Prevention
Plain polysaccharide vaccines
In the polysaccharide vaccine, only the sugar part of the bacterium, the capsule, is included as the antigen to stimulate an immune response.
Polysaccharide vaccines are created using purified high molecular weight polysaccharides (>100 000 Da) consisting of sialic acid, with the exception of serogroup A, which contains N-acetyl-mannosamine-1-phosphate repetitions,
- Induce a type 2 thymus independent response,
- Induce IgG, IgM, and IgA production (assessed as serum bactericidal antibody – SBA, the correlate of protection)
- Induce Oligoclonal response
| Advantages: | Disadvantages: |
| Less expensive when compared to conjugate vaccines |
Not effective against serogroup B (risk of inducing auto-immune reactions) Do not induce immunological memory, |
Polysaccharide conjugate vaccines
Here, the sugar part of the bacterium (the capsule), is joined to a carrier protein like an inactivated toxin. This elicits a stronger T-cell dependent immune response.
They are a result of the conjugation of the capsular polysaccharide (type 2 antigen) to a highly immunogenic carrier protein (diphtheria, tetanus toxoids and the non-toxic diph- theria toxin variant CRM). As a result:
- they elicit T-cell dependent antisaccharide antibody response
- B memory cells are primed
- Primarily IgG (IgG1) and IgM
- Oligoclonal response with more diversity
| Advantages: | Disadvantages: |
| Generates a T-cell mediated immune response – high affinity IgG Generates mucosal immune response (impact on carriage and herd immunity) Induces immunological memory Induces immune response in young children (younger than 2 years) |
Capsular polysaccharide purified directly from the bacterium Not effective against serogroup B (risk of inducing auto-immune reactions) Capsular group replacement? |
Outer membrane vesicle (OMV) vaccines
Bacteria naturally generate non-replicating, highly immunogenic spherical nanoparticles called outer membrane vesicles.
- Initially synthesised by the extraction of outer membrane proteins from meningococcal homologous strains, resulting in strain specific antibodies, predominantly against the PorA protein.
- Vaccines were improved by combining OMV vaccines with a selection of immunogenic proteins identified using reversed vaccinology (proteome and genome –based), amplifying the spectrum of coverage possible (e.g Bexsero™) .
| Advantages: | Disadvantages: |
| First effective MenB vaccines, were able to control epidemics due to homologous strains Have some impact in heterologous strains and on non-MenB strains (MeNZB™ , Bexsero™), Effective in infants, young children and adolescents Reduces carriage |
Their efficacy against all MenB strains is not known |
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