Abara Winston E, Modaressi Sharareh, Fireman Bruce, Klein Nicola P, Layefsky Evan, Goddard Kristin, Bernstein Kyle T, Kirkcaldy Robert D, Zerbo Ousseny
Division of STD Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States.
Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, CA, United States.
Vaccine. 2024 Dec 2;42(26):126312. doi: 10.1016/j.vaccine.2024.126312. Epub 2024 Sep 10.
Outer membrane vesicle (OMV) meningococcal serogroup B (MenB) vaccines might be protective against gonorrhea. We evaluated the effectiveness of MenB-4C, an OMV MenB vaccine, against gonorrhea.
We identified gonococcal mono-infections, chlamydial mono-infections, and gonococcal/chlamydial co-infections among persons aged 15-30 years in the electronic health records of Kaiser Permanente Northern California during 2016-2021. We determined MenB-4C vaccination status (vaccinated [≥1 MenB-4C vaccine dose] or unvaccinated [MenB-4C vaccine naïve]) at each infection. We used log-binomial regression with generalized estimating equations to calculate adjusted prevalence ratios (APR) and 95 % confidence intervals (CI) to determine if MenB-4C vaccination was protective against gonococcal mono-infections compared to chlamydial mono-infection. We also evaluated if MenB-4C vaccination was protective against gonococcal/chlamydial co-infections. Because of concerns with small sample size of vaccinated persons, we estimated effects using a limited model (adjusting for race/ethnicity only) and an expanded model (adjusting for additional potential confounders).
Of 68,454 persons, we identified 558 (0.8 %) MenB-4C vaccinated persons and 85,393 infections (13,000 gonococcal mono-infections, 68,008 chlamydial mono-infections, and 4385 gonococcal/chlamydial co-infections). After adjusting for race/ethnicity, MenB-4C vaccination was 23 % protective against gonococcal mono-infection compared to chlamydial mono-infection (APR = 0.77, 95 % CI = 0.64-0.99) in the limited model but not in the expanded model.
MenB-4C vaccination was protective against gonococcal mono-infection, independent of race/ethnicity. This protective effect was not observed when other potential confounders were included in the analysis. Protection against gonococcal/chlamydial co-infection was not observed. Efficacy data from clinical trials are needed.
外膜囊泡（OMV）B群脑膜炎球菌（MenB）疫苗可能对淋病具有保护作用。我们评估了一种OMV MenB疫苗MenB - 4C对淋病的有效性。
我们在2016 - 2021年北加利福尼亚凯撒医疗集团的电子健康记录中，确定了15至30岁人群中的淋病单一感染、衣原体单一感染以及淋病/衣原体混合感染情况。我们确定了每次感染时的MenB - 4C疫苗接种状态（接种过[≥1剂MenB - 4C疫苗]或未接种过[未接种过MenB - 4C疫苗]）。我们使用带有广义估计方程的对数二项回归来计算调整后的患病率比（APR）和95%置信区间（CI），以确定与衣原体单一感染相比，MenB - 4C疫苗接种对淋病单一感染是否具有保护作用。我们还评估了MenB - 4C疫苗接种对淋病/衣原体混合感染是否具有保护作用。由于担心接种疫苗人群的样本量较小，我们使用有限模型（仅调整种族/族裔）和扩展模型（调整其他潜在混杂因素）来估计效果。
在68454人中，我们确定了558名（0.8%）接种过MenB - 4C疫苗的人以及85393次感染（13000次淋病单一感染、68008次衣原体单一感染和4385次淋病/衣原体混合感染）。在有限模型中，调整种族/族裔后，与衣原体单一感染相比，MenB - 4C疫苗接种对淋病单一感染有23%的保护作用（APR = 0.77，95% CI = 0.64 - 0.99），但在扩展模型中未观察到这种保护作用。
MenB - 4C疫苗接种对淋病单一感染具有保护作用，与种族/族裔无关。当分析中纳入其他潜在混杂因素时，未观察到这种保护作用。未观察到对淋病/衣原体混合感染的保护作用。需要来自临床试验的疗效数据。
