Meningitis B Vaccine to Be Used for Gonorrhea in England
- by Amber Baker
- Published
- Vaccines
In August 2025, England will become the first country to offer a vaccine for gonorrhea after cases exceed 85,000 in 2023—the highest gonorrhea levels since recordkeeping began in 1918. The program, offered through the United Kingdom’s National Health Service (NHS), will repurpose the meningitis B vaccine, routinely given to infants, in an attempt to reduce rates of gonorrhea.1
Neisseria gonorrhoeae, which live in the oral and genital mucosa, and Neisseria meningitidis, which live in the upper respiratory tract, are closely related bacterial species that cause disease exclusively in humans and compete with each other in the human microbiome and have made adaptations to evade immune defenses and develop antibiotic resistance.2 Gonorrhea is a sexually transmitted bacterial infection (STI) that, if left untreated, can cause infertility, pelvic inflammatory disease (PID), and an increased risk of HIV infection. Infected individuals do not always have symptoms, but gonorrhea can cause a burning sensation or pain while urinating, unusual discharge from the genitals, and pain or swelling in the testicles.3
Most infants and children asymptomatically colonize meningococcal bacteria in their nose and throat, which usually provides lifelong immunity, and five to 10 percent of individuals in a population are actively colonizing the bacteria in their nose and throat without showing symptoms. However, very rarely individuals genetically and biologically vulnerable to invasive meningococcal infection of the blood (sepsis) and meninges (meningitis) will suddenly develop fever and chills, severe headache, stiff neck, confusion, nausea, vomiting or diarrhea, pain in muscles and joints, chest and stomach, shock and other symptoms that can be rapidly followed by death or lead to loss of limbs and neurological damage.4
Public health officials have reported that the meningitis B vaccine is 30 percent effective in preventing gonorrhea and in England the vaccine will be prioritized for groups considered at highest risk for gonorrhea. These include gay and bisexual men 16–25 years of age with multiple sexual partners, individuals with a history of STIs, and those of Black or Caribbean heritage. Public health officials say the decision reflects not only the record number of gonorrhea cases in England, but growing concern about gonorrhea’s 80-year trend toward antibiotic resistance, which has made the infection increasingly difficult to treat. Some doctors warn that the sexually transmitted disease could eventually become untreatable.1
Dr. Katy Sinka, , epidemiologist and consultant microbiologist at the U.K. Health Security Agency (UKHSA), said “Gonorrhoea is becoming increasingly resistant to antibiotics, risking the possibility of it becoming untreatable in the future. Untreated gonorrhoea can lead to serious health issues, including pelvic inflammatory disease and infertility.” This is significant as global fertility rates have already been declining for decades. A March 2024 study published in The Lancet by the Institute for Health Metrics and Evaluation (IHME) projects that by 2100, 97 percent of countries will have fertility rates below the replacement level of 2.1 children per woman, suggesting that, without intervention, population decline will affect most of the world.5 6
Bacterial Similarities Cited as Basis for Off-Label Gonorrhoea Vaccine Use
The use of the meningitis B vaccine to prevent gonorrhea is considered off-label, as the vaccine was not originally developed to target the sexually transmitted infection. However, public health officials, who note that the bacteria responsible for meningitis B and gonorrhea are closely related, believe the vaccine may reduce gonorrhea cases by approximately one-third. Off-label prescribing—using a drug for a purpose not approved by the FDA—is a common practice in medicine. For instance, popular GLP-1 receptor agonists like Ozempic (semaglutide), Mounjaro (tirzepatide), and Rybelsus (semaglutide), originally approved for type 2 diabetes, are frequently prescribed off-label for weight loss.7
The BBC quoted Professor Andrew Pollard, the chair of the Joint Committee on Vaccination and Immunisation (JCVI), which recommended the off-label use of the meningitis B vaccine, as saying that despite the low rate of effectiveness, it was “worth having” and could have “a huge impact.1
Doctors Not Legally Required to Inform Patients of Off-Label Drug Prescription
Several factors contribute to the prevalence of off-label prescribing. The FDA licensing process, which requires manufacturers to meet standards for safety and effectiveness can deter pharmaceutical companies from seeking approval for additional use indications. Additionally, certain patient populations are frequently excluded from clinical trials, resulting in a lack of approved treatments for these groups. In such cases, off-label use can become an easier option to provide expanded use of the product. However, it may also carry added risks as the medication may not have been rigorously tested for safety or effectiveness in the off-label context. This can increase the likelihood of adverse effects, unexpected interactions, or unintended outcomes.8
Physicians are not legally required to inform patients that a drug is being used off-label, underscoring the need for transparent patient-doctor communication about the risks, benefits, and quality of evidence supporting its use.
A 2024 study by Fair Health shows that sexually transmitted diseases (STDs) are on the rise in the United States, with gonorrhea ranking second after syphilis. Among older adults, cases of HPV (human papillomavirus) show the sharpest rise—up more than 30 percent in those aged 65 years and older. In response to rising STI rates, England will begin offering the meningitis B vaccine in August through sexual health clinics, with other parts of the U.K. planning to implement similar programs. People will also be offered vaccines for mpox (monkeypox), HPV, and hepatitis during the same visit.1 9
No studies, however, have confirmed the safety of administering all these vaccines simultaneously, and the potential for synergistic adverse effects have not been thoroughly evaluated. It remains unclear how long meningitis B vaccine protection against gonorrhea will last or whether ongoing booster shots will be recommended.
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