Background: There is substantial diversity among meningococcal serogroup B (MenB) surface proteins, which makes it essential to assess the breadth of coverage (BoC) of protein-based MenB vaccines against strains that cause invasive meningococcal disease (IMD). Demonstrating this breadth of strain coverage is fundamental to the licensure and the successful real-world utilization of these vaccines to meet public health needs.
Methods: We have summarized key data generated from the serum bactericidal antibody assay with human complement (hSBA), the qualitative endogenous complement hSBA assay (enc-hSBA) and the hSBA-validated Meningococcal Antigen Surface Expression (MEASURE) assay to assess the BoC of the bivalent factor H binding protein (fHbp) MenB vaccine (MenB-fHbp; Trumenba®) across 3126 disease-causing strains. An hSBA titre ≥1:4 is the established correlate of protection for IMD.
Results: Broad protection with MenB-fHbp was demonstrated across multiple studies, with robust hSBA responses observed using conservative endpoints across 4 primary, randomly selected, vaccine-heterologous, diverse, low-to-medium fHbp‒expressing, epidemiologically relevant MenB test strains (ie, A22/A56/B24/B44). Among participants 10–25 years of age, 67%–95% had ≥4-fold rise in hSBA titre and 74% achieved composite seroprotection (ie, hSBA titre ≥1:8 [A56/B24/B44] and hSBA titre ≥1:16 [A22]). Across 10 additional MenB strains (ie, A06/A07/A12/A15/A19/A29/B03/B09/B15/B16), 71%–97% of participants had seroprotective hSBA titres. Following licensure, hSBA responses using sera from MenB-fHbp‒vaccinated individuals demonstrated extensive BoC against 14 US, Canadian, and Norwegian endemic and outbreak isolates (1976−2016), 6 French outbreak isolates (2011−2015), 3 UK outbreak isolates (2021−2025), and 6 non-MenB strains. The qualitative enc-hSBA assay assessed 144 MenB strains and 412 paired (baseline and post-vaccination) serum samples from 7 countries representative of fHbp diversity (2000−2022). Overall, 93.6% of participants with baseline titres <1:4 had titres ≥1:4 after receiving MenB-fHbp−containing vaccines. Further evaluation using the conservative MEASURE assay predicted that 90.1% of 3060 MenB isolates from 9 countries (2000−2022) were highly likely to be susceptible to killing by MenB-fHbp−elicited antibodies based on fHbp expression levels.
Conclusion: Overall, complementary and robust methods employed during MenB-fHbp clinical development and after licensure demonstrated broad BoC for MenB-fHbp−containing vaccines against diverse disease-causing MenB strains.
Sponsored by Pfizer Inc.