Vaccination Significantly Protected College Students from Gonorrhea

A new Research Letter suggests meningococcal group B vaccination (MBV) offers significant protection against gonorrhea, a sexually transmitted disease.

Most women infected with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection.

On August 31, 2023, the new research was published in the peer-reviewed journal JAMA Network Open, which assessed whether receipt of outer membrane vesicle (OMV) based MBV was associated with subsequent lower gonorrhea prevalence.

The Public Health Institutional Review Board covering Oregon's Public Health Division approved this case-control study's use of public health data.

The study's populations included 15,760 recipients of 1 or more OMV-based MBV (8510 females [54%], 7250 males [46%]; median [IQR] age at receipt, 19.3 [18-20] years).

And 15 212 recipients of 1 or more non–OMV–based MBV (8519 females [56%], 6693 males [44%]; median [IQR] age at receipt, 19.4 [18-20] years).

Overall, 53% of non–OMV–based MBV recipients received more than one dose vs. 57% of OMV-based MBV recipients.

Twenty-four cases of gonorrhea were reported in OMV-based MBV recipients vs. 44 patients in non–OMV–based MBV recipients.

The OMV-based MBV was 47% (95% CI, 13%-68%) effective in preventing gonorrhea among recipients aged 18 to 29.

Among those aged 18 to 19, 12 gonorrhea cases were reported in OMV-based MBV recipients and 27 in non–OMV–based MBV recipients (vaccine effectiveness, 59%; 95% CI, 20%-79%).

However, vaccine effectiveness for recipients of 2 or more vaccines vs. one vaccine was 11% (95% CI, –0.98% to 0.60%).

These researchers wrote the study's 'results were consistent with other study findings that OMV-based vaccines may offer protection against gonorrhea.'

Given the global burden of gonorrhea, further investigation of OMV-based vaccination technology may be warranted, concluded these researchers.

This study's limitations included low numbers of gonorrhea cases, the likelihood of students graduating and leaving the disease-reporting area, and shifts in gonorrhea risk over time. 

Because both MBVs were used at each university, this study reduced the selection bias inherent in retrospective, population-based studies. And there were no industry-related conflicts of interest disclosed.

Currently, two meningococcal vaccines are available in the U.S.: MenB-4C (OMV-based) and MenB-FHbp (not OMV-based).

The U.S. Centers for Disease Control and Prevention (CDC) reported about 710,000 cases of gonorrhea in 2021, making it the second most common sexually transmitted infection in the U.S. In addition, the CDC announced on April 11, 2023, that gonorrhea rates increased by more than 4% in 2022. 

The CDC recommends meningococcal vaccines for preteens, teens, and certain other people in the U.S. A booster dose at 16 years old gives teens continued protection when they are at the highest risk.