Meningitis vaccine could offer cost-effective treatment for gonorrhea

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A vaccine used against meningitis B could be a cost-effective way to treat gonorrhea, according to a new study.

Researchers at Imperial College London have found that offering the Bexsero vaccine to people with a confirmed diagnosis of gonorrhea, and who are therefore at greater risk of infection, would prevent more than 43,000 cases and save over £2.2 million over 10 years.

The study, published in The Lancet Infectious Diseases journal, is the first analysis to show that targeted vaccination of groups at high risk of gonorrhea could save money and benefit health.

Gonorrhea is a sexually transmitted disease (STI) caused by bacteria and if left untreated can lead to serious health problems such as pelvic inflammatory disease in women and infertility.

Cases of gonorrhea are increasing worldwide amid increased resistance to drug treatments and a lack of currently approved vaccines to treat the infection. The World Health Organization (WHO) has designated gonorrhea as a public health priority.

Previous studies have shown that meningitis vaccinations may offer protection against gonorrhea, but this is the first to analyze the costs of vaccination, savings from reduced testing and treatment of infections, and the value of health gains resulting from disease prevention.

The researchers looked at high-risk groups. In England, men who have sex with men (MSM) have the highest incidence of infection, accounting for almost half of diagnosed cases. They are also most at risk of getting a drug-resistant infection.

By modeling the cost-benefit ratio per dose of vaccine administered, the researchers determined that offering the vaccine to people in the high-risk group with a confirmed diagnosis of gonorrhea would be the most cost-effective solution and would prevent more than 43,900 cases.

Dr Lilith Whittles, from the Imperial College School of Public Health, said: ‘If existing meningitis vaccines were targeted at risk groups, they would not only have a big impact on the gonorrhea epidemic in men who have sex with men, but could also reduce costs for the NHS.

Offering gonorrhea vaccination to all MSM in England attending sexual health clinics would have the fastest and most significant health impact, researchers say, preventing more than 110,000 cases, but this solution is less profitable because it requires a large quantity of vaccines.

Alternatively, vaccination based on future risk of infection could also be offered and was the most cost effective but might be the most difficult to implement. This group would include those diagnosed with gonorrhea and those reporting a high number of sexual partners. Researchers suggest vaccination could prevent more than 110,200 cases and save more than £7.9 million.

Professor Peter White of Imperial College London said: ‘We have found that the most cost-effective approach is to offer vaccination to men who have sex with men who are most at risk, but this requires asking questions about sexual behavior which might be sensitive for some people and therefore might be difficult to do in practice.

He added: “If we cannot put this approach into practice, an alternative pragmatic approach is to offer vaccination to all MSM who test positive for gonorrhea, as the diagnosis of gonorrhea is an indicator of risk for future infection. “

A version of this article was first published by Pulse’s sister title, The Pharmacist

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