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MeNZB

MeNZB
Vaccine description
Targetgroup B meningococcus strain
Vaccine typeSubunit
Clinical data
Routes of
administration
Injected
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
CAS Number
ChemSpider
  • none
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MeNZB was a vaccine against a specific strain of group B meningococcus,[1] used to control an epidemic of meningococcal disease in New Zealand. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningococcal disease can cause meningitis and sepsis, resulting in brain damage, failure of various organs, severe skin and soft-tissue damage, and death.

Immunisation with MeNZB requires three doses, administered approximately six weeks apart (except in newborns, who have them in conjunction with their 6-week, 3-month and 5-month injections). People who have been fully immunised may still carry the meningococcus bacteria and may still contract meningococcal disease.

Components

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Each dose is 0.5 ml and contains:

The antigen in MeNZB is prepared from B:4:P1.7b,4 (NZ 98/254 ) N. meningitidis strain, grown in a fermentor. The bacteria are grown in a synthetic culture medium containing sugar, essential amino acids and essential elements such as iron and potassium. The fermentation does not use bovine or porcine products. The cellular outer membranes are extracted with the detergent deoxycholate, which kills the bacteria. Outer membrane vesicles are purified out of the culture medium by ultracentrifugation, stabilised by histidine and then adsorbed to aluminium hydroxide Al(OH)3 as an adjuvant. Purification is achieved by ultrafiltration/diafiltration.

Impact

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Since its introduction in 2004 the vaccine has had a dramatic impact on the meningitis epidemic began in 1991.[2] Between 2004 and 2006 New Zealand offered free MeNZB vaccination to anyone under the age of 20. Routine immunisation for babies and preschoolers continued until June 2008. The last phase of this programme, immunisation for people with a high medical risk, ended in March 2011. [3] Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term.[4] The primary analysis estimated MeNZB to have an effectiveness of 77% after 3 doses and a mean follow-up time of 3.2 years.[5]

As N. gonorrhoeae and N. meningitidis are closely related bacteria and have 80–90% homology in their genetic sequences some cross-protection by meningococcal vaccines against N. gonorrhoeae infections is plausible. A study published in 2017 showed that MeNZB vaccine provided a partial protection against Gonorrhea.[6] The vaccine efficiency was calculated to be 31%.[7]

References

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  1. ^ Loring BJ, Turner N, Petousis-Harris H (November 2008). "MeNZB vaccine and epidemic control: when do you stop vaccinating?". Vaccine. 26 (47): 5899–5904. doi:10.1016/j.vaccine.2008.08.062. PMID 18804134.
  2. ^ Holst J, Martin D, Arnold R, Huergo CC, Oster P, O'Hallahan J, Rosenqvist E (June 2009). "Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis". Vaccine. 27 (Suppl 2): B3–B12. doi:10.1016/j.vaccine.2009.04.071. PMID 19481313.
  3. ^ "Meningococcal vaccines". Ministry of Health website.
  4. ^ Arnold R, Galloway Y, McNicholas A, O'Hallahan J (September 2011). "Effectiveness of a vaccination programme for an epidemic of meningococcal B in New Zealand". Vaccine. 29 (40): 7100–6. doi:10.1016/j.vaccine.2011.06.120. PMID 21803101.
  5. ^ "Vaccines". Meningococcal: New Insights for the Healthcare Professional (2012 ed.). ScholarlyEditions. 10 December 2012. pp. 48–64 (51). ISBN 978-1-4649-7337-6.
  6. ^ Gottlieb SL, Johnston C (February 2017). "Future prospects for new vaccines against sexually transmitted infections". Current Opinion in Infectious Diseases. 30 (1): 77–86. doi:10.1097/QCO.0000000000000343. PMC 5325242. PMID 27922851.
  7. ^ Petousis-Harris H, Paynter J, Morgan J, Saxton P, McArdle B, Goodyear-Smith F, Black S (September 2017). "Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study". Lancet. 390 (10102): 1603–1610. doi:10.1016/S0140-6736(17)31449-6. PMID 28705462. S2CID 4230156.
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