Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: A qualitative and quantitative assessment

Ulrich Vogel, Muhamed Kheir Taha, Julio A. Vazquez, Jamie Findlow, Heike Claus, Paola Stefanelli, Dominique A. Caugant, Paula Kriz, Raquel Abad, Stefania Bambini, Anna Carannante, Ala Eddine Deghmane, Cecilia Fazio, Matthias Frosch, Giacomo Frosi, Stefanie Gilchrist, Marzia M. Giuliani, Eva Hong, Morgan Ledroit, Pietro G. LovaglioJay Lucidarme, Martin Musilek, Alessandro Muzzi, Jan Oksnes, Fabio Rigat, Luca Orlandi, Maria Stella, Danielle Thompson, Mariagrazia Pizza, Rino Rappuoli, Davide Serruto, Maurizio Comanducci, Giuseppe Boccadifuoco, John J. Donnelly, Duccio Medini, Raymond Borrow*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    267 Citations (Scopus)

    Abstract

    Background: A novel multicomponent vaccine against meningococcal capsular group B (MenB) disease contains four major components: factor-H-binding protein, neisserial heparin binding antigen, neisserial adhesin A, and outer-membrane vesicles derived from the strain NZ98/254. Because the public health effect of the vaccine, 4CMenB (Novartis Vaccines and Diagnostics, Siena, Italy), is unclear, we assessed the predicted strain coverage in Europe. Methods: We assessed invasive MenB strains isolated mainly in the most recent full epidemiological year in England and Wales, France, Germany, Italy, and Norway. Meningococcal antigen typing system (MATS) results were linked to multilocus sequence typing and antigen sequence data. To investigate whether generalisation of coverage applied to the rest of Europe, we also assessed isolates from the Czech Republic and Spain. Findings: 1052 strains collected from July, 2007, to June, 2008, were assessed from England and Wales, France, Germany, Italy, and Norway. All MenB strains contained at least one gene encoding a major antigen in the vaccine. MATS predicted that 78% of all MenB strains would be killed by postvaccination sera (95% CI 63-90, range of point estimates 73-87% in individual country panels). Half of all strains and 64% of covered strains could be targeted by bactericidal antibodies against more than one vaccine antigen. Results for the 108 isolates from the Czech Republic and 300 from Spain were consistent with those for the other countries. Interpretation: MATS analysis showed that a multicomponent vaccine could protect against a substantial proportion of invasive MenB strains isolated in Europe. Monitoring of antigen expression, however, will be needed in the future. Funding: Novartis Vaccines and Diagnostics.

    Original languageEnglish
    Pages (from-to)416-425
    Number of pages10
    JournalThe Lancet Infectious Diseases
    Volume13
    Issue number5
    DOIs
    Publication statusPublished - May 2013

    Bibliographical note

    Funding Information:
    UV has acted as a consultant for Novartis, GlaxoSmithKline, and Baxter Biosciences, received travel support from Novartis and has done contract research for Novartis and GlaxoSmithKline on behalf of the University of Würzburg, Germany. M-KT has acted as a consultant for and received travel support from GlaxoSmithKline, Novartis, and Pfizer, and has undertaken contract research on behalf of the Institut Pasteur, Paris, France, for Novartis, Pfizer, and Sanofi Pasteur. JAV has acted as a consultant for and received travel support from GlaxoSmithKline, and Sanofi Pasteur, and has undertaken contract research on behalf of the National Institute of Health Carlos III, Madrid, Spain, for GlaxoSmithKline, Novartis, Pfizer, Merck, and Sanofi Pasteur. JF has acted as a consultant for and received travel support from Baxter Biosciences, GlaxoSmithKline, Novartis, and Pfizer, and has undertaken contract research on behalf of the Health Protection Agency for Baxter Biosciences, GlaxoSmithKline, Novartis, Merck, Pfizer, and Sanofi Pasteur. DAC has acted as a consultant for GlaxoSmithKline, Novartis, Pfizer, and Sanofi Pasteur, and undertaken contract research on behalf of the Norwegian Institute of Public Health, Oslo, Norway, for Novartis and Pfizer. PK has acted as a consultant for Baxter Biosciences, GlaxoSmithKline, Novartis, and Pfizer. SB, GF, MMG, FR, LO, MS, MP, RR, DS, MC, GB, JJD, and DM are employees of Novartis. MF has received travel support from Novartis. PGL has acted as a consultant for Novartis. RB has acted as a consultant for and received travel support from Baxter Biosciences, GlaxoSmithKline, Novartis, Pfizer, and Sanofi Pasteur, and undertaken contract research on behalf of the Health Protection Agency for Baxter Biosciences, GlaxoSmithKline, Novartis, Merck, Pfizer, and Sanofi Pasteur. The other authors declare that they have no conflicts of interest.

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