A Gonococcal Vaccine Has the Potential to Rapidly Reduce the Incidence of Neisseria gonorrhoeae Infection Among Urban Men Who Have Sex With Men

Abstract

Background A gonococcal vaccine is urgently needed due to increasing gonorrhoea incidence and emerging multidrug-resistant gonococcal strains worldwide. Men who have sex with men (MSM) have among the highest incidences of gonorrhoea and may be a key target population for vaccination when available. Methods An individual-based, anatomical site-specific mathematical model was used to simulate Neisseria gonorrhoeae transmission in a population of 10,000 MSM. The impact of vaccination on gonorrhoea prevalence was assessed. Results With a gonococcal vaccine of 100% or 50% protective efficacy, gonorrhoea prevalence could be reduced by 94% or 62%, respectively, within 2 years if 30% of MSM are vaccinated on presentation for STI testing. Elimination of gonorrhoea is possible within 8 years with vaccines of ≥50% efficacy over 2 years, providing a booster vaccination is available every 3 years on average. A vaccine's impact may be reduced if it is not effective at all anatomical sites. Conclusions Our study indicates that with a vaccine of modest efficacy and an immunisation strategy that targets MSM presenting for STI screening, the prevalence of gonorrhoea in this population could be rapidly and substantially reduced.

Engagement With HIV and COVID-19 Prevention: Nationwide Cross-sectional Analysis of Users on a Geosocial Networking App

“…However, our study may be underpowered to detect these differences. If high rates of vaccine acceptability or uptake can indeed be confirmed in this population, it may provide supportive data to advocate for vaccine-based STI prevention strategies, such as the ongoing MAGI trial leveraging the serogroup B meningococcal vaccine as a potential Neisseria gonorrhoeae vaccine (ClinicalTrials.gov NCT04350138) [ 59 , 60 ]. Our data provide further evidence that once structural barriers are decreased, public health interventions may be well received among users of GSN apps.…”

Gonococcal Vaccines for Controlling Neisseria gonorrhoeae in Men Who Have Sex With Men: A Promising Game Changer

“…In this issue of The Journal of Infectious Diseases , Hui et al [ 7 ] present the results from a mathematical modelling study estimating the impact of a vaccination program against N. gonorrhoeae , across multiple anatomical sites, in a hypothetical population of 10 000 men who have sex with men (MSM) in Australia. They estimate gonorrhea prevalence could be reduced by 62% within 2 years if a vaccine had 50% efficacy against infection and there is 30% uptake of vaccination in MSM when they present for STI testing.…”

“…The authors also highlight the importance of boosters for maintaining control, due to the likely relatively short duration of vaccine-induced protection. Hui et al [ 7 ] suggest elimination may be possible within 8 years with vaccines of ≥ 50% efficacy and booster doses given on average every 3 years.…”

“…Gonorrhea rates in MSM are high, so this group presents an obvious target for vaccination; in European Union/European Economic Area (EEA) countries in 2019, 42% of reported gonorrhea cases were in MSM [ 8 ]. The work by Hui et al [ 7 ] adds to modelling evidence from England that vaccinating MSM, even with a partially protective vaccine, could have a considerable impact on gonorrhea incidence [ 9 ]. Going further, the suggested prospect of elimination of gonorrhea among the MSM community within a decade is enticing.…”

“…Going further, the suggested prospect of elimination of gonorrhea among the MSM community within a decade is enticing. However, the work of Hui et al [ 7 ] may be overly optimistic because it is highly dependent on vaccine uptake. The model is set up for a site with very high levels of health contact for MSM globally, assuming 80% of MSM are tested for STIs each year with 30% of them choosing to be vaccinated at each presentation.…”