T wo meningococcal serogroup B vaccines contain factor H binding protein (FHbp) (1, 2). One of the vaccines, Bexsero (Novartis Vaccines), is licensed in Europe, Australia, and Canada for use in infants, older children, and adults. This vaccine also contains three other antigens capable of eliciting bactericidal antibodies (2) and is referred to as "4CMenB" (four component meningococcal B). The second vaccine, Trumenba (Pfizer), was licensed in the United States on 29 October 2014 for use with the age group from 10 to 25 years. This vaccine contains FHbp (see below).As of October 2014, there were 758 distinct amino acid sequence variants of FHbp, each assigned a unique "peptide" identifier (ID) as designated on a public database (http://pubmlst.org /neisseria/fHbp/). Based on amino acid sequence relatedness, FHbp sequence variants can be subdivided into two subfamilies, A and B (3, 4), or into three variant groups (5). There is general agreement that protection conferred by anti-FHbp antibody is subfamily (3) or variant group (5) specific. There is also general agreement that isolates with very low FHbp expression are resistant to anti-FHbp bactericidal activity and that isolates with relatively high expression are susceptible as long as there is an antigenic match between the FHbp sequence variant expressed by the isolate and that of the vaccine used to raise the antibody (6-8).The Pfizer FHbp vaccine contains two FHbp sequence variants, one from each subfamily. The Novartis 4CMenB vaccine contains only a subfamily B FHbp sequence variant. Antibodies elicited by the three other antigens in 4CMenB provide coverage against the majority of meningococci with subfamily A FHbp sequence variants. To date, defining threshold levels of FHbp expression and/or cross-reactivity that are sufficient for predicting susceptibility of an isolate to anti-FHbp bactericidal activity has largely been done empirically by correlating FHbp expression of isolates from different strain collections with susceptibility to bactericidal activity of serum pools from vaccinated infants or adolescents (9-11).In the present study, we identified four disease-causing serogroup B isolates with relatively high expression of FHbp that were resistant to complement-mediated bactericidal activity of sera from mice immunized with FHbp sequence variants that matched those of the isolates. As described below, two of the four isolates had evidence of human FH-dependent complement evasion independent of FHbp. We report the results of investigations of the basis for the anti-FHbp bactericidal resistance in these two isolates.