Meningitis vaccines ‘could help protect against gonorrhoea as cases rise globally’

Existing meningitis vaccines could be used to tackle untreatable gonorrhoea, studies suggest.

As the vaccines have become more widely available, studies have shown they also offer some protection against gonorrhoea, and that even partial protection could reduce cases of the infection considerably.

According to three linked papers published in The Lancet Infectious Diseases journal, the vaccines could help improve protection against the sexually transmitted disease (STD).

It comes amid rising cases globally and increasing bacterial resistance to drugs used to treat the infection. More than 80 million new cases of gonorrhoea were recorded worldwide in 2020.

The studies also suggest that the 4CMenB vaccine may offer significant protection to young adults, and to men who have sex with men who might be at higher risk of infection.

A study led by Dr Winston Abara, of the US Centers for Disease Control and Prevention, used health records to identify laboratory-confirmed cases of gonorrhoea and chlamydia – another leading STI – among 16 to 23-year-olds in New York City and Philadelphia, between 2016 to 2018.

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These cases were compared with immunisation records to determine people’s vaccination status with 4CMenB.

Results showed that there were more than 167,000 infections – 18,099 gonorrhoea, 124,876 chlamydia, and 24,731 co-infections –  among almost 110,000 people. A total of 7,692 people had received the 4CMenB vaccine, with 52 per cent receiving one dose, 47 per cent two doses, and less than one per cent more than two doses.

A full 4cMenB vaccination – receiving two doses – was estimated to provide 40 per cent protection against gonorrhoea, while one vaccine provided 26 per cent protection.

Dr Winston Abara said: “Our findings suggest that meningitis vaccines that are even only moderately effective at protecting against gonorrhoea could have a major impact on prevention and control of the disease.

“Clinical trials focused on the use of 4CMenB against gonorrhoea are needed to better understand its protective effects and could also offer important insights towards the development of a vaccine specifically for gonorrhoea.”

As the findings were only attributed to people aged 16-23 in two large urban settings in the US, they are somewhat limited.

However, another observational study in South Australia among infants, adolescents and young adults, suggested that a two-dose course of 4CMenB was 33 per cent effective against gonorrhoea.

Professor Helen Marshall, of the Women’s and Children’s Hospital in Adelaide, said: “While recent studies have provided evidence that 4CMenB vaccination is associated with reduced risk of gonorrhoea, the vaccine was only offered to adolescents and young adults for short periods.

“The unprecedented scale of South Australia’s 4CMenB vaccination programme offers valuable real-world evidence of the vaccine’s effectiveness against meningococcal B meningitis in children and adolescents, and gonorrhoea in adolescents and young people.

“This information is vital to inform global meningitis vaccination programmes and policy decisions.”

If untreated, gonorrhoea can lead to serious health conditions, including infertility in women, transmission to newborn babies, and increased risk of HIV.

The declining effectiveness of drug treatments for gonorrhoea and the lack of a licensed vaccine to prevent the infection has raised concerns about the possibility that the STD may become more resistant to treatment, or even untreatable, in future.

In 2016, the WHO set a target to reduce gonorrhoea incidences by 90 per cent by 2030, however, an effective vaccine has yet to be developed.

Vaccination based on infection risk could prevent 110,000 cases in England and save £8 million over 10 years

Until now, no study has assessed both the health impact and cost-effectiveness of using a vaccine to avert gonorrhoea infections.