In a recent review, lead study author Leah Vincent, PhD, of the National Institute of Allergy and Infectious Diseases, in Rockville, MD, describes the growing public health concern surrounding Neisseria gonorrhea infections as well as the need for developing a gonorrhea vaccine despite the presence of many research challenges and gaps.
Research indicates that there are approximately 78 million new N. gonorrhea infections yearly. Not only do these infections cause significant morbidity and mortality, but also greatly impact both maternal as well as neonatal health.
“Current control measures are clearly inadequate and threatened by the rapid emergence of antibiotic resistance,” Dr. Vincent states. She adds, “The gonococcus now holds the status of ‘‘super-bug” as there is currently no single reliable monotherapy for empirical treatment of gonorrhea.” Antibiotic resistance not only leads to elevated treatment and socioeconomic costs but the need to establish proper surveillance programs as well.
Due to these factors, the authors point out, the need for a gonorrhea vaccine is evident. Recent research in this field has led to the identification of many conserved candidate gonorrhea vaccine antigens that are currently in pre-clinical testing stages. Additionally, because the risk of co-infection with chlamydia is high in these patients, the authors emphasize the importance of testing candidate vaccines in gonorrhea/chlamydia coinfection models.
In their review, the study authors also suggest several approaches that should be considered when developing a gonorrhea vaccine. Because low- and middle-income countries (LMIC) carry the greatest disease burden, an inexpensive, single dose vaccine is optimal. Dr Vincent also states that target groups should be considered in vaccine development and adds, “It is generally thought that the best target group would be girls and boys aged 9–13, preferably before sexual debut, similar to the HPV vaccination program.”
N. gonorrhea infections are associated with significant morbidity and mortality and have become a growing public health concern. In this review, Dr Vincent describes the challenges to vaccine development as well as the general approaches that should be considered.
Vincent LR, Jerse AE. Biological feasibility and importance of a gonorrhea vaccine for global public health. Vaccine. DOI: 10.1016/j.vaccine.2018.02.081.