MeNZB

MeNZB
Vaccine description
Target disease group B meningococcus strain
Type Subunit
Clinical data
Routes of
administration		 Injected
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
ChemSpider
  • none
 NYesY (what is this?)  (verify)

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 septicaemia, 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

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

Since its introduction the vaccine has had a dramatic impact on the meningitis epidemic that broke out in 2004.[2] In April 2008 it was announced by the New Zealand Ministry of Health that the MeNZB vaccination programme will be completed by 31 December 2008, and that after this period vaccination would require authorization of a GP. 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.[3] Others speculate that the cost of providing the vaccine is too high for the NZ government to justify. The primary analysis estimated MeNZB to have an effectiveness of 77% after 3 doses and a mean follow-up time of 3.2 years.[4]

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.[5]The vaccine efficiency was calculated to be 31%.[6]

References

  1. ↑ Loring BJ, Turner N, Petousis-Harris H (November 2008). "MeNZB vaccine and epidemic control: when do you stop vaccinating?". Vaccine. 26 (47): 5899–904. PMID 18804134. doi:10.1016/j.vaccine.2008.08.062.
  2. ↑ Holst J, Martin D, Arnold R, et al. (June 2009). "Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis". Vaccine. 27 Suppl 2: B3–12. PMID 19481313. doi:10.1016/j.vaccine.2009.04.071.
  3. ↑ Ministry of Health statement, http://www.health.govt.nz/news-media/media-releases/menzb-vaccine-helped-curb-epidemic
  4. ↑ Meningococcal: New Insights for the Healthcare Professional: 2012 Edition: ScholarlyBrief. ScholarlyEditions. 10 December 2012. pp. 51–. ISBN 978-1-4649-7337-6.
  5. ↑ Gottlieb, Sami L.; Johnston, Christine (2017). "Future prospects for new vaccines against sexually transmitted infections". Curr Opin Infect Dis. 30: 77–86. doi:10.1097/QCO.0000000000000343.
  6. ↑ Petousis-Harris, Helen (2017). "Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study". Lancet. doi:10.1016/S0140-6736(17)31449-6.

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