Advances with vaccination against Neisseria meningitidis

Abstract

In the last decade, meningococcal serogroup C conjugate vaccination programs have been demonstrated to be hugely successful with a truly impressive public health impact. In sub-Saharan Africa, with the implementation of an affordable serogroup A conjugate vaccine, it is hoped that a similar public health impact will be demonstrated. Challenges still remain in the quest to develop and implement broadly protective vaccines against serogroup B disease. New, broad coverage vaccines against serogroup B are for the first time becoming available although little is known about their antibody persistence, effectiveness or effect on nasopharyngeal carriage. Enhanced surveillance following any potential vaccine introduction against serogroup B needs to be thoroughly implemented. The future now holds a distinct possibility, globally, for substantially decreasing meningococcal disease, regardless of infecting serogroup.

Bivalent rLP2086 Vaccine (Trumenba®): A Review in Active Immunization Against Invasive Meningococcal Group B Disease in Individuals Aged 10–25 Years

“…Vaccines based on detergentextracted outer membrane vesicles (OMVs), containing various cell surface proteins, have been successfully used to control clonal MenB disease outbreaks in several regions of the world [11][12][13]. However, because of the high antigenic diversity of the immunodominant antigen in these vaccines (porin A), OMV vaccines are limited in their ability to provide broad strain coverage, only protecting against strains closely related to the vaccine strain [9,11,12].…”

“…Five of these (A, B, C, W, and Y) are responsible for the vast majority of IMD cases in most parts of the world [2,6,7], with a sixth serogroup (X) having emerged as a substantial cause of meningococcal disease in the meningitis belt of Africa [7,8]. Purified polysaccharide and polysaccharide protein conjugate vaccines have been developed and successfully used in the prevention of disease caused by serogroups A, C, W, and Y [9,10]. However, the development of a vaccine effective against N. meningitidis serogroup B (MenB), responsible for around one-third of IMD cases in the USA (and [75 % of cases in Europe) [1,6], has been more challenging.…”

“…However, the development of a vaccine effective against N. meningitidis serogroup B (MenB), responsible for around one-third of IMD cases in the USA (and [75 % of cases in Europe) [1,6], has been more challenging. The MenB capsular polysaccharide is not considered an appropriate vaccine target because of its structural similarity to components of human neural glycoproteins, making it poorly immunogenic and raising safety concerns about the potential induction of an autoimmune response [9,11].…”

“…An alternative approach to capsular polysaccharide-based vaccines has been to develop vaccines targeting surfaceexposed proteins [9,11,12]. Vaccines based on detergentextracted outer membrane vesicles (OMVs), containing various cell surface proteins, have been successfully used to control clonal MenB disease outbreaks in several regions of the world [11][12][13].…”

A Safety and Immunogenicity Study of a Single Dose of a Meningococcal (Groups A, C, W, and Y) Polysaccharide Diphtheria Toxoid Conjugate Vaccine (MEN-ACWY-D) in Healthy Japanese Participants

“…Prevention with an effective vaccine is therefore important. The quadrivalent meningococcal polysaccharide diphtheria toxoid conjugate vaccine (Men-ACWY-D) has been shown both in clinical trials and during a >10-year period following licensure in the US to be safe and immunogenic, providing durable protection against IMD (3)(4)(5)(6)(7)(8). It was licensed in Japan in July 2014 (9, 10).…”