Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016

Soeters, Heidi M.; Dinitz-Sklar, Jill; Kulkarni, Prathit A.; MacNeil, Jessica R.; McNamara, Lucy A.; Zaremski, Elizabeth F.; Chang, How-Yi; Lujan, Eduardo; Granoff, Dan M.; Lasky, Melodee; Montana, Barbara

doi:10.3201/eid2305.161870

Cited by 22 publications

(26 citation statements)

References 5 publications

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“…The magnitude, and subsequent societal and economic burden, of Nm outbreaks is often influenced by country/regional population structures, the diagnostic capacity of health-care systems and outbreak response (vaccination/prophylaxis). In the U.S.A., there have been numerous university outbreaks [12, [66][67][68][69][70]; MenB predominated, with MenC more commonly seen in communitybased outbreaks. Examples of university outbreaks between 2008 and 2017 involving MenB include Ohio University (2008-2010) [70], Princeton University (2013-2014) [67,68], and Rutgers University [69].…”

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

“…In the U.S.A., there have been numerous university outbreaks [12, [66][67][68][69][70]; MenB predominated, with MenC more commonly seen in communitybased outbreaks. Examples of university outbreaks between 2008 and 2017 involving MenB include Ohio University (2008-2010) [70], Princeton University (2013-2014) [67,68], and Rutgers University [69]. In Africa, the high incidence of IMD was thought to be due to the dry season and start of the Harmattan (dry and sandy east wind) in sub-Saharan Africa, which favors colonization and transmission of Nm in the pharynx [6].…”

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

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The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

147

159

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2019) The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and highrisk populations, Expert Review of Vaccines, 18:1, 15-30, ABSTRACT Introduction: The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents. Areas covered: Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide. Expert commentary: The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention. ARTICLE HISTORY

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Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

147

159

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“…The Princeton University strain had FHbp sub-family B (FHbp ID 276 with 96% amino acid identity with the sub-family B ID 1 antigen in MenB-4C and positive expression by flow cytometry), and expressed NHba with 100% amino acid identity to NHba in MenB-4C [15]. The Rutgers University strain was mismatched for all four MenB-4C antigens (Table 1) [20]. …”

Section: Methodsmentioning

confidence: 99%

The role of anti-NHba antibody in bactericidal activity elicited by the meningococcal serogroup B vaccine, MenB-4C

Partridge

Lujan

Giuntini

et al. 2017

Vaccine

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Background MenB-4C (Bexsero®) is a multicomponent serogroup B meningococcal vaccine. For vaccine licensure, efficacy was inferred from serum bactericidal antibody (SBA) against three antigen-specific indicator strains. The bactericidal role of antibody to the fourth vaccine antigen, Neisserial Heparin binding antigen (NHba), is incompletely understood. Methods We identified nine adults immunized with two or three doses of MenB-4C who had sufficient volumes of sera and >3-fold increases in SBA titer against a strain with high NHba expression, which was mismatched with the other three MenB-4C antigens that elicit SBA. Using 1 month-post-immunization sera we measured the effect of depletion of anti-NHba and/or anti-Factor H binding protein (FHbp) antibodies on SBA. Results Against three strains matched with the vaccine only for NHba, depletion of anti-NHba decreased SBA titers by an average of 43–79% compared to mock-adsorbed sera (P<0.05). Despite expression of sub-family A FHbp (mismatched with the subfamily B vaccine antigen), depletion of anti-FHbp antibodies also decreased SBA by 45–64% (P<0.05). Depletion of both antibodies decreased SBA by 84–100%. Against a strain with sub-family B FHbp and expression of NHba with 100% identity to the vaccine antigen, depletion of anti-NHba decreased SBA by an average of 26%, compared to mock-adsorbed sera (P<0.0001), and depletion of anti-FHbp antibody decreased SBA by 92% (P<0.0001). Conclusions Anti-NHba antibody can contribute to SBA elicited by MenB-4C, particularly in concert with anti-FHbp antibody. However, some high NHba-expressing strains are resistant, even with an exact match between the amino acid sequence of the vaccine and strain antigens.

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“…Six of the case isolates had FHbp subfamily A, and eight had FHbp subfamily B. Six case isolates were from recent outbreaks on U.S. college campuses (Princeton University [15,19], University of California, Santa Barbara [15], Ohio University [18], Santa Clara University [20,43], a college in Rhode Island [16,34], and Rutgers University [13]). Two additional case isolates were from patients hospitalized between 2009 and 2013 in Quebec, Canada, during a period of hyperendemic serogroup B disease (17).…”

Section: Methodsmentioning

confidence: 99%

Breadth and Duration of Meningococcal Serum Bactericidal Activity in Health Care Workers and Microbiologists Immunized with the MenB-FHbp Vaccine

Lujan

Partridge

Giuntini

et al. 2017

Clin Vaccine Immunol

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MenB-FHbp is a meningococcal serogroup B vaccine with two factor H binding protein (FHbp) antigens from subfamilies A and B. For licensure, efficacy was inferred from serum bactericidal antibody (SBA) responses to four reference strains. Only limited information is available on the breadth or duration of protective SBA responses to genetically diverse disease-causing strains. Seventeen health care or laboratory workers were immunized with two (n ϭ 2) or three (n ϭ 15) doses of MenB-FHbp at 0, 2, and 6 months. SBA levels were measured against 14 serogroup B case isolates, including 6 from U.S. college outbreaks and 2 from Quebec during hyperendemic disease. Compared with preimmunization titers, the proportion of subjects with Ն4-fold increases in SBA titer 1 month after 2 doses of vaccine ranged from 35% to 94% for six isolates with FHbp subfamily A and from 24% to 76% for eight isolates with subfamily B FHbp. The respective proportions with Ն4-fold titer increases at 1 month after dose 3 were 73% to 100% and 67% to 100%. At that time point, the proportion of subjects with titers of Ն1:4 (presumed sufficient for short-term protection) ranged from 93% to 100% for all 14 isolates. By 9 to 11 months after dose 3, 50% or fewer of the subjects with follow-up sera had protective titers of Ն1:4 for 4 of 9 isolates tested. Three doses of MenB-FHbp elicited short-term protective SBA responses to diverse disease-causing serogroup B strains. For some strains, serum titers declined to Ͻ1:4 by 9 to 11 months, which raises concerns about the duration of broad, long-term protection. (This study has been registered at ClinicalTrials.gov under registration no. NCT02569632.)

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Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016

Cited by 22 publications

References 5 publications

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

The role of anti-NHba antibody in bactericidal activity elicited by the meningococcal serogroup B vaccine, MenB-4C

Breadth and Duration of Meningococcal Serum Bactericidal Activity in Health Care Workers and Microbiologists Immunized with the MenB-FHbp Vaccine

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