Meningitis Jab may be cost effective to fight gonorrhea | Imperial News

Meningococcal vaccines may be cost-effective to combat gonorrhea as cases increase worldwide and resistance to drug treatment increases.

This is the discovery of a new modeling study published in. Lancet infection A journal investigating the cost-effectiveness of using a meningitis B (called “Bexero”) vaccine to protect against gonorrhea.

Gonorrhea is a sexually transmitted disease (STI) caused by bacteria and can lead to serious health if left untreated. The World Health Organization has designated gonorrhea as a public health priority, raising concerns about increasing numbers of cases worldwide, increasing bacterial resistance to drug treatments, and potentially incurable gonorrhea. increase.

Currently, there is no approved vaccine for gonorrhea.
Previously, New Zealand researchers have shown that vaccines used to prevent meningitis provide some protection against gonorrhea, and similar Xelo vaccines were expected to be more protective. rice field.

Cost-effectiveness measurement

The question for public health decision makers is whether Bexsero provides sufficient protection against gonorrhea for use in a cost-effective manner.

This imperial modeling study is the first cost-effectiveness analysis of vaccines against gonorrhea to explain the impact of vaccination on future infections and diagnoses. Researchers have considered the cost of vaccination, the cost savings of reducing testing and treatment for gonorrhea infections, and the value of improving health by avoiding the disease. They found that vaccination not only saves overall money, but can also benefit health.

In the analysis, researchers considered men (MSMs) having sex with men, a major internationally affected group. In the United Kingdom, the incidence of infection is highest, accounting for almost half of the diagnosed cases, and the risk of taking the drug is the highest. Resistant infection.

When existing meningitis vaccines are targeted at risk groups, not only can they have a significant impact on the epidemic of gonorrhea in men who have sex with men, but they can also save NHS costs. Dr. Lilith Whittles Faculty of Public Health

Modeling has shown that it is cost effective to use Bexsero to protect MSM from gonorrhea in order to maximize its effectiveness per dose when delivered to people at high risk of infection.

Providing vaccinations to all MSMs in the UK who attend sexually transmitted disease clinics for STI testing is costly and cost effective as it can achieve similar health benefits while actually saving money. It was not considered a high approach.

Providing a vaccine to people with a confirmed gonorrhea diagnosis (statistically at high risk of re-infection in the future) is cost-effective, prevents more than 43,900 cases, and saves more than £ 2.2 million in 10 years. ..

Risk-based

Providing vaccinations based on future risk of infection (patients diagnosed with gonorrhea and those who reported multiple sexual partners) prevented more cases (more than 110,200) and more money (790) Save over £ 10,000). However, this approach requires patients to be asked about sexual behavior, which can be difficult to implement if they do not want to disclose it.

Efforts are underway to produce vaccines, especially for protection from gonorrhea, and an important additional finding is that improving efficacy increases the value of the vaccine rather than improving the duration of protection. ..

Professor Peter WhiteAt Imperial College London, said: Therefore, it can be difficult to do in practice, so it is recommended that a sexual health clinic conduct a feasibility study. If this approach cannot be practiced, a diagnosis of gonorrhea is an indicator of the risk of future infection, so an alternative practical approach is to provide vaccination for all gonorrhea-positive MSM tests. “

Dr. Lilith Whittles Imperial College London said: “If existing meningitis vaccines are targeted at risk groups, they will not only have a significant impact on the epidemic of gonorrhea in men who have sex with men, but will also save NHS costs. To inform the person, current vaccine protection is likely to be relatively short-lived, which means that repeated booster immunization is required, but improving efficacy is more of a vaccine than improving protection. It turns out that the value of is increased.

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Lilith Whittles et al’s “Public Health Impacts and Cost-Effectiveness of Gonorrhea Vaccination: Integrated Communication-Dynamic Health-Economic Modeling Analysis” Lancet infection..

Note:

Cases increased in the United Kingdom for over a decade, peaked at 70,000 in 2019, and remained very high despite a decline during the COVID-19 pandemic. In 2020, 80 million new cases of gonorrhea were recorded worldwide.

At the time of the study, there was no estimate of the effectiveness of Vexero for gonorrhea. Therefore, even though Vexero® was expected to be more protective, the study hypothesized that it was as protective as the previous MeNZB vaccine (ie 31%). .. This study also considered scenarios where protection was superior to protection up to 2.5 times that of MeNZB. Abara et al. Published the first estimate of Bexsero efficacy in the same issue of Lancet Infectious Diseases and reported that it was 40%, which was within the range considered in the modeling analysis.

In addition, the duration of protection against gonorrhea provided by Vexero is unknown, so this study was cautious and was expected to last 18 months after the primary vaccination and 36 months after the booster vaccination. This is the estimated period during which Vexero protects the baby from meningitis. B. Other evidence suggests that adult protection can last for 4, 7.5 years, or longer, so the modeling also considered these potentially longer protection periods.

Estimates in two targeting scenarios: (i) 110,000 avoidances and £ 7.9m savings, or (ii) 43,900 avoidances and £ 2m savings over 10 years, are 31% lasting 18 months after primary. We use a careful quote of protection. 36 months after vaccination and booster immunization vaccine. Greater effects, and / or longer protection periods, as estimated by Abara and his colleagues, mean more cases are avoided and more money is saved.