Immunogenicity of 2 Serogroup B Outer-Membrane Protein Meningococcal Vaccines

Abstract

ENINGOCOCCAL DISEASE caused predominantly by Neisseria meningitidis serogroups A, B, and C occurs predominantly in young children and remains a substantial cause of morbidity and mortality worldwide. 1,2 In addition to causing endemic disease globally, meningococci, unlike other encapsulated bacteria, cause epidemics. Serogroup B epidemics, problematic in Norway and throughout much of Latin America in the 1980s and 1990s, 1 have recently emerged in New Zealand 3 and the United States. [4][5][6] Response to serogroup B epidemics, unlike serogroup A and C epidemics, is difficult because existing serogroup B vaccines have not been shown to be efficacious on an international scale. [7][8][9][10] Quadrivalent meningococcal polysaccharide vaccine is efficacious against meningococcal disease caused by the A, C, W-135, and Y serogroups. [11][12][13] Serogroup B polysaccharide antigen, however, is poorly immunogenic in humans, 14,15 and the elicitation of antibodies to serogroup B polysaccharide antigen is of concern because this antigen is present in human neonatal neural tissue. 16,17 Therefore, alternative Author Affiliations are listed at the end of this article.

Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil

“…This vaccine, which includes strains with serosubtypes that account for 70.6% of cases of meningococcal meningitis in Salvador, would be a candidate for use in Salvador if it proves efficacious. However, existing limitations of OMV-based meningococcal vaccines, including lower efficacy in young children (Costa et al, 1996;De Moraes et al, 1992;Sierra et al, 1991;Tappero et al, 1999), inability to induce immunological memory (Wedege et al, 1998) and failure to provide cross-protection against non-vaccine strains, may delay their use (Pollard and Levin, 2000). Alternatively, reverse vaccinology approaches have identified antigens that induce antibactericidal antibody responses against the spectrum of meningococcal serogroup B strains associated with invasive disease (Giuliani et al, 2006;Masignani et al, 2003).…”

“…Six years later, a tetravalent conjugate meningococcal vaccine, including the capsular polysaccharides of serogroups A, C, Y and W-135, was licensed for use among persons aged 11-55 years (Bilukha and Rosenstein, 2005). Despite these advances, an effective vaccine against serogroup B, a major cause of invasive meningococcal disease in many European countries and the Americas, is not currently available (Bjune et al, 1991;De Moraes et al, 1992;Sierra et al, 1991;Tappero et al, 1999;Tsolia et al, 2006). Future prevention of serogroup B disease will rely both on outer membrane vesicle (OMV) vaccines being used for specific serosubtypes and new vaccines containing multiple other antigens.…”

The Dual Role of Lipids of the Lipoproteins in Trumenba, a Self-Adjuvanting Vaccine Against Meningococcal Meningitis B Disease

“…To control these outbreaks, vaccines based on the highly variable porin A protein were used, but Electronic supplementary material The online version of this article (doi:10.1208/s12248-016-9979-x) contains supplementary material, which is available to authorized users. these vaccines were not broadly effective against other invasive NmB strains (5,6).…”

Cost-effectiveness analysis of a multicomponent meningococcal serogroup B vaccine in hypothetic epidemic situation in a middle-income country

“…The proportion of individuals suffering sequelae from MD in 1993 was 28.3% after one year of follow up and the lethality was 7.3%. 17,19,20 At that time, the Ministry of Health considered the outer membrane protein (OMP) meningococcal vaccine, but data suggested that this vaccine did not confer protection during a heterologous strain outbreak. 17 The aim of this study was to determine the cost-effectiveness of using 4CMenB in a one-time intervention strategy for the control of a hypothetical epidemic outbreak in Chile, a middleincome country.…”