4CMenB Immunization Induces Serum Bactericidal Antibodies Against Non-Serogroup B Meningococcal Strains in Adolescents

Alessia Biolchi, Sara Tomei, Brunella Brunelli, Maria Giuliani, Stefania Bambini, Raymond Borrow, Heike Claus, Maria Cecilia O. Gorla, Eva Hong, Ana Paula S. Lemos, Jay Lucidarme, Muhamed Kheir Taha, Ulrich Vogel, Sonia Budroni, Marzia M. Giuliani, Rino Rappuoli, Philip Boucher, Mariagrazia Pizza

Research output: Contribution to journalArticlepeer-review


Introduction: Invasive meningococcal disease (IMD) is an important public health concern. In developed countries, most IMD is caused by meningococcal serogroup B (MenB) and two protein-based MenB vaccines are currently available: the four-component vaccine 4CMenB (Bexsero, GSK) and the bivalent vaccine MenB-FHbp (Trumenba, Pfizer). Genes encoding the 4CMenB vaccine antigens are also present in strains belonging to other meningococcal serogroups. Methods: To evaluate the potential of 4CMenB vaccination to protect adolescents against non-MenB IMD, we tested the bactericidal activity of sera from immunized adolescents on 147 (127 European and 20 Brazilian) non-MenB IMD isolates, with a serum bactericidal antibody assay using human complement (hSBA). Serum pools were prepared using samples from randomly selected participants in various clinical trials, pre- and post-vaccination: 12 adolescents who received two doses of 4CMenB 2 months apart, and 10 adolescents who received a single dose of a MenACWY conjugate vaccine (as positive control). Results: 4CMenB pre-immune sera killed 7.5% of the 147 non-MenB isolates at hSBA titers ≥ 1:4. In total, 91 (61.9%) tested isolates were killed by post-dose 2 pooled sera at hSBA titers ≥ 1:4, corresponding to 44/80 (55.0%) MenC, 26/35 (74.3%) MenW, and 21/32 (65.6%) MenY isolates killed. Conclusion: 4CMenB vaccination in adolescents induces bactericidal killing of non-MenB isolates, suggesting that mass vaccination could impact IMD due to serogroups other than MenB.

Original languageEnglish
Pages (from-to)307-316
Number of pages10
JournalInfectious Diseases and Therapy
Issue number1
Publication statusPublished - Mar 2021


  • 4CMenB
  • Cross-protection
  • Meningococcal vaccine
  • Non-MenB strains
  • Serum bactericidal antibody activity


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