Journal of the International AIDS Society · Published 2026-07-01 · DOI 10.1002/jia2.70155
Sami L. Gottlieb, Jane Rowley, Nuria Balibrea, Dominique A. Caugant, Ray Borrow, Antoine Durupt, Helen S. Marshall, Maeve B. Mello, Marco Aurelio Sáfadi, Marie‐Pierre Preziosi
ABSTRACT Introduction Clinical trials are evaluating the efficacy of serogroup B meningococcal (MenB) outer membrane vesicle (OMV) vaccines in preventing gonorrhoea. We assessed the global epidemiology of gonorrhoea and MenB invasive meningococcal disease (IMD) and reviewed national MenB‐OMV vaccination policies to inform potential use of these vaccines. Methods We included country‐specific epidemiologic data from 2015 through October 2025. Gonorrhoea prevalence data for general populations of women were extracted from published systematic reviews and case reports taken from well‐established reporting systems. Country‐specific MenB IMD incidence rates were drawn from published reviews and surveillance reports. National MenB‐OMV immunization policies were obtained from published reviews and databases from the World Health Organization and vaccine manufacturers. Results Forty‐two countries had ≥1 gonorrhoea prevalence study. Mean prevalence was <1.0% in 19 (45%) countries, 1.0%−2.49% in 10 (24%), 2.5%−4.99% in 10 (24%) and ≥5% in three (7%), with higher prevalences mostly in the WHO African Region. MenB IMD incidence was reported in 62 countries: 17 (27%), mainly in the WHO African Region, had no cases; 28 (45%) had incidence <0.25/100,000; 14 (23%) had incidence 0.25−0.49/100,000; and only three had incidence ≥0.5/100,000 annually. Only 15 countries had data for both conditions. Case‐report data showed gonorrhoea incidence peaking at ages 20–24 and being substantially higher among men who have sex with men (MSM). MenB IMD incidence was highest among children <4 years, with a second peak among 15‐ to 24‐year‐olds in some countries. Twenty‐one countries incorporated MenB‐OMV vaccines into infant immunization programmes and seven into adolescent programmes. One country had a targeted MenB‐OMV vaccination programme (MSM at high‐risk) for gonorrhoea prevention. Discussion Epidemiologic data were lacking in many countries; only a handful had a substantial burden of both gonorrhoea and MenB IMD. Low‐ and middle‐income countries with high gonorrhoea prevalence typically reported no MenB IMD or lacked data, whereas high‐income countries with higher MenB IMD incidence and MenB‐OMV vaccine use had low gonorrhoea prevalence but high rates in subpopulations like MSM. Conclusions If trials confirm MenB‐OMV vaccine cross‐protection against gonorrhoea, global epidemiology can help identify settings and populations for potential vaccine use against gonococcal infection alone, or for both conditions. Improved data collection and cost‐effectiveness analyses across both conditions can further inform decision‐making.
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Gottlieb, S., Rowley, J., Balibrea, N., et al. (2026). Potential Use of Neisseria meningitidis Serogroup B Vaccines to Prevent Neisseria gonorrhoeae Infection: Epidemiological Considerations. Journal of the International AIDS Society. https://doi.org/10.1002/jia2.70155