Vaccination May Be Economically and Epidemiologically Advantageous Over Frequent Screening for Gonorrhea Prevention

Area of Science:

• Epidemiology
• Infectious Disease Prevention
• Public Health Modeling

Background:

• Antimicrobial resistance in gonorrhea necessitates novel prevention strategies.
• A serogroup B meningococcal vaccine shows potential partial efficacy against gonorrhea.
• The role and viability of vaccination for gonorrhea control remain under investigation.

Purpose of the Study:

• To model gonorrhea transmission and identify optimal investment strategies for vaccination and screening programs.
• To determine the most effective year-over-year allocation of a fixed budget for gonorrhea prevention.
• To compare the effectiveness of vaccination versus screening in reducing gonorrhea incidence.

Main Methods:

• A 10-year compartmental transmission model of gonorrhea in a heterosexual population was developed.
• The model incorporated vaccination and quarterly screening strategies, stratified by sex and enrollment venue.
• Optimal investment patterns were identified under various budget and cost assumptions.

Main Results:

• Vaccinating men with recent symptomatic infections proved optimal for population-level gonorrhea control.
• A $3 per capita budget could avert 9.5% of gonorrhea infections, reducing sequelae and antimicrobial use.
• Vaccination strategies averted more infections than screening-only approaches (9.5% vs. 5.5%).

Conclusions:

• A currently available, modestly effective vaccine may outperform frequent testing for population-level gonorrhea control.
• Targeted vaccination strategies represent a viable and potentially superior method for gonorrhea prevention.
• Further research into vaccine implementation for gonorrhea is warranted.