You are here

Article Text

Article menu

Download PDFPDF

Poster Presentations
PS02 – POSTER VIEWING SESSION – TUESDAY
Tuesday, July 16, 2019 5:45 PM – 7:00 PM
P505 The impact of gonorrhoea vaccination in men who have sex with men on prevalence and resistance: mathematical modelling study
Free
  1. Janneke Heijne1,
  2. Maria Xiridou1,
  3. Katy Turner2,
  4. Birgit Van Benthem1,
  5. Nicola Low3
  1. 1National Institute for Public Health and the Environment (RIVM), Epidemiology and Surveillance, Centre for Infectious Diseases Control, Bilthoven, Netherlands
  2. 2University of Bristol, Bristol, UK
  3. 3Institute of Social and Preventive Medicine (ISPM), Bern, Switzerland

Abstract

Background Men who have sex with men (MSM) are disproportionately affected by Neisseria gonorrhoeae (gonorrhoea) and antimicrobial resistance (AMR) is common. Gonorrhoea vaccine development is challenging, but a N. meningitidis (group B) vaccine might have reduced gonorrhoea incidence by ≈30%. This study aims to investigate the impact of vaccination on gonorrhoea transmission and on AMR in MSM.

Methods We developed a deterministic compartmental model of gonorrhoea transmission among Dutch MSM. We included three sexual activity classes that differed in numbers of partners/year and unprotected sex acts/partnership. AMR to first-line treatment was assumed to be complete, occurring at a low probability after treatment. We modelled a partially protective prophylactic vaccine (reducing susceptibility) providing 2 years’ protection. We estimated the prevalence of sensitive and resistant gonorrhoea strains after 10 and 50 years for vaccine efficacies (VE) of 30% (lower) and 60% (higher) and different uptake levels in high sexual activity MSM.

Results Gonorrhoea prevalence in the model was 0.45% overall, 8.3% in high sexual activity MSM, and 0.002% resistant strains (baseline). With lower VE, after 10 years, the prevalence of the sensitive strain was reduced by 75% (for 50% uptake). AMR prevalence increased (irrespective of uptake) although less than without vaccination. With lower VE, after 50 years, AMR prevalence decreased only with uptake ≥60%, levels at which the sensitive strain was already eliminated. With higher VE, AMR prevalence decreased after 10 years for uptake ≥30% and after 50 years for uptake of ≥20%.

Conclusion In this modelling study, a partially protective prophylactic vaccine for gonorrhoea decreased overall prevalence, even with lower VE. This study also shows how vaccination can reduce the spread of AMR. For gonorrhoea, vaccination can decrease the speed at which AMR is transmitted, and even reduce AMR prevalence, but only with higher levels of vaccine efficacy or uptake in high sexual activity MSM.

Disclosure No significant relationships.

  • gay bisexual and other men who have sex with men
  • Neisseria gonorrhoeae
  • modeling and prevalence
  • prevention
  • intervention and treatment

https://doi.org/10.1136/sextrans-2019-sti.585

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.