This story reports on a New Zealand study that suggests a vaccine that protects against a strain of meningitis may also offer some protection against gonorrhea. The research, published in the Lancet, estimated that a meningitis B vaccine administered to teens and young adults during an outbreak in the early 2000s was 31 percent effective in protecting against gonorrhea.
The story does a good job of covering the science behind this surprising finding, but its optimistic assertion that the “world might be catching a break when it comes to drug-resistant gonorrhea” seems premature. Also, the potential costs and side effects were not discussed. Excluding the drawbacks plays into the marketing strategy of GlaxoSmithKline, which is pushing to increase sales of its vaccine, Bexsero.
Gonorrhea is common worldwide, with an estimated 820,000 new infections annually in the U.S. Untreated, it can cause infertility and lead to infections in other parts of the body. Yet journalists should use caution when reporting on the potential for a vaccine. This industry-sponsored study received broad coverage, much of which downplayed the lack of safety and efficacy data while raising an alarm about antibiotic-resistant gonorrhea and neglecting other strategies to combat the disease.
There’s no mention of how much a gonorrhea vaccine might cost. In the U.S. meningitis B vaccine Bexsero, which contains manufactured by GlaxoSmithKline, costs $99 for a pediatric dose and $106 for an adult dose. Two doses are required.
A discussion of cost and cost-effectiveness is particularly important when considering a widespread public vaccination campaign.
The story just passes the bar, giving actual numbers far down in the story. It states researchers “found people who were vaccinated were 31 percent less likely to be infected with gonorrhea than those who hadn’t received the meningococcal B vaccine.”
We would have liked to see that data higher in the story. Instead, the story states in the third paragraph that the gonorrhea rate was “significantly lower” among those who were vaccinated. The story doesn’t give the overall risk of getting gonorrhea, so it’s hard to tell whether a 31 percent drop amounts to a significant benefit for individuals.
The study itself states that the findings provide preliminary evidence of “moderate” cross-protection, and we think that should have been given more discussion so people get a better sense of how little is known about the efficacy compared to other vaccines.
Any vaccine has potential side effects, and these aren’t mentioned. According to the CDC, more than half of the people who get meningitis B vaccines have mild problems such as headaches or soreness where the shot was given. Fainting, allergic reactions and shoulder pain are less common effects. Also, the vaccine appears to be only moderately effective, meaning people may get infected regardless.
Overall, not much is known about this vaccine’s safety–whether it’s being used for meningitis or gonorrhea. As Bloomberg News explained, many health experts decry the lack of data on the vaccine. Discussing this issue would have made the story stronger.
The story states that the findings were observational and adds: “Clinical trials will need to be conducted to see if the effect researchers have observed is actually due to the meningococcal B vaccine.”
It explains that only a particular vaccine component that protects against one strain of meningitis appears to offer some protection against gonorrhea, while meningococcal vaccines that protect against other strains do not.
The story could have mentioned the number of vaccinated young people in the study, which was nearly 15,000.
The story dramatizes the threat of antibiotic resistance with an unattributed statement: “The last remaining drugs to cure this sexually transmitted infection are showing signs they may only have a few more years of usefulness left.”
It also gives a quote from a GSK spokeswoman who calls the findings “a positive step in the search for a vaccine against this common and distressing disease that is increasingly resistant to antibiotic treatment.”
As this Scientific American article explains, that actual rate of antibiotic-resistance–while on the rise–is still pretty small.
Independent sources would have been useful on this point, but we wouldn’t say this rises to the level of disease mongering.
The story reports that the study was funded by GSK and Auckland Uniservices, the commercialization arm of the University of Auckland. It does not mention that one of the researchers in the study has been a paid consultant for GSK and other drugmakers.
The story appears to use one independent source, Dr. Jean Longtin, head of Quebec’s public health laboratory. It also quotes from an accompanying editorial by Kate Seib, of Australia’s Institute for Glycomics, who declared no conflicts.
There’s no discussion of other strategies to address the spread of gonorrhea. The CDC has urged the development of new treatments for gonorrhea. Public health education, including condom use, can prevent new cases. A report sponsored by health agencies in the U.S. and the United Kingdom highlighted the need for strong data-driven public health surveillance to better understand how resistant strains evolve and get transmitted, as well as point-of-care diagnostic testing to identify resistant strains. At least a line or two discussing these alternatives would have informed readers that the vaccine isn’t the only solution.
The story says the single-component vaccine used in New Zealand is no longer made but that the component is part of GSK’s Bexsero vaccine, which is on the market. The story also distinguishes the B vaccine from others on the market: “Meningococcal vaccines that protect against the other strains do not seem to have the same effect (on gonorrhea).”
Significance is conveyed in the headline: “Vaccine shows protection against gonorrhea for first time, study says.”
The story does not appear to rely on the news release from The Lancet.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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