Effect of outer membrane vesicle vaccine against group B meningococcal disease in Norway

Lancet. 1991 Nov 2;338(8775):1093-6. doi: 10.1016/0140-6736(91)91961-s.


For more than 15 years, Norway has had the highest incidence of meningococcal disease in northern Europe, with 80% of cases being due to serogroup B meningococci. The case-fatality has remained high, at about 10%. In this study, an outer membrane vaccine, which had previously been shown to induce an increase in bactericidal antibodies to the parent strain, was assessed in a large-scale, randomised, double-blind trial. From October, 1988, 171,800 students in secondary schools volunteered to take part in a double-blind, placebo-controlled, efficacy trial with school as the randomisation unit. Hospitals and clinics that routinely receive patients with infectious disease were asked to report urgently all cases of suspected meningitis and/or septicaemia in 13-21-year-old students in Norway. These cases were registered and further investigated according to a detailed protocol. 89 out of the 221 cases investigated by June 3, 1991, were shown to be severe systemic disease due to group B meningococci. 36 cases in 35 schools took part in the trial (11 schools with vaccinated students and 24 with students given placebo). The calculated rate of protection was thus 57.2% (p = 0.012, one-sided test). The findings suggest that, although the vaccine conferred protection against group B meningococcal disease, the effect was insufficient to justify a public vaccination programme.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, Bacterial / administration & dosage*
  • Bacterial Capsules
  • Bacterial Outer Membrane Proteins / administration & dosage*
  • Bacterial Vaccines / administration & dosage*
  • Child
  • Child, Preschool
  • Disease Outbreaks / prevention & control*
  • Double-Blind Method
  • Evaluation Studies as Topic
  • Follow-Up Studies
  • Humans
  • Immunization Schedule
  • Infant
  • Meningitis, Meningococcal / epidemiology
  • Meningitis, Meningococcal / prevention & control*
  • Meningococcal Vaccines
  • Neisseria meningitidis / immunology*
  • Norway / epidemiology
  • Polysaccharides, Bacterial / administration & dosage*
  • Vaccination*


  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins
  • Bacterial Vaccines
  • Meningococcal Vaccines
  • Polysaccharides, Bacterial
  • capsular polysaccharide, meningococcal group B