Evaluating cross-protection: Meningococcal vaccines show effectiveness in gonorrhoea prevention – A systematic review and meta-analysis

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-05-06 DOI:10.1016/j.vaccine.2025.127188

I. Szondy , K. Lőrincz , A. Walter , A.A. Mohammed , P. Hegyi , N. Kiss , F.A. Meznerics , A. Bánvölgyi

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Abstract

Background

Gonorrhoea remains a significant global health concern, with men who have sex with men (MSM) being disproportionately affected. Recent evidence suggests that outer membrane vesicle (OMV) meningococcal vaccines, such as the most widely used 4CMenB vaccine, may provide cross-protection against gonorrhoea.

Objectives

We aimed to evaluate the effectiveness of OMV vaccines against gonorrhoea through a systematic review and meta-analysis.

Methods

PubMed, Embase, and CENTRAL were searched from inception to 10 July 2024. Original articles were included if they investigated gonorrhoea incidence among recipients of OMV vaccines. Our primary endpoint was the incidence of gonorrhoea among vaccinated and unvaccinated individuals. The risk of bias was assessed using ROBINS-I, and the RoB-2 tools. A random-effects model with a 95 % confidence interval (CI) was applied to estimate pooled effect sizes. The study was registered on PROSPERO, CRD42024530848.

Results

We identified 12 eligible studies for qualitative analysis. Six retrospective studies and one prospective study were included in the quantitative analysis, of which six investigated the 4CMenB OMV vaccine. The pooled analysis yielded a vaccine effectiveness (VE) of 38 % [95 % CI:22 %–50 %; I² = 55 %]. Including only the 4CMenB vaccine, VE was 41 % (OR = 0.59; 95 % CI:0.46–0.76; I² = 44 %). Complete vaccination might offer 24 % greater protection compared to partial vaccination (OR = 0.76; 95 % CI:0.31–1.85; I² = 86 %). VE declined in 2–3 years post-vaccination. Four studies were rated as low risk, four as moderate risk, and four as having serious risk of bias. The certainty of the evidence was graded as moderate. The main limitations include the retrospective nature and the high heterogeneity of the included studies.

Conclusions

OMV vaccines offer moderate protection against gonorrhoea. 4CMenB OMV vaccine should be prioritised for sexually active individuals over non-OMV alternatives, with emphasis on completing the full vaccination series. Consideration should be given to administering 4CMenB to high-risk MSM groups specifically for gonorrhoea prevention.

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评估交叉保护：脑膜炎球菌疫苗显示淋病预防的有效性——系统回顾和荟萃分析

淋病仍然是一个重要的全球健康问题，男男性行为者（MSM）受到的影响不成比例。最近的证据表明，外膜囊泡（OMV）脑膜炎球菌疫苗，如最广泛使用的4CMenB疫苗，可能提供对淋病的交叉保护。目的：通过系统回顾和荟萃分析，评估OMV疫苗对淋病的有效性。方法检索spubmed、Embase和CENTRAL数据库，检索时间为建站至2024年7月10日。如果原创文章调查了OMV疫苗接种者的淋病发病率，则纳入其中。我们的主要终点是接种疫苗和未接种疫苗的个体中淋病的发病率。使用robins - 1和robins -2工具评估偏倚风险。采用95%置信区间（CI）的随机效应模型估计合并效应大小。该研究已在PROSPERO注册，CRD42024530848。结果我们确定了12项合格的研究进行定性分析。定量分析包括6项回顾性研究和1项前瞻性研究，其中6项研究调查了4CMenB OMV疫苗。合并分析得出疫苗有效性（VE）为38% [95% CI: 22% - 50%；[2 = 55%]。仅包括4CMenB疫苗，VE为41% (OR = 0.59；95% ci: 0.46-0.76；i2 = 44%)。与部分疫苗接种相比，完全疫苗接种可能提供24%的保护(OR = 0.76；95% ci: 0.31-1.85；i2 = 86%)。疫苗接种后2-3年内VE下降。四项研究被评为低风险，四项为中度风险，四项为严重偏倚风险。证据的确定性被评为中等。主要的限制包括回顾性和纳入研究的高度异质性。结论somv疫苗对淋病具有中等保护作用。4CMenB OMV疫苗应优先用于性活跃个体，而不是非OMV替代品，重点是完成完整的疫苗接种系列。应考虑给高危男男性接触者注射4CMenB，以预防淋病。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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