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Meta-Analysis
. 2025 Feb 4;231(1):61-70.
doi: 10.1093/infdis/jiae383.

Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis

Winston E Abara  1 , Robert D Kirkcaldy  2 , Kyle T Bernstein  2 , Eboni Galloway  1 , Emily R Learner  1
Affiliations
Meta-Analysis

Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis

Winston E Abara et al. J Infect Dis. .

Abstract

Background: There is no licensed vaccine against gonorrhea, but Neisseria meningitidis serogroup B outer membrane vesicle-based vaccines, such as MenB-4C, may offer cross-protection against gonorrhea. This systematic review and meta-analysis synthesized the published literature on MenB-4C vaccine effectiveness against gonorrhea.

Methods: We conducted a literature search of electronic databases (PubMed, Medline, Embase, Global Health, Scopus, Google Scholar, CINAHL, and Cochrane Library) to identify peer-reviewed articles published in English from 1 January 2013 to 11 September 2024 that reported MenB-4C vaccine effectiveness estimates against gonorrhea and gonorrhea/chlamydia coinfection and the duration of MenB-4C vaccine-induced protection. We estimated pooled MenB-4C vaccine effectiveness (≥1 dose) against gonorrhea using the DerSimonian-Laird random effects model.

Results: Eight articles met our eligibility criteria. Receipt of ≥1 dose of MenB-4C vaccine was 23% to 47% effective against gonorrhea. Two doses of MenB-4C vaccine were 33% to 40% effective against gonorrhea, and 1 dose of MenB-4C vaccine was 26% effective. MenB-4C vaccine effectiveness against gonorrhea/chlamydia coinfection was mixed, with 2 studies reporting effectiveness estimates of 32% and 44% and 2 other studies showing no protective effect. MenB-4C vaccine effectiveness against gonorrhea was comparable in people with HIV (44%) and people without HIV (23%-47%). Pooled MenB-4C vaccine effectiveness (≥1 dose) against gonorrhea was 32.4%. One study concluded that MenB-4C vaccine effectiveness against gonorrhea may wane approximately 36 months postvaccination.

Conclusions: MenB-4C vaccine is moderately effective against gonorrhea in various populations. Prospective clinical trials that assess the efficacy of MenB-4C against gonorrhea, gonorrhea/chlamydia coinfection, and duration of protection are warranted to strengthen this evidence.

Keywords: MenB-4C vaccine; Outer membrane vesicle serogroup B meningococcal vaccine; STI vaccine; gonorrhea; vaccine effectiveness.

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Conflict of interest statement

Potential conflicts of interest . All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Flow chart showing study selection for inclusion in systematic review
Figure 2.
Figure 2.
Forest plot showing MenB-4C vaccine effectiveness (VE) (≥1 dose) against gonorrhea from nine VE estimates (eight studies) and pooled MenB-4C VE Heterogeneity: Q(8)=6.65, P=0.5753; tau2 =0.00; I2=0.00%
Figure 3.
Figure 3.
Sensitivity analysis of forest plot showing MenB-4C vaccine effectiveness (VE) (≥1 dose) against gonorrhea from eight VE estimates (seven studies) and pooled MenB-4C VE Heterogeneity: Q(7)=5.55, P=0.5931; tau2 =0.00; I2=0.00%
See this image and copyright information in PMC

References

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