Oral Presentation 25th International Pathogenic Neisseria Conference 2026

Global epidemiology of the factor H binding protein (fHbp) on meningococcal serogroup B  (MenB) invasive isolates and protection predicted for vaccines containing a bivalent fHbp (MenB-fHbp) component against diverse circulating fHbp peptides. (142818)

Jamie Findlow 1 , Raffaella Iantomasi 2 , Stephen A Clark 1 , Lacey Lopez 3 , Joan Forns 4 , Sarah R Slate 5 , Panagiotis Maniatis 6 , Yamini Gorantla 6 , Steven Shen 7 , Elise Gowen 8 , Sundaram Ajay Vishwanathan 6 , Julie A Bettinger 9 10 , Kayla Weiss 11
  1. Pfizer Ltd, Tadworth, SURREY, United Kingdom
  2. Global Vaccines Medical Affairs, Pfizer srl, Rome, Italy
  3. RTI Health Solutions, Durham, NC, USA
  4. RTI Health Solutions, Barcelona, Spain
  5. Boston University School of Public Health, Boston, MA, USA
  6. Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
  7. Global Vaccines Medical Affairs, Pfizer Canada ULC, Kirkland, QC, Canada
  8. Seneca Federal Health, Chantilly, VA, USA
  9. Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
  10. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
  11. Vaccine Research & Development, Pfizer Inc, Pearl River, NY, USA

Background

Available vaccines against meningococcal serogroup B (MenB), a leading cause of invasive meningococcal disease globally, include factor H binding protein (fHbp) antigens. As for other MenB vaccine protein antigens, temporal and geographic diversity of circulating fHbp variants and expression levels warrants continued isolate characterization and corresponding vaccine coverage predictions. We reviewed global fHbp epidemiological data among invasive MenB isolates and coverage predictions, based on fHbp expression levels, for bivalent fHbp MenB (MenB-fHbp)−containing vaccines.

Methods

fHbp peptide frequency data were procured from published literature using PubMed searches. fHbp expression data, assessed using the flow cytometry‒based Meningococcal Antigen Surface Expression (MEASURE) assay, were from published literature and unpublished data from authors’ files. MenB-fHbp−containing vaccines were predicted to cover strains expressing fHbp at >1000 MEASURE mean fluorescence intensity units, which, as previously established, indicates likely susceptibility to killing by MenB-fHbp−elicited antibodies. We also compared MEASURE data with Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) index MenB-fHbp coverage predictions, which rely on MEASURE and human complement−dependent serum bactericidal antibody assessments.

Results

Publications from 34 countries across 6 continents indicated geographic and temporal variation in fHbp subfamily prevalence. fHbp peptide variability also differed geographically; eg, among Spanish isolates (n=187; 2011−2023; 68 unique peptides), 42.8% harboured less common peptides (ie, those harboured by <5 isolates), compared with 18.5% of US isolates (n=303; 2015−2017; 53 peptides) and 30.2% of UK isolates (n=202; 2016; 46 peptides). In a recent PubMLST database analysis, 72.5% of 5659 global invasive MenB isolates (2007−2021) harboured the 10 most common fHbp peptides/variants: 1/B24, 4/B16, 19/A22, 14/B03, 15/B44, 13/B09, 16/A19, 24/A12, 45/A05, and 47/A06. For most of these peptides, pooled global MEASURE results indicated likely MenB-fHbp coverage for 80.0%−100% of isolates; predicted 45/A05 coverage was lowest (53.6%). MEASURE data predicted high MenB-fHbp strain coverage for 24/A12 and 12 less common fHbp peptides with “insufficient data” MenB-fHbp susceptibility designations in MenDeVAR.

Conclusions

Pronounced geographic and temporal fHbp variability across invasive MenB isolates highlights the importance of continued surveillance and broadly protective MenB vaccines. MEASURE data predict robust coverage of MenB-fHbp‒containing vaccines against isolates expressing most prevalent and many less common circulating fHbp peptides. Funding: Pfizer.