Ecologic Study of Meningococcal B Vaccine and Neisseria gonorrhoeae Infection, Norway.

To the Editor: Gonorrhea is a sexually transmitted disease that can cause pelvic inflammatory disease, ectopic pregnancy, and salpingitis in women and infertility in men and women. Rates vary; incidence is 12.5 cases/100,000 population in Europe (1) and ≈6,000 cases/100,000 population in parts of sub-Saharan Africa (2). Recurrent infection is common, antimicrobial drug resistance is growing, and no licensed vaccine is available to protect against gonorrhea infection. Components of some meningococcal B (MenB) vaccines could provide protection against the causative bacterium, Neisseria gonorrhoeae (M. Pizza, pers. comm.), because the meningococcus bacterium is of the same Neisseria genus and the 2 bacteria share key protein antigens, such as the outer membrane vesicle (OMV). Ecologic evidence from Cuba supports a decline in gonococcus infection after a nationwide OMV vaccine campaign in the 1980s (3). In Norway, a trial of another OMV MenB vaccine (MenBvac, Norwegian Institute of Public Health, Oslo, Norway) was conducted among teenagers during 1988–1992. We retrospectively examined associations between MenB vaccine coverage during 1988–1992 and national gonorrhea rates for persons >16 years of age during 1993–2008 in Norway.