Public health perspective of a pentavalent meningococcal vaccine combining antigens of MenACWY-CRM and 4CMenB

Bekkat-Berkani, Rafik; Fragapane, Elena; Preiss, Scott; Rappuoli, Rino; Sohn, Woo-Yun; Soumahoro, Lamine; Vadivelu, Kumaran

doi:10.1016/j.jinf.2022.09.001

Cited by 11 publications

(6 citation statements)

References 76 publications

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“…Both 4CMenB and MenB-FHbp are components of pentavalent MenABCWY meningococcal vaccines under development [ 146 , 147 ] . While clinical studies evaluate immunogenicity and safety in younger adults (up to 25 years), these are reported as pooled data incorporating data from adolescents [ 148 , 149 ].…”

Section: Menb Vaccinesmentioning

confidence: 99%

Meningococcal B Immunisation in Adults and Potential Broader Immunisation Strategies: A Narrative Review

et al. 2023

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Recombinant vaccines against invasive meningococcal disease due to Neisseria meningitidis serogroup B (MenB) have shown substantial impact in reducing MenB disease in targeted populations. 4CMenB targets four key N. meningitidis protein antigens; human factor H binding protein (fHbp), Neisserial heparin binding antigen (NHBA), Neisseria adhesin A (NadA) and the porin A protein (PorA P1.4), with one or more of these expressed by most pathogenic MenB strains, while MenB-FHbp targets two distinct fHbp variants. While many countries recommend MenB immunisation in adults considered at high risk due to underlying medical conditions or immunosuppression, there are no recommendations for routine use in the general adult population. We reviewed the burden of MenB in adults, where, while incidence rates remain low (and far lower than in young children < 5 years of age at greatest risk), a substantial proportion of MenB cases (20% or more) is now observed in the adult population; evident in Europe, Australia, and in the United States. We also reviewed immunogenicity data in adults from clinical studies conducted during MenB vaccine development and subsequent post-licensure studies. A 2-dose schedule of 4CMenB generates hSBA titres ≥ 1:4 towards all four key vaccine target antigens in up to 98–100% of subjects. For MenB-FHbp, a ≥ fourfold rise in hSBA titres against the four primary representative test strains was observed in 70–95% of recipients following a 3-dose schedule. While this suggests potential benefits for MenB immunisation if used in adult populations, data are limited (especially for adults > 50 years) and key aspects relating to duration of protection remain unclear. Although a broader adult MenB immunisation policy could provide greater protection of the adult population, additional data are required to support policy decision-making. Graphical Abstract

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Section: Menb Vaccinesmentioning

confidence: 99%

Meningococcal B Immunisation in Adults and Potential Broader Immunisation Strategies: A Narrative Review

et al. 2023

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“…Additionally, the pentavalent MenABCWY vaccine currently in late-stage development has the potential to provide further public health benefits through broad IMD protection programs encompassing serogroups A, B, C, W, and Y. 74 , 75 …”

Section: Discussionmentioning

confidence: 99%

Safety and immunogenicity of co-administered meningococcal serogroup B (4CMenB) vaccine: A literature review

Abitbol,

Sohn,

Horn

et al. 2023

Human Vaccines & Immunotherapeutics

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The four-component meningococcal serogroup B vaccine (4CMenB) is indicated for the prevention of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup B. Co-administering 4CMenB with other vaccines may improve vaccine uptake provided that the safety and immunogenicity of either are not affected. Published literature on the immunogenicity and reactogenicity of 4CMenB co-administered with other routine childhood and adulthood vaccines was reviewed. From 282 publications identified, data were collated from 10 clinical studies, 3 real-world studies, and 3 reviews. The evidence showed that 4CMenB co-administration is not associated with significant safety concerns or clinically relevant immunological interferences. The increased reactogenicity (e.g., fever) associated with 4CMenB co-administration can be adequately managed with prophylactic paracetamol in children. Thus, 4CMenB co-administration has the potential to maximize vaccine coverage and improve protection against IMD globally.

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“…Indeed, currently only monovalent vaccines against this serogroup ( Bexsero ® , GSK, and Trumenba ® , Pfizer) are licensed, not allowing a direct comparison to MenACWY. However, it is worth mentioning that a pentavalent MenABCWY vaccine is currently under development, which is expected to simplify and improve vaccinations programmes wordwide [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Quadrivalent Conjugate Meningococcal Vaccines: A Systematic Review and Meta-Analysis

et al. 2023

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Over the last decades, different quadrivalent antimeningococcal vaccine formulations (diphteria toxoid conjugate, MenACWY-D; tetanus toxoid conjugate, MenACWY-TT; CRM197 protein conjugate, MenACWY-CRM) have been developed. However, their availability varies, both in terms of authorized formulations and of inclusion in vaccination schedules. Furthermore, several countries include only the monovalent meningococcal C (MenC) vaccine in their immunization programmes. Finally, there is currently no updated systematic review that directly compares the MenACWY formulations. Thus, we summarized the evidence on efficacy and safety through four parallel, independent systematic literature reviews with meta-analysis which included randomized controlled trials comparing the abovementioned vaccines. A total of 16 studies have been included. In terms of efficacy, MenACWY-TT outperformed MenACWY-D and MenACWY-CRM for A, W-135, and Y serogroups, while no significant difference was found for serogroup C. Furthermore, we did not find significant differences in efficacy between MenC and MenACWY-TT. Regarding the safety, we were able to perform a quantitative analysis only between MenACWY-TT and MenC, finding no significant differences. Similarly, among the different MenACWY formulations no relevant differences were identified. These findings suggest that MenACWY-TT could be preferable to other formulations to improve current vaccination programs and to better develop future immunization policies.

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Public health perspective of a pentavalent meningococcal vaccine combining antigens of MenACWY-CRM and 4CMenB

Cited by 11 publications

References 76 publications

Meningococcal B Immunisation in Adults and Potential Broader Immunisation Strategies: A Narrative Review

Meningococcal B Immunisation in Adults and Potential Broader Immunisation Strategies: A Narrative Review

Safety and immunogenicity of co-administered meningococcal serogroup B (4CMenB) vaccine: A literature review

Efficacy and Safety of Quadrivalent Conjugate Meningococcal Vaccines: A Systematic Review and Meta-Analysis

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