On the controversy about the efficacy of the antimeningococcal B vaccine: methodological pitfalls

Costa, Eduardo

doi:10.1590/s0102-311x1995000200018

Cited by 8 publications

(9 citation statements)

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“…10,11 Because it is a detergent extracted OMV-based vaccine, the protective activity induced by this preparation is mainly targeted against homologous strains. 10,[13][14][15] Nevertheless, some cross-reactive immune responses can be observed in clinical trials with this vaccine candidate, which are presumably induced by minor proteins. This hypothesis is supported by the finding of Williams et al (2014), 16 who observed this type of crossresponse against proteins other than the major antigens of meningococcus.…”

Section: Introductionmentioning

confidence: 99%

A deeper mining on the protein composition of VA-MENGOC-BC®: An OMV-based vaccine againstN. meningitidisserogroup B and C

Masforrol

Gil

García

et al. 2017

Human Vaccines & Immunotherapeutics

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The protein composition of an Outer Membrane Vesicle (OMV) preparation that constitutes the active pharmaceutical ingredient of VA-MENGOC-BC®, an effective vaccine against Neisseria meningitidis serogroups B, and C is presented. This preparation has a high lipid content and five abundant membrane proteins (FetA, PorA, PorB, RmpM, and Opc), constituting approximately 70% of the total protein mass. The protein composition was determined by combining the use of the Hexapeptide Ligand Library and an orthogonal tandem fractionation of tryptic peptides by reverse-phase chromatography at alkaline and acid pH. This approach equalizes the concentration of tryptic peptides derived from low- and high-abundance proteins as well as considerably simplifying the number of peptides analyzed by LC-MS/MS, enhancing the possibility of identifying low-abundance species. Fifty-one percent of the proteins originally annotated as membrane proteins in the genome of the MC58 strain were identified. One hundred and sixty-eight low-abundance cytosolic proteins presumably occluded within OMV were also identified. Four (NadA, NUbp, GNA2091, and fHbp), out of the five antigens constituting the Bexsero® vaccine, were detected in this OMV preparation. In particular, fHbp is also the active principle of the Trumenba® vaccine developed by Pfizer. The HpuA and HpuB gene products (not annotated in the MC58 genome) were identified in the CU385 strain, a clinical isolate that is used to produce this OMV. Considering the proteins identified here and previous work done by our group, the protein catalogue of this OMV preparation was extended to 266 different protein species.

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Section: Introductionmentioning

confidence: 99%

A deeper mining on the protein composition of VA-MENGOC-BC®: An OMV-based vaccine againstN. meningitidisserogroup B and C

Masforrol

Gil

García

et al. 2017

Human Vaccines & Immunotherapeutics

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“…The effectiveness reported against serogroup B was 72% in children between 6 and 83 months of age. 23 …”

Section: Resultsmentioning

confidence: 99%

“…For the prospective part, the estimated and actual coverage were 93% and 92% respectively, and effectiveness increased to 55%. 20 , 23 …”

Section: Resultsmentioning

confidence: 99%

Cross-protection induced by VA-MENGOC-BC® vaccine

Ochoa-Azze

2018

Human Vaccines & Immunotherapeutics

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I would like to comment on the article “Commentary: Impact of meningococcal group B OMV vaccines, beyond their brief”, DOI: 10.1080/21645515.2017.1381810. The author states that meningococcal group B OMVs vaccines –such as VA-MENGOC-BC®– may induce moderate protection against Neisseria gonorrhoeae. I agree. However, the author states that “there was no evidence of effectiveness in the younger children.” The effectiveness of VA-MENGOC-BC® in heterologous contexts has been higher than 80% in individuals older than 4 years old, but the effectiveness in younger children should not be undervalued; it has usually been higher than 60%, and results markedly higher when evaluated based on mortality rates. There is strong evidence that VA-MENGOC-BC® may induce cross-protection against heterologous N. meningitidis strains and N. gonorrhoeae.

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“…Although the circulating strains were not specifi ed in these studies, they were likely similar to those isolated in Sao Paulo, with wide circulation of heterologous strains. [23,25] When Brazil's Ministry of Health assessed the impact of vaccination with VA-MENGOC-BC in 6 Brazilian states, including those referred to here, it reported effectiveness against serogroup B as 72% (CI 63%-80%) in children aged 6-83 months. [25] The effectiveness found in Brazil is high, especially considering the country's geographical and epidemiological characteristics.…”

Section: Peer Reviewedmentioning

confidence: 98%

“…[23,25] When Brazil's Ministry of Health assessed the impact of vaccination with VA-MENGOC-BC in 6 Brazilian states, including those referred to here, it reported effectiveness against serogroup B as 72% (CI 63%-80%) in children aged 6-83 months. [25] The effectiveness found in Brazil is high, especially considering the country's geographical and epidemiological characteristics. The great diversity of meningococcal serosubtypes supports the contention that VA-MENGOC-BC induced crossreactive protection in the age groups assessed.…”

Section: Peer Reviewedmentioning

confidence: 98%

Effectiveness of a Serogroup B and C Meningococcal Vaccine Developed in Cuba

2018

MEDICC Review

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INTRODUCTION Serogroup B meningococcal outer membrane vesicle vaccines have been effective against vaccine-type strains, but their effectiveness against heterologous strains has been controversial. The Cuban VA-MENGOC-BC vaccine is of this type, but also includes meningococcus C capsular polysaccharide.OBJECTIVES Assess the effectiveness of VA-MENGOC-BC in reducing meningococcal disease caused by homologous or heterologous serogroup B strains and its serological effectiveness against meningococcus C. METHODS A review of studies of VA-MENGOC-BC's application in Cuba, Brazil, Uruguay and Colombia was carried out to examine the vaccine's effectiveness in reducing meningococcal disease during serogroup B outbreaks. Serological effectiveness against serogroup C determined in these studies (indicated by bactericidal antibody titers before and after vaccination) was also analyzed.RESULTS VA-MENGOC-BC's effectiveness against homologous serogroup B strains has consistently been greater than 80% in all age groups. Effectiveness in heterologous contexts was also above 80% in individuals aged >4 years. Lower effectiveness in heterologous contexts was found in Brazilian children aged <2 years, although still >50%. Effectiveness increased when assessed based on mortality rates, as well as in cases of clinically severe meningococcal disease. The carrier-state pattern was modifi ed after vaccination with reduction of hypervirulent lineages. Some 60% of infants (aged <1 year) attained protective bactericidal antibody titers against serogroup C. Higher protection rates were achieved in older children. CONCLUSIONSIn addition to prevention of meningococcal disease caused by homologous serogroup B strains, VA-MENGOC-BC should be considered for heterologous contexts. It is protective against serogroup C in all age groups.

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On the controversy about the efficacy of the antimeningococcal B vaccine: methodological pitfalls

Cited by 8 publications

References 1 publication

A deeper mining on the protein composition of VA-MENGOC-BC®: An OMV-based vaccine againstN. meningitidisserogroup B and C

A deeper mining on the protein composition of VA-MENGOC-BC®: An OMV-based vaccine againstN. meningitidisserogroup B and C

Cross-protection induced by VA-MENGOC-BC® vaccine

Effectiveness of a Serogroup B and C Meningococcal Vaccine Developed in Cuba

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