Effectiveness of MenB-4C vaccine against gonorrhea: A systematic review and meta-analysis

Introduction: There is no licensed vaccine against gonorrhea but Neisseria meningitidis serogroup
B outer membrane vesicle-based vaccines, like MenB-4C, may offer cross-protection against
gonorrhea. This systematic review and meta-analysis synthesized the published literature on
MenB-4C vaccine effectiveness against gonorrhea.
Methods: We conducted a literature search of electronic databases (PubMed, Medline, Embase,
Global Health, Scopus, Google Scholar, CINAHL, and Cochrane Library) to identify peerreviewed papers, published in English, from 1/1/2013–7/12/2024 that reported MenB-4C vaccine effectiveness estimates against gonorrhea and gonorrhea/chlamydia co-infection, and the duration of MenB-4C vaccine-induced protection. We estimated pooled MenB-4C vaccine effectiveness (≥1 dose) against gonorrhea using the DerSimonian-Laird random effects model.
Results: Eight papers met our eligibility criteria. Receipt of ≥1 dose of MenB-4C vaccine was
23%–47% effective against gonorrhea. Two doses of MenB-4C vaccine were 33–40% effective
against gonorrhea and one dose of MenB-4C vaccine was 26% effective. MenB-4C vaccine
effectiveness against gonorrhea/chlamydia co-infection was mixed with two studies reporting
effectiveness estimates of 32% and 44%, and two other studies showing no protective effect.
MenB-4C vaccine effectiveness against gonorrhea was comparable in people living with HIV
(44%) and people not living with HIV (23%–47%). Pooled MenB-4C vaccine effectiveness (≥1 dose) against gonorrhea was 32.4%. One study concluded that MenB-4C vaccine effectiveness
against gonorrhea may wane approximately 36 months post-vaccination.
Conclusion: MenB-4C vaccine is moderately effective against gonorrhea in various populations.
Prospective clinical trials that assess the efficacy of MenB-4C against gonorrhea,
gonorrhea/chlamydia co-infection, and duration of protection are warranted to strengthen this
evidence.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • General HIV+ population
  • General HIV- population
• Prevention, Engagement and Care Cascade
  • Prevention
• Prevention
  • Biomedical interventions
• Co-infections
  • Chlamydia
  • Gonorrhea