Volume 23, Number 5—May 2017
Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016
||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.|
||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.
||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.
- US Food and Drug Administration. Bexsero US package insert [cited 2016 Nov 18]. http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM431447.pdf
- US Food and Drug Administration. Trumenba US package insert [cited 2016 Nov 18]. http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM421139.pdf
- MacNeil JR. Considerations for use of 2- and 3-dose schedules of MenB-FHbp (Trumenba®). Presented at: meeting of the Advisory Committee on Immunization Practices; October 16, 2016; Atlanta, GA, USA [cited 2016 Nov 18]. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2016-10/meningococcal-05-macneil.pdf
- Pajon R, Fergus AM, Koeberling O, Caugant DA, Granoff DM. Meningococcal factor H binding proteins in epidemic strains from Africa: implications for vaccine development. PLoS Negl Trop Dis. 2011;5:e1302.
- MacNeil JR, Rubin L, Folaranmi T, Ortega-Sanchez IR, Patel M, Martin SW. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:1171–6.
- Beernink PT, Giuntini S, Costa I, Lucas AH, Granoff DM. Functional analysis of the human antibody response to meningococcal factor H binding protein. MBio. 2015;6:e00842–15.
- Giuntini S, Lujan E, Gibani MM, Dold C, Rollier CS, Pollard AJ, et al. Serum bactericidal antibody responses of adults immunized with the MenB-4C vaccine against genetically diverse serogroup B meningococci. Clin Vaccine Immunol. 2017;24:e00430–16.
- MacNeil JR, Rubin L, McNamara L, Briere EC, Clark TA, Cohn AC; Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC. Use of MenACWY-CRM vaccine in children aged 2 through 23 months at increased risk for meningococcal disease: recommendations of the Advisory Committee on Immunization Practices, 2013. MMWR Morb Mortal Wkly Rep. 2014;63:527–30.
- Borrow R, Balmer P, Miller E. Meningococcal surrogates of protection—serum bactericidal antibody activity. Vaccine. 2005;23:2222–7.