vaccination periods. Gonorrhea incidence was also analyzed by age groups.

Results: VA-MENGOC-BC was successfully used to control a meningococcal epidemic in Cuba. The strategy to combat the epidemic was carried out in two stages. The first one was a nationwide mass-vaccination campaign from 1989 to 1990, targeting the population at highest-risk aged 3 months to 24 years. During the second stage, begun in 1991, it was included in the Expanded Immunization Program. Gonorrhea incidence increased from 1970 to 1989. However, after the VA-MENGOC-BC massive vaccination campaign a sharp decrease of gonorrhea incidence was observed. It lasted between 1989 and 1993. A second incidence peak was detected in 1995, but it dropped again. Data clearly show a decline in the incidence of gonorrhea following massive vaccination, in contrast with other sexually transmitted diseases. Incidence rates in unvaccinated age groups also decreased, probably due to herd immunity.

Conclusion: There is evidence that VA-MENGOC-BC could induce a moderate protection against gonorrhea.

Keywords: Gonorrhea; Neisseria gonorrhoeae; Neisseria meningitidis; Vaccines.

Fig. 1. Incidence rates of meningococcal disease and sexually transmitted diseases in Cuba. Data published in the Time Series [10] and the Cuban Health Statistical Yearbook [11] from 1970 to 2017 on the morbidity of meningococcal disease, gonorrhea and syphilis. Hepatitis B was reported between 1989 and 2017. HIV infection was registered in the Cuban statistical data and the Joint United Nations Programme on HIV and AIDS (UNAIDS) [12]. Condyloma acuminatum was analyzed with published data from 1970 to 2013. HIV, human immunodeficiency virus.

Fig. 2. Gonorrhea incidence rates by age groups. Data published in the Cuban Time Series from 1970 to 2013 [10].