The next chapter for group B meningococcal vaccines

Abstract

The majority of invasive meningococcal disease (IMD) in the developed world is caused by capsular group B Neisseria meningitidis, however success with vaccination against organisms bearing this capsule has previously been restricted to control of geographically limited clonal outbreaks. As we enter a new era, with the first routine program underway to control endemic group B meningococcal disease for infants in the UK, it is timely to review the key landmarks in group B vaccine development, and discuss the issues determining whether control of endemic group B disease will be achieved. Evidence of a reduction in carriage acquisition of invasive group B meningococcal strains, after vaccination among adolescents, is imperative if routine immunization is to drive population control of disease beyond those who are vaccinated (i.e. through herd immunity). The need for multiple doses to generate a sufficiently protective response and reactogenicity remain significant problems with the new generation of vaccines. Despite these limitations, early data from the UK indicate that new group B meningococcal vaccines have the potential to have a major impact on meningococcal disease, and to provide new insight into how we might do better in the future.

Keywords:

• Neisseria meningitidis
• meningococcal disease
• outer membrane vesicle
• recombinant protein
• factor H binding protein

Acknowledgements

Some figures in this manuscript were produced using components from Servier Medical Art with permission, for which the authors would like to acknowledge Servier. Available from: http://www.servier.com/Powerpoint-image-bank.

Disclosure statement

A.J. Pollard has previously conducted clinical trials of vaccines on behalf of Oxford University funded by meningococcal vaccine manufacturers but does not receive any personal payments from them. His department received unrestricted educational grants from Pfizer/GSK/AstraZeneca in July 2016 for a course on Infection and Immunity in Children.

A.J. Pollard is chair of the UK Department of Health’s (DH) Joint Committee on Vaccination and Immunisation (JCVI), and a member of WHOs SAGE, but the views expressed in this manuscript do not necessarily represent the views of JCVI or DH or WHO.

Additional information

Funding

A.J. Pollard is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, a partnership between Oxford University Hospitals NHS Foundation Trust, and the University of Oxford.