Meningococcal serogroup B strain coverage of the multicomponent 4CMenB vaccine with corresponding regional distribution and clinical characteristics in England, Wales, and Northern Ireland, 2007–08 and 2014–15: a qualitative and quantitative assessment

Abstract

Public Health England, GlaxoSmithKline.

Frequent capsule switching in ‘ultra-virulent’ meningococci – Are we ready for a serogroup B ST-11 complex outbreak?

“…The Meningococcal Antigen Typing System (MATS) is an ELISA that collectively measures both of these qualities to predict strain coverage afforded by the 4CMenB vaccine 18 . Large scale studies incorporating MATS are contributing to our knowledge of potential 4CMenB coverage by virtue of specific peptide variants of the individual vaccine antigens within the study populations 19, 20…”

Characterisation of carried and invasive Neisseria meningitidis isolates in Shanghai, China from 1950 to 2016: implications for serogroup B vaccine implementation

“…Two protein-based MenB substitute vaccines were licensed and implemented in vaccination interventions in Europe and the USA [10, 11]. The coverage of MenB isolates by Bexsero® in the UK during 2014/15 was predicted to be 60.8% using BAST [14], and 66% by MATS [33]. For Trumenba®, coverage rates of 78-100% to collections of diverse strains in Europe and the USA was estimated using serum bactericidal assay [20-23].…”

“…Chinese cc41/44 isolates mainly harboured fHbp peptide 19 (71.4%) and PorA-VR2 variant 25 (33.3%), while European cc41/44 meningococci mostly include fHbp peptide 1 and PorA-VR2 variant 4 [35], part of the Bexsero® vaccine. Therefore, the likely impact of Bexsero® on Chinese cc32 (4.3%) and cc41/44 (42.9%) was lower than in Europe (93-100%) [33]. Alternative approaches include an OMV-based vaccine specific for MenB cc4821, and the characterisation of ST and antigen data, especially PorA variants, reported here will be invaluable in assessing vaccine coverage and future serogroup B-substitute vaccine development in China.…”

Potential benefits of using a multicomponent vaccine for prevention of serogroup B meningococcal disease

“…However, this may vary over time and by geographic region. In the UK for example, the percentage of isolates harboring a functional NadA gene increased from 5.8% in 2007-2008 to 8.0% in 2014-2015 (Parikh et al, 2017). Among the six variants identified, NadA1, NadA2, and NadA3 have been found to be highly immunogenic and to elicit cross-reactive antibodies with serum bactericidal activity Comanducci et al, 2002Comanducci et al, 2002.…”

“…MATS-based estimates of 4CMenB coverage range from 68% to 89% in European countries and from 66% to 91% in Australia, Canada, Brazil, and the USA (Abad et al, 2016;Medini et al, 2015;Parikh et al, 2017;Rajam et al, 2017;Simoes et al, 2017;Tzanakaki et al, 2014;Vogel et al, 2013;Wasko et al, 2016), with an overall estimated coverage of 81% calculated for a sample size of 3912 invasive MenB strains, collected from 17 different countries (Muzzi et al, 2019). Antibodies induced by the NHBA and fHbp components of 4CMenB have been consistently observed to make the highest contribution to coverage.…”