Meningitis B Vaccine Shows Disappointing Immune Response

Jennifer G. Allen
Published Online: Thursday, July 28th, 2016
The protection and immunity rate for serogroup B meningococcal vaccine Bexsero (4CMenB) may be lower than expected, recent research results suggest.
The study, which was published in the July 2016 issue of New England Journal of Medicine, investigated the 2013 meningitis B (MenB) outbreak at Princeton University and found that 34% of students vaccinated with 2 doses of Bexsero didn’t develop antibodies and therefore weren’t immune to MenB.
Although rates of meningococcal disease in the United States have been declining since the late 1990s, college students are among those at greatest risk because of their close living conditions and potentially risky behaviors.
From March 2013 to March 2014, the Princeton campus experienced 9 cases of MenB, including one that became fatal. With special FDA approval, all 6000 Princeton students were eligible to receive the Bexsero vaccine to protect them from the outbreak. Of those students, 89% received at least the first dose within 2 months.
Researchers collected blood samples from 499 students who had received both doses. Of that cohort, just 66% showed bactericidal activity against the strain of MenB that infected students on campus—although none of those students actually contracted MenB.
“This level of seropositivity was lower than expected, given the antigenic similarity between the outbreak strain and the components of the vaccine and given that the Meningococcal Antigen Typing System predicted that 4CMenB would induce responses against the outbreak strain,” the authors wrote.
At the time, Bexsero was only approved for use in Canada and Europe. The FDA approved the product for use in the United States in January 2015.
Prior to this special approval, the only other MenB vaccine approved by the FDA was a 3-dose vaccine called Trumenba. All other meningitis vaccines licensed in the United States protect against more common strains of meningococcus: groups A, C, W, and Y.
“We had the unique opportunity to test the vaccine before licensure in US,” said Nicole Basta, PhD, MPhil, assistant professor of epidemiology and community health at the University of Minnesota. “All students who were tested had an immune response to at least one strain contained in the vaccine, but one-third didn't have any response to the outbreak strain.”
For now, the CDC’s Advisory Committee on Immunization Practices recommendations state that a MenB vaccine may be administered to adolescents and young adults 16 to 23 years to provide short-term protection against most strains of serogroup B meningococcal disease.
“For a relatively uncommon but devastating infectious disease, the regulatory approval of a vaccine in the absence of ideal data may be necessary and appropriate if the vaccine is deployed in the context of a systematic public health response,” wrote Jerome Kim, MD, in an accompanying editorial.
Even with those small numbers, Dr. Basta said she’d recommend Bexsero to teens and young adults, especially those heading to college. Many states require incoming college students to have a meningitis vaccination prior to arriving on campus, and retail clinicians should promote their clinic as a convenient place to receive needed immunizations.

Current Issue

The Educated Patient

Bethany Rettberg, NPC
Practitioners should get a detailed medical history and conduct a thorough physical to treat sinus infections.
Jennifer L. Hofmann, MS, PA-C
Providing them with advice can improve control of the disease and reduce hospitalizations, morbidity, and unscheduled health care visits.
Emily C. Hayes, PharmD Candidate
Colds, coughs, and a relentless influx of sick patients in retail health clinics keep the health care providers who work there very busy.
Kristen Marjama, DNP, APRN-BC
Although the rate of foot and leg amputation has greatly declined over the past 2 decades, increasing awareness for macrovascular and microvascular complications of diabetes is essential because diabetes is the leading cause of lower-limb amputations in the United States.
$vacMongoViewPlus$ $vAR$
Contemporary Clinic
MJH Associates
American Journal of Managed Care
MD Magazine
Pharmacy Times
Specialty Pharmacy Times
Targeted Oncology
About Us
Contact Us
Terms & Conditions
Pharmacy Healthcare & Communications, LLC
2 Clarke Drive
Suite 100
Cranbury, NJ 08512
P: 609-716-7777
F: 609-257-0701

Copyright Contemporary Clinic 2019
Pharmacy Healthcare & Communications, LLC. All Rights Reserved.