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| ● Introduction ● Prevention of gonorrhea with meningococcus B vaccine (see) ● Inclusion of chickenpox vaccination in the childhood vaccination program (see) ● Next steps (see) ● More information, bibliographic references and recommended links on this website (see) |
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| ● The JCVI, the UK government’s main vaccination advisory committee, has issued new vaccine recommendations. ● JCVI recommends the use of meningococcal B vaccine (4CmenB) for the prevention of gonorrhea in high-risk population groups. ● JCVI recommends starting universal varicella vaccination with a two-dose schedule at 12 and 18 months of age. ● A decision from the UK Government regarding the JCVI recommendations is awaited. |
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Introduction
He Joint Committee on Vaccination and Immunization (JCVI) is the UK government’s main vaccination advisory committee. It has recently issued innovative recommendations regarding the prevention of gonorrhea with meningococcus B vaccine and the introduction of universal chickenpox vaccination.
Below is a brief overview of these JCVI decisions.
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Preventing Gonorrhea with Meningococcus B Vaccine
On November 10, JCVI published a press release and a report titled “JCVI advice on the use of meningococcal B vaccination for the prevention of gonorrhea(UKDHSC, November 10, 2023).
In the report, after presenting general data on the epidemiology of sexually transmitted infections Neisseria gonorrhoeae (Gonorrhea) and the 4CMenB (Bexsero) vaccine against Meningococcus B, the available data on the effectiveness of said vaccination against gonococcal disease and the economic model of the profitability of said vaccination are described.
After analyzing the data, JCVI concludes by recommending,
- A specific program using the 4CMenB vaccine should be initiated for the prevention of gonorrhea in those at greatest risk of infection.
- This program should be offered opportunistically through specialized sexual health services that have extensive experience in the assessment and identification of people at high risk of bacterial sexually transmitted infections.
- It is important that people who are offered the vaccine (primarily, but not only, men who have sex with men) understand that real-world studies have estimated that the 4CMenB vaccine is 32.7% effective against gonorrhea. Is effective up to 42%. Therefore, although vaccination would be expected to reduce the chance of becoming infected, it would not completely eliminate that possibility. People who have been vaccinated can be expected to have some reduction in the risk of getting gonorrhea; However, the main benefit of the vaccination program is expected to be at the community level, leading to a significant reduction in the overall number of cases.
- Even with modest vaccine efficacy, vaccination is beneficial because prior gonorrhea infection is believed to provide little protection against future infection and therefore reinfection is common.
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Inclusion of chickenpox vaccination in childhood vaccination program
The United Kingdom’s childhood vaccination program does not include vaccination against chickenpox virus. In the rest of Europe (ECDC Vaccine Scheduler): It is included in and funded by the childhood vaccination schedules of: Germany, Finland, Greece, Spain, Iceland and Luxembourg; It is recommended, but only in specific groups: Belgium (not funded), Czechia (not funded) and Poland; It is a mandatory vaccination in: Hungary, Italy and Latvia; Rescue vaccination: Germany, Spain and Greece.
On 14 November the JCVI published a press release and report titled “”.The Joint Committee on Vaccination and Immunization (JCVI) statement sets out its recommendations on a universal varicella (chickenpox) vaccination programme.” (UKDHSC, 14/November 2023) in which they explained and justified their recommendation to include universal chickenpox vaccination in the childhood vaccination programme.
After a brief review of the epidemiology of chickenpox, the JCVI reviews decisions rejecting childhood vaccination against chickenpox in previous years. It believes that the predicted increase in cases of chickenpox and shingles in adults after childhood vaccination, based on the theory of exogenous reinforcement due to exposure to chickenpox in childhood, does not confirm the above risk.
It also reviews its disease burden data, universal vaccination experiences in several countries, where it has been done for almost 20 years, and economic profitability models.
Finally, JCVI recommends,
- Vaccination with triple vaccine (SRP) or quadruple viral vaccine (SRPV) at 12 and 18 months of age. Either of these vaccines in both doses, since it is estimated that the greater risk of febrile seizures with SRPV vaccine in the first dose is not relevant.
