title: Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: a qualitative and quantitative assessment.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Novartis Vaccines and Diagnostics.
authors: University of Würzburg, Institute for Hygiene and Microbiology, Würzburg, Germany.
authors: Ulrich
authors: U
authors: Vogel
authors: Muhamed-Kheir
authors: MK
authors: Taha
authors: Julio A
authors: JA
authors: Vazquez
authors: Jamie
authors: J
authors: Findlow
authors: Heike
authors: H
authors: Claus
authors: Paola
authors: P
authors: Stefanelli
authors: Dominique A
authors: DA
authors: Caugant
authors: Paula
authors: P
authors: Kriz
authors: Raquel
authors: R
authors: Abad
authors: Stefania
authors: S
authors: Bambini
authors: Anna
authors: A
authors: Carannante
authors: Ala Eddine
authors: AE
authors: Deghmane
authors: Cecilia
authors: C
authors: Fazio
authors: Matthias
authors: M
authors: Frosch
authors: Giacomo
authors: G
authors: Frosi
authors: Stefanie
authors: S
authors: Gilchrist
authors: Marzia M
authors: MM
authors: Giuliani
authors: Eva
authors: E
authors: Hong
authors: Morgan
authors: M
authors: Ledroit
authors: Pietro G
authors: PG
authors: Lovaglio
authors: Jay
authors: J
authors: Lucidarme
authors: Martin
authors: M
authors: Musilek
authors: Alessandro
authors: A
authors: Muzzi
authors: Jan
authors: J
authors: Oksnes
authors: Fabio
authors: F
authors: Rigat
authors: Luca
authors: L
authors: Orlandi
authors: Maria
authors: M
authors: Stella
authors: Danielle
authors: D
authors: Thompson
authors: Mariagrazia
authors: M
authors: Pizza
authors: Rino
authors: R
authors: Rappuoli
authors: Davide
authors: D
authors: Serruto
authors: Maurizio
authors: M
authors: Comanducci
authors: Giuseppe
authors: G
authors: Boccadifuoco
authors: John J
authors: JJ
authors: Donnelly
authors: Duccio
authors: D
authors: Medini
authors: Ray
authors: R
authors: Borrow
mesh_terms: D018829:Adhesins, Bacterial / Q000032:analysis; D000942:Antigens, Bacterial / Q000235:genetics; D015373:Bacterial Typing Techniques / Q000379:methods; D004269:DNA, Bacterial / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005060:Europe / Q000453:epidemiology; D005798:Genes, Bacterial; D005838:Genotype; D005843:Geography; D006801:Humans; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D058885:Multilocus Sequence Typing / Q000379:methods; D038541:Neisseria meningitidis, Serogroup B / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D011159:Population Surveillance / Q000379:methods; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D018829:Adhesins, Bacterial; D000942:Antigens, Bacterial; D004269:DNA, Bacterial; D022401:Meningococcal Vaccines; C501982:NadA protein, Neisseria meningitidis