The potential public health impact of adolescent 4CMenB vaccination on Neisseria gonorrhoeae infection in England: a modelling study

Katharine J Looker; Ross Booton; Najida Begum; Ekkehard Beck; Jing Shen; Katherine M E Turner; Hannah Christensen

doi:10.1186/s12889-022-14670-z

The potential public health impact of adolescent 4CMenB vaccination on Neisseria gonorrhoeae infection in England: a modelling study

BMC Public Health. 2023 Jan 10;23(1):1. doi: 10.1186/s12889-022-14670-z.

Authors

Katharine J Looker¹, Ross Booton², Najida Begum³, Ekkehard Beck⁴, Jing Shen⁵, Katherine M E Turner⁶, Hannah Christensen⁷

Affiliations

¹ Research Fellow in Mathematical Epidemiology of Infectious Diseases, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. katharine.looker@bristol.ac.uk.
² Senior Research Associate in Mathematical Epidemiology of Infectious Diseases, Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK.
³ Freelance Consultant c/o GSK, Wavre, Belgium, 1300.
⁴ Senior Director, Value Evidence and Outcomes, GSK, Wavre, Belgium, 1300.
⁵ Senior Manager, Health Economics, GSK, Wavre, Belgium, 1300.
⁶ Reader in Infectious Disease Epidemiology, Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK.
⁷ Senior Lecturer in Infectious Disease Mathematical Modelling, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.

Abstract

Introduction: Diagnoses of gonorrhoea in England rose by 26% between 2018 and 2019. Recent evidence that a vaccine against meningococcal B disease currently offered to infants in the UK (4CMenB) could additionally protect (with 31% efficacy) against gonorrhoea has led to renewed hope for a vaccine. A Phase 2 proof-of-concept trial of 4CMenB vaccination against gonorrhoea in adults is currently underway.

Objectives: To investigate the potential public health impact of adolescent gonorrhoea vaccination in England, considering different implementation strategies.

Methods: We developed a deterministic transmission-dynamic model of gonorrhoea infection among heterosexual 13-64-year-olds stratified by age, sex and sexual activity. We explored the impact of a National Immunisation Programme (NIP) among 14-year-olds for a vaccine with 31% efficacy, 6 years' duration of protection, and 85% uptake. We also explored how impact might change for varying efficacy (20-50%) and uptake (75-95%), the addition of a catch-up programme, the use of boosters, and varying duration of protection.

Results: An NIP against gonorrhoea could lead to 50,000 (95% credible interval, CrI 31,000-80,000) and 849,000 (95%CrI 476,000-1,568,000) gonorrhoea infections being averted over 10 and 70 years, respectively, in England, for a vaccine with 31% efficacy and 85% uptake. This is equivalent to 25% (95%CrI 17-33%) of heterosexual infections being averted over 70 years. Vaccine impact is predicted to increase over time and be greatest among 13-18-year-olds (39% of infections 95%CrI 31-49% averted) over 70 years. Varying vaccine efficacy and duration of protection had a noticeable effect on impact. Catch-up and booster vaccination increased the short- and long-term impact, respectively.

Conclusions: A partially-effective vaccine against gonorrhoea infection, delivered to 14-year-olds alongside the MenACWY vaccine, could have an important population impact on gonorrhoea. Catch-up and booster vaccination could be considered alongside cohort vaccination to increase impact.

Keywords: England; Gonorrhoea; Humans; Neisseria gonorrhoeae; Public health; Sexually-transmitted infection; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
England / epidemiology
Gonorrhea* / epidemiology
Gonorrhea* / prevention & control
Humans
Infant
Meningococcal Infections* / epidemiology
Meningococcal Vaccines* / therapeutic use
Proof of Concept Study
Public Health
Vaccination

Substances

Meningococcal Vaccines