Wang Bing, Giles Lynne, Andraweera Prabha, McMillan Mark, Beazley Rebecca, Sisnowski Jana, Almond Sara, Mitchell Janine, Lally Noel, Bell Charlotte, Flood Louise, Ward James, Marshall Helen
Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.
Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Open Forum Infect Dis. 2024 Dec 13;12(1):ofae726. doi: 10.1093/ofid/ofae726. eCollection 2025 Jan.
A 4-component meningococcal B (4CMenB) vaccine program was introduced in adolescents in 2019 in South Australia. We aimed to evaluate long-term vaccine effectiveness (VE) and impact (VI) on gonococcal infection 4 years after implementation of the program.
Disease notification data were provided by SA Health. VE was estimated as the reduction in the odds of infection using the screening and case-control methods. Time-to-event analyses assessed vaccine effect on reinfections. VI was estimated as incidence rate ratios (IRRs) using negative binomial regression models.
At 4 years after implementation of the program, 2-dose VE against gonococcal infection was 44.3% (95% CI, 35.1%-52.2%) using chlamydia patients as controls. Lower VE estimates were demonstrated in those >48 months post-4CMenB vaccination (26.2%; 95% CI, -2.6% to 47.0%) compared with those who had been vaccinated within ≤48 months (46.0%; 95% CI, 36.3%-54.2%). Slightly higher VE estimates were observed in females (48.7%; 95% CI, 36.9%-58.2%) compared with males (38.0%; 95% CI, 22.0%-50.7%). The risk of a second episode of gonococcal infection was lower in vaccinated gonococcal cases (adjusted hazard ratio, 0.682; 95% CI, 0.450-1.034). The adjusted IRR was 0.635 (95% CI, 0.421-0.957), with an observed 36.5% reduction in gonococcal infection.
4CMenB demonstrates moderate effectiveness against gonococcal infection, with a lower VE estimate after 4 years postvaccination. 4CMenB may reduce the risk of recurrent gonococcal infection. The requirement for a booster dose and dosing interval warrants evaluation.
2019年，南澳大利亚州针对青少年推行了四价B群脑膜炎球菌（4CMenB）疫苗接种计划。我们旨在评估该计划实施4年后疫苗对淋病感染的长期有效性（VE）和影响（VI）。
疾病通报数据由南澳大利亚州卫生部提供。使用筛查法和病例对照法，将VE估计为感染几率的降低。生存分析评估疫苗对再次感染的效果。使用负二项回归模型将VI估计为发病率比（IRR）。
在该计划实施4年后，以衣原体患者作为对照，2剂疫苗预防淋病感染的VE为44.3%（95%置信区间，35.1%-52.2%）。与在4CMenB疫苗接种后≤48个月内接种的人群（46.0%；95%置信区间，36.3%-54.2%）相比，在4CMenB疫苗接种后>48个月的人群中，VE估计值较低（26.2%；95%置信区间，-2.6%至47.0%）。与男性（38.0%；95%置信区间，22.0%-50.7%）相比，女性的VE估计值略高（48.7%；95%置信区间，36.9%-58.2%）。接种疫苗的淋病病例再次感染淋病的风险较低（调整后的风险比，0.682；95%置信区间，0.450-1.034）。调整后的IRR为0.635（95%置信区间，0.421-0.957），观察到淋病感染减少了36.5%。
4CMenB疫苗对淋病感染显示出中等有效性，接种疫苗4年后VE估计值较低。4CMenB疫苗可能会降低淋病反复感染的风险。加强剂量和给药间隔的要求值得评估。