- Preventive vaccination in children under 5 years of age and other groups of susceptible people should be scheduled according to the instructions and limitations.
This decision of the JCVI has been the subject of attention from scientific methods (Kimitowicz Z, BMJ 2023) and celebrated by some experts (LSHTM).
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next steps
The JCVI recommendations will be reviewed by UK health authorities, who will ultimately decide if, when and how these measures are put into practice.
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More information on this website
Bibliographic references and recommended links
- ECDC. Vaccine Scheduler.
- Kmietowicz Z. Vaccinate children against chickenpox with MMR, JCVI recommends. BMJ. 2023;383:p2677.
- London School of Hygiene & Tropical Medicine, 15 November 2023. LSHTM experts comment on the recommendation of a universal chickenpox vaccination program by the UK Joint Committee on Vaccination and Immunization (JCVI).
- WHO, July 18, 2023. Key Facts. Gonorrhea (Neisseria gonorrhoeae infection).
- UK Department of Health and Social Care (UKDHSC), 10 November 2023. Independent report. JCVI advice on the use of meningococcal B vaccination for the prevention of gonorrhea.
- UK Health Protection Agency (UKHSA), UK Department of Health and Social Care (UKDHSC), 10 November 2023. Press release. The JCVI gives advice on gonorrhea and mpox vaccination. The Joint Committee on Vaccination and Immunization (JCVI) advises the UK Government on vaccination and immunization matters.
- UK Department of Health and Social Care (UKDHSC), 14 November 2023. Independent report. Childhood varicella vaccination programme: JCVI advice, 14 November 2023. The Joint Committee on Vaccination and Immunization (JCVI) has given its recommendations on a universal varicella (chickenpox) vaccination programme.
- UK Health Protection Agency (UKHSA), 14 November 2023. Press release. The JCVI recommends chickenpox vaccine in the childhood vaccination programme. Childhood varicella (chickenpox) vaccine will be given in 2 doses at 12 and 18 months of age.
- UK Health Protection Agency (UKHSA), 20 October 2023. Guidance. Complete routine vaccination program from 1 September 2023.
Other references on Gonorrhea and its prevention with the 4CmB vaccine
- Abara us, and others, Effectiveness of serogroup B outer membrane vesicle meningococcal vaccine against gonorrhea: a retrospective observational study. Lancet Infect Dis. 2022;22(7):1021-9.
- Bruxvoort KJ, and others, Prevention of Neisseria gonorrhoeae with meningococcal B vaccine: a matched cohort study in southern California. Clin Infect Dis. 2023;76(3):1341-9.
- Kurz S. and others, What to know about gonorrhea. Jama. 2023;330(14):1397.
- watcher kj, and others, Potential public health impact of 4CMenB vaccination of adolescents on Neisseria gonorrhoeae infection in England: a modeling study. BMC Public Health. 2023;23:1.
- The study found that the Mahase E. meningitis vaccine may protect against gonorrhea. BMJ. 2022;377:o997.
- Ong JJ, and others, Is the end near for gonorrhea? Lancet Infect Dis. 2022;22(7):919-21.
- robison sg, and others, Association of receipt of group B meningococcal vaccine with reduced incidence of gonorrhea in university students. Jama network opened. 2023;6(8):e2331742. Comment on CIDRAP, August 31, 2023.
- Wang B. and others, 4CMenB maintained vaccine effectiveness against invasive meningococcal B disease and gonorrhea up to three years after program implementation. J infected. 2023;87(2):95-102.
- Wang B. and others, Efficacy and efficacy of 4CMenB vaccine against invasive serogroup B meningococcal disease and gonorrhea in the infant, child and adolescent program: an observational cohort and case-control study. Lancet Infect Dis. 2022;22(7):1011-20
- white pj, and others, We need estimates of gonorrhea vaccine protection and symptomatology by gender and body site. Lancet Infect Dis. 2022;22(7):937.
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