Drug-Resistant "Super Gonorrhea" Could Be Protected Against With Existing Meningitis Vaccine

The fight against “super gonorrhea” just gained an unlikely hero: a meningitis vaccine. Three peer-reviewed research papers have found that a pre-existing vaccine affords some protection against gonorrhea infection, something the world could do with in the face of rising cases and increasing drug resistance.

Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae. Not everyone with gonorrhea displays symptoms and diagnosed cases can be treated with antibiotics. However, in recent years gonorrhea “superbugs” have been detected which are resistant to traditional drug therapies.

Slowing the spread of this “super gonorrhea” is, therefore, a high priority as once it’s out it can be harder than previous strains to reign back in again. Now, three papers published in The Lancet Infectious Diseases journal have found that an existing vaccine may be able to lend a helping hand – one that’s usually deployed to prevent meningitis infection.

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Two doses of the 4CMenB vaccine were found to provide 40 percent protection against gonorrhea infection among 16 to 23-year-olds in a study based on health records of New York City residents. It was led by researchers from the US Centers for Disease Control and Prevention (CDC), the Philadelphia Department of Public Health, and New York City Department of Health and Mental Hygiene.

“Our findings suggest that meningitis vaccines that are even only moderately effective at protecting against gonorrhoea could have a major impact on prevention and control of the disease,” said Dr Winston Abara in a statement, who led the CDC study.

“Clinical trials focused on the use of 4CMenB against gonorrhoea are needed to better understand its protective effects and could also offer important insights towards the development of a vaccine specifically for gonorrhoea.”

While these findings are limited to a specific age group, a second observational study from South Australia used data from the most extensive 4CMenB vaccination program in the world, with participants’ ages ranging from infant to young adult. This research indicated that two doses of the 4CMenB vaccine gave adolescents and young adults 33 percent protection against gonorrhea.

“While recent studies have provided evidence that 4CMenB vaccination is associated with reduced risk of gonorrhoea, the vaccine was only offered to adolescents and young adults for short periods,” said study lead Professor Helen Marshall of the Women’s and Children’s Hospital in Adelaide.

“The unprecedented scale of South Australia’s 4CMenB vaccination programme offers valuable real-world evidence of the vaccine’s effectiveness against meningococcal B meningitis in children and adolescents, and gonorrhoea in adolescents and young people.”

A third paper by researchers from Imperial College London, University of Warwick, and Public Health England carried out a simulation model to effectively carry out a cost-benefit analysis of different vaccination approaches and how they might influence future rates of infection.

It looked at rates of gonorrhea among men who have sex with men (MSM) in England and simulated three vaccination models: vaccination of all men attending sexual health clinics; vaccination after a gonorrhea diagnosis; or vaccination-based on infection risk. Their results showed that selectively vaccinating MSM at the highest risk of gonorrhea infection could prevent around 110,000 cases, saving around £8 million over 10 years.

“With a gonorrhoea-specific vaccine likely to take years to develop, a key question for policymakers is whether the meningitis vaccine 4CMenB should be used against gonorrhoea infection,” said lead researcher Professor Peter White. “Our analysis suggests that giving the vaccine to those at the greatest risk of infection is the most cost-effective way to avert large numbers of cases.”

Gonorrhea can cause serious health problems including an increased risk of HIV and infertility, and can be passed on to newborn babies. In the face of rising cases, fears are mounting over the possibility that increased transmission could lead to increased drug resistance, possibly even resulting in untreatable cases of gonorrhea.

While all three papers aren’t without limitations, the collective results appear to demonstrate that effective deployment of the 4CMenB vaccine could have benefits both in the face of drug-resistant strains of gonorrhea as well as preventing deadly meningitis infections.

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