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Volume 23, Number 5—May 2017
Research Letter

Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016

Heidi M. SoetersComments to Author , Jill Dinitz-Sklar, Prathit A. Kulkarni, Jessica R. MacNeil, Lucy A. McNamara, Elizabeth Zaremski, How-yi Chang, Eduardo Lujan, Dan Granoff, Melodee Lasky, and Barbara Montana
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (H.M. Soeters, P.A. Kulkarni, J.R. MacNeil, L.A. McNamara, H. Chang); New Jersey Department of Health, Trenton, New Jersey, USA (J. Dinitz-Sklar, P.A. Kulkarni, E. Zaremski, B. Montana); University of California San Francisco Benioff Children’s Hospital, Oakland, California, USA (E. Lujan, D. Granoff); Rutgers University, New Brunswick, New Jersey, USA (M. Lasky)

Main Article


Molecular profile and flow cytometry analysis of the university outbreak strain with reference to MenB vaccine antigens, New Jersey, 2016*

Outbreak strain
MenB-4C vaccine (Bexsero)
MenB-FHbp vaccine (Trumenba)
FHbp A22†/2.19‡ B24†/1.1‡ A05†, B01† The 2 FHbp subfamilies (A and B) are not expected to be cross-reactive. The outbreak strain has a subfamily A FHbp. MenB-FHbp contains FHbp from subfamilies A and B. Although the subfamily A FHbp contained in MenB-FHbp (A05) is not the same peptide allele as that in the outbreak strain (A22), some level of cross-reactivity is expected based on prior testing by the manufacturer (2). However, based on flow cytometry, the strain had relatively low expression of FHbp, which would be expected to decrease susceptibility to anti-FHbp bactericidal activity (4). MenB-4C contains a subfamily B FHbp, which is not expected to provide protection against the outbreak strain FHbp.
Not included
The PorA present in MenB-4C and in the outbreak strain are 2 different PorA variable region sequence types and are not expected to be cross-reactive; therefore, no protection based on PorA is expected for either vaccine.
Not included
The NHba present in MenB-4C and in the outbreak strain are 2 different peptide alleles. The extent of cross-reactivity is not known. By flow cytometry, low binding to the outbreak strain was observed by using antisera against NHba p0002, but it is unclear whether this low binding is attributable to the difference in sequence between p0020 and p0002, low NHba expression in the outbreak strain, or both. Low binding with NHba p0002 antisera is consistent with decreased susceptibility to anti-NHba bactericidal activity in persons vaccinated with MenB-4C, but the correlation between flow cytometric binding and hSBA response has not been established. No protection based on NHba is expected for MenB-FHbp.
NadA Negative 2/3.8 Not included The outbreak strain does not contain NadA; therefore, no protection based on NadA is expected for either vaccine.

*FHbp, factor H binding protein; hSBA, serum bactericidal activity testing using human complement; MenB, serogroup B meningococcal; NadA, Neisserial adhesion A; NHba, Neisserial heparin binding antigen.
†Pfizer classification scheme.
‡GlaxoSmithKline classification scheme.

Main Article

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  2. US Food and Drug Administration. Trumenba US package insert [cited 2016 Nov 18].
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Main Article

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Page updated: April 17, 2017
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