Prevention of Neisseria gonorrhoeae With Meningococcal B Vaccine: A Matched Cohort Study in Southern California

Author:

Bruxvoort Katia J12ORCID,Lewnard Joseph A345,Chen Lie H2,Tseng Hung Fu26,Chang Jennifer7,Veltman Jennifer8,Marrazzo Jeanne9,Qian Lei2

Affiliation:

1. Department of Epidemiology, University of Alabama at Birmingham , Birmingham, Alabama , USA

2. Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, California , USA

3. Division of Epidemiology, School of Public Health, University of California–Berkeley , Berkeley, California , USA

4. Division of Infectious Diseases & Vaccinology, School of Public Health, University of California–Berkeley , Berkeley, California , USA

5. Center for Computational Biology, College of Engineering, University of California–Berkeley , Berkeley, California , USA

6. Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, California , USA

7. Department of Infectious Diseases, Los Angeles Medical Center, Southern California Permanente Medical Group , Los Angeles, California , USA

8. Division of Infectious Diseases, Loma Linda University Health School of Medicine , Loma Linda, CA , USA

9. Division of Infectious Diseases, University of Alabama at Birmingham Heersink School of Medicine , Birmingham, Alabama , USA

Abstract

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 determinants 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 to 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, and 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 6641 recipients of 4CMenB matched to 26 471 recipients of MenACWY. During follow-up, gonorrhea incidence rates per 1000 person-years (95% confidence intervals [CIs]) 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 (hazard ratio [HR], 0.54; 95% CI, .34–.86), but chlamydia rates were similar between vaccine groups (HR, 0.98; 95% CI, .82–1.17). Conclusions These results suggest cross-protection of 4CMenB against gonorrhea, supporting the potential for vaccination strategies to prevent gonorrhea.

Funder

Kaiser Permanente Southern California

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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