Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: A qualitative and quantitative assessment

Ulrich Vogel, Muhamed Kheir Taha, Julio A. Vazquez, Jamie Findlow, Heike Claus, Paola Stefanelli, Dominique A. Caugant, Paula Kriz, Raquel Abad, Stefania Bambini, Anna Carannante, Ala Eddine Deghmane, Cecilia Fazio, Matthias Frosch, Giacomo Frosi, Stefanie Gilchrist, Marzia M. Giuliani, Eva Hong, Morgan Ledroit, Pietro G. LovaglioJay Lucidarme, Martin Musilek, Alessandro Muzzi, Jan Oksnes, Fabio Rigat, Luca Orlandi, Maria Stella, Danielle Thompson, Mariagrazia Pizza, Rino Rappuoli, Davide Serruto, Maurizio Comanducci, Giuseppe Boccadifuoco, John J. Donnelly, Duccio Medini, Raymond Borrow

Research output: Contribution to journalArticlepeer-review

235 Citations (Scopus)


Background: A novel multicomponent vaccine against meningococcal capsular group B (MenB) disease contains four major components: factor-H-binding protein, neisserial heparin binding antigen, neisserial adhesin A, and outer-membrane vesicles derived from the strain NZ98/254. Because the public health effect of the vaccine, 4CMenB (Novartis Vaccines and Diagnostics, Siena, Italy), is unclear, we assessed the predicted strain coverage in Europe. Methods: We assessed invasive MenB strains isolated mainly in the most recent full epidemiological year in England and Wales, France, Germany, Italy, and Norway. Meningococcal antigen typing system (MATS) results were linked to multilocus sequence typing and antigen sequence data. To investigate whether generalisation of coverage applied to the rest of Europe, we also assessed isolates from the Czech Republic and Spain. Findings: 1052 strains collected from July, 2007, to June, 2008, were assessed from England and Wales, France, Germany, Italy, and Norway. All MenB strains contained at least one gene encoding a major antigen in the vaccine. MATS predicted that 78% of all MenB strains would be killed by postvaccination sera (95% CI 63-90, range of point estimates 73-87% in individual country panels). Half of all strains and 64% of covered strains could be targeted by bactericidal antibodies against more than one vaccine antigen. Results for the 108 isolates from the Czech Republic and 300 from Spain were consistent with those for the other countries. Interpretation: MATS analysis showed that a multicomponent vaccine could protect against a substantial proportion of invasive MenB strains isolated in Europe. Monitoring of antigen expression, however, will be needed in the future. Funding: Novartis Vaccines and Diagnostics.

Original languageEnglish
Pages (from-to)416-425
Number of pages10
JournalThe Lancet Infectious Diseases
Issue number5
Publication statusPublished - May 2013


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