The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
J Infect Dis. 2022 Mar 15;225(6):983-993. doi: 10.1093/infdis/jiab581.
A gonococcal vaccine is urgently needed due to increasing gonorrhea incidence and emerging multidrug-resistant gonococcal strains worldwide. Men who have sex with men (MSM) have among the highest incidences of gonorrhea and may be a key target population for vaccination when available.
An individual-based, anatomical site-specific mathematical model was used to simulate Neisseria gonorrhoeae transmission in a population of 10 000 MSM. The impact of vaccination on gonorrhea prevalence was assessed.
With a gonococcal vaccine of 100% or 50% protective efficacy, gonorrhea prevalence could be reduced by 94% or 62%, respectively, within 2 years if 30% of MSM are vaccinated on presentation for sexually transmitted infection (STI) testing. Elimination of gonorrhea is possible within 8 years with vaccines of ≥ 50% efficacy lasting 2 years, providing a booster vaccination is available every 3 years on average. A vaccine's impact may be reduced if it is not effective at all anatomical sites.
Our study indicates that with a vaccine of modest efficacy and an immunization strategy that targets MSM presenting for STI screening, the prevalence of gonorrhea in this population could be rapidly and substantially reduced.
由于淋病发病率上升和全球出现耐多药淋球菌菌株，急需开发一种淋病疫苗。男男性行为者（MSM）的淋病发病率最高，在疫苗可用时，他们可能是疫苗接种的重点目标人群。
使用基于个体、解剖部位特异性的数学模型来模拟 10000 名 MSM 人群中淋病奈瑟菌的传播。评估了疫苗接种对淋病流行率的影响。
如果 30%的 MSM 在接受性传播感染（STI）检测时接种疫苗，具有 100%或 50%保护效力的淋病疫苗可分别在 2 年内将淋病流行率降低 94%或 62%。如果疫苗效力≥50%且持续 2 年，并且每 3 年平均提供一次加强疫苗接种，则在 8 年内可消除淋病。如果疫苗在所有解剖部位均无效，则其效果可能会降低。
我们的研究表明，对于效力适中的疫苗和针对接受 STI 筛查的 MSM 的免疫接种策略，该人群中的淋病流行率可迅速显著降低。
