Vaccination with a multicomponent meningococcal B vaccine in prevention of disease in adolescents and young adults

Abstract

Vaccination programs employing capsular-based meningococcal vaccines have proved successful in a variety of settings globally since first introduced over 40 years ago. Similar successes have been demonstrated using meningococcal vaccines for use against serogroup B (MenB) outbreak strains but the diversity of MenB strains has limited vaccine use outside targeted geographic regions. MenB continues to be a significant cause of outbreaks in adolescents and young adults, as recently demonstrated in university settings in the US (Princeton, New Jersey and Santa Barbara, California) and has the potential for hyperendemic disease levels such as currently experienced in Québec and the United Kingdom. In adolescents, increased endemic disease rates and outbreak potential are likely associated with social behaviors putting individuals at risk for carriage acquisition and may explain regional and temporal variations in epidemiology. A protein-based, multi-component MenB vaccine (4CMenB) is currently licensed for use in 37 countries including EU/EEA countries, Australia, Canada, Chile, Colombia, Uruguay, and the US. In this article we review the most recent clinical trial data with 4CMenB with a focus on adolescents and young adults. The vaccine appears to have an acceptable safety profile and is well-tolerated in adolescents and young adults while providing robust, persistent levels of bactericidal antibodies considered protective for each of the four antigenic components of the vaccine. With the recent availability of this vaccine, health care providers have the first comprehensive opportunity to control meningococcal disease, a highly disruptive public health problem with a disproportionate impact on adolescents and young adults.

Immunogenicity of a Meningococcal B Vaccine during a University Outbreak

“…16,24-27 Our results are similar to those from a clinical trial conducted in Chile among adolescents who had received two doses of 4CMenB, 1 month apart. 16 We also found higher seropositivity for the vaccine reference strains (86.9 to 100%) in a subgroup of participants who had no detectable hSBA titer against the outbreak strain, yet there was only moderate correlation between the hSBA response to the outbreak strain and the response to the 44/76-SL strain and no correlation between the outbreak strain and the 5/99 strain.…”

Randomized Trial of 2 Schedules of Meningococcal B Vaccine in Adolescents and Young Adults, Canada1

“…Limited data have been reported on the immunogenicity of these schedules among students 17-25 years of age (13), and few studies have assessed duration of protection. Shorter dosing schedules can improve compliance and lead to higher vaccine coverage (11). An accelerated dosing schedule for MenB-4C vaccine in a campus setting would reduce the time required to conduct the vaccine campaign and the resources required.…”

“…During MenB outbreaks, MenB-4C has been administered in 2 doses at varying schedules, including 0 and 30 days, 0 and 6-8 weeks, 0 and 2 months, and 0 and 10 weeks (7)(8)(9). However, few controlled studies have investigated the immunogenicity and reactogenicity of MenB-4C in older adolescents and young adults to compare various vaccination schedules (10)(11)(12)(13).…”

Meningococcal B vaccination: real-world experience and future perspectives

“…The most frequent reactions were local as pain at the injection site (86%), while the most common general reaction was malaise (51%); fever occurred between the first and the second day after vaccination in a very low percentage of vaccinated subjects (0.2%). 74 The use of paracetamol (Prophylactic acetaminophen) has been recommended in order to reduce the incidence of post-vaccination fever in children. Acetaminophen, administered at the time of vaccination, followed by two subsequent doses at 4-6 h intervals, reduced the incidence of fever of 51-65% in the seven days following vaccination.…”