Gonorrhea, one of the most common sexually transmitted infections worldwide, can lead to serious sequelae, including infertility and increased HIV transmission.
Recently, untreatable, multidrug-resistant Neisseria gonorrhoeae strains have been reported. In the absence of new antibiotics, and given the speed with which resistance has emerged to all previously used antibiotics, development of a vaccine would be the ideal solution to this public health emergency.
Understanding the desired characteristics, target population, and expected impact of an anti-gonococcal vaccine is essential to facilitate vaccine design, assessment and implementation. The modeling presented herein aims to fill these conceptual gaps, and inform future gonococcal vaccine development.
Using an individual-based, epidemiological simulation model, gonococcal prevalence was simulated in a heterosexual population of 100,000 individuals after the introduction of vaccines with varied efficacy (10–100%) and duration of protection (2.5–20 years). Model simulations predict that gonococcal prevalence could be reduced by at least 90% after 20 years, if all 13-year-olds were given a non-waning vaccine with 50% efficacy, or a vaccine with 100% efficacy that wanes after 7.5 years. A 40% reduction in prevalence is achievable with a non-waning vaccine of only 20% efficacy.
We conclude that a vaccine of moderate efficacy and duration could have a substantive impact on gonococcal prevalence, and disease sequelae, if coverage is high and protection lasts over the highest risk period (i.e., most sexual partner change) among young people.
Below: The prevalence of gonorrhea in the absence of a vaccine, and with (A) vaccines of differing efficacies and 20 years duration of protection, or (B) vaccines with 100% efficacy and of differing durations of protection. Vaccine coverage is 100% of 13-year-olds.
Below: The prevalence of gonorrhea in the absence of a vaccine, and with different rates and types of vaccine coverage. (A) Vaccines have 100% efficacy and 20 years duration. (B) Vaccines have 50% efficacy and 20 years duration.
By: Andrew P. Craig,a Richard T. Gray,a Jennifer L. Edwards,b Michael A. Apicella,c Michael P. Jennings,d David P. Wilson,#a and Kate L. Seib#d,*
a The Kirby Institute, UNSW Australia, Sydney 2052, NSW, Australia
b Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, and The Ohio State University Department of Pediatrics, Columbus, OH, USA
c Department of Microbiology, University of Iowa, Iowa City, IA, USA
d Institute for Glycomics, Griffith University, Southport, QLD, Australia
* Corresponding author. Tel.: +61 755527453; fax: +61 7 5552 8098. Email: email@example.com (K.L. Seib).
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