title: Vaccines against meningococcal serogroup B disease containing outer membrane vesicles (OMV): lessons from past programs and implications for the future.
abstract: The utility of wild-type outer membrane vesicle (wtOMV) vaccines against serogroup B (MenB) meningococcal disease has been explored since the 1970s. Public health interventions in Cuba, Norway and New Zealand have demonstrated that these protein-based vaccines can prevent MenB disease. Data from large clinical studies and retrospective statistical analyses in New Zealand give effectiveness estimates of at least 70%. A consistent pattern of moderately reactogenic and safe vaccines has been seen with the use of approximately 60 million doses of three different wtOMV vaccine formulations. The key limitation of conventional wtOMV vaccines is their lack of broad protective activity against the large diversity of MenB strains circulating globally. The public health intervention in New Zealand (between 2004-2008) when MeNZB was used to control a clonal MenB epidemic, provided a number of new insights regarding international and public-private collaboration, vaccine safety surveillance, vaccine effectiveness estimates and communication to the public. The experience with wtOMV vaccines also provide important information for the next generation of MenB vaccines designed to give more comprehensive protection against multiple strains.
authors.affiliation: Division of Infectious Disease Control; Norwegian Institute of Public Health; Oslo, Norway.
authors.forename: Johan
authors.initials: J
authors.lastname: Holst
authors.forename: Philipp
authors.initials: P
authors.lastname: Oster
authors.forename: Richard
authors.initials: R
authors.lastname: Arnold
authors.forename: Michael V
authors.initials: MV
authors.lastname: Tatley
authors.forename: Lisbeth M
authors.initials: LM
authors.lastname: Næss
authors.forename: Ingeborg S
authors.initials: IS
authors.lastname: Aaberge
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Galloway
authors.forename: Anne
authors.initials: A
authors.lastname: McNicholas
authors.forename: Jane
authors.initials: J
authors.lastname: O'Hallahan
authors.forename: Einar
authors.initials: E
authors.lastname: Rosenqvist
authors.forename: Steven
authors.initials: S
authors.lastname: Black
mesh_terms: D055252:Cell-Derived Microparticles / Q000276:immunology*; D003462:Cuba; D006801:Humans; D008589:Meningococcal Infections / Q000382:microbiology* / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology*; D009520:New Zealand; D009664:Norway
chemical_list: D022401:Meningococcal Vaccines
keywords: Neisseria meningitidis; New Zealand MenB outbreak; OMV vaccines; controlling MenB epidemics; meningococcal disease