Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Linda L. Niccolai

Abstract

Gonorrhea infection is caused by Neisseria gonorrhoeae and it is the second most common bacterial sexually transmitted infection around the globe. Although gonorrhea infection is treatable with antibiotics, the level of antimicrobial resistance continues to increase and has become a major public health concern. As options of available treatments are reduced by the emergence of AMR, it has become urgent to develop effective vaccines against gonorrhea infection. The purpose of this scoping review is to describe existing epidemiological evidence in support of gonorrhea vaccine development, to discuss the current vaccine candidates in clinical stages, and to evaluate the theoretical impact of gonorrhea vaccines. Published papers and clinical trial records on gonorrhea vaccine immunogenicity and efficacy, vaccine effectiveness and potential impact were reviewed after selection. Outer membrane vesicles-based meningococcal serogroup B vaccination showed moderate (approximate 30%) cross-protection against gonorrhea infections in multiple retrospective studies, and subsequent clinical studies assessing the immunogenicity and vaccine efficacy are currently undergoing. Modeling studies suggested that the theoretical impact of gonorrhea vaccines vary by vaccine efficacy, mode of action, duration of protection, uptake percentage, and disease prevalence in the population, but a vaccine with efficacy and duration of protection equivalent to the meningococcal serogroup B vaccine can have substantial impact and public health value if delivered in optimal vaccination strategy. However, generalizability of the study results remains questionable because studies included were mostly limited to developed country settings. To investigate vaccines with higher efficacy and to better evaluate the value of potential gonorrhea vaccines, research on disease natural history and gonorrhea epidemiology in low- or middle-income countries in the near future.

Comments

This is an Open Access Thesis.

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