The vaccine used in Canada is Bexsero®. There is another vaccine called Trumenba®. Both vaccines are inactivated (non-living) vaccines, therefore not contraindicated in people living with HIV with low CD4 counts (below 400 copies).
The Bexsero® vaccine is given in two doses spaced at least 1 month apart. The vaccine is administered intramuscularly (injection into a large muscle). In the ANRS 174 DoxyVAC study, doses were spaced two (2) months apart. The vaccine must be given by a healthcare professional authorized to administer vaccines. After vaccination, the person should wait between 15 and 30 minutes before leaving the vaccination site. The wait is necessary in case the person experiences a severe allergic reaction such as anaphylaxis.
The Trumenba® vaccine can be given in two doses spaced 6 months apart or in three doses at 0, 1-2, and 6 months (2nd dose 1 to 2 months after the initial dose and the 3rd dose 6 months after the 2nd dose). The vaccine is administered intramuscularly (injection into a large muscle). This vaccine has not been studied for gonorrhea prevention (at least no studies found). The vaccine must be given by a healthcare professional authorized to administer vaccines. After vaccination, the person should wait between 15 and 30 minutes before leaving the vaccination site. The wait is necessary in case the person experiences a severe allergic reaction such as anaphylaxis.
The efficacy of the Bexsero® vaccine is slightly over 30% depending on the study. For the past 3-4 years, the vaccine has generated a lot of interest in the specialized medical field of STIs and PrEP because vaccination is a safe method of prevention. By vaccinating, we also avoid the development of antibiotic resistance by Neisseria Gonorrhea.
Anticipation studies, or modeling studies, estimate that a vaccine like Bexsero® with modest efficacy would reduce gonorrhea incidence by 62% in two years among HARSAH if mass vaccination were carried out, with possible elimination of Neisseria Gonorrhea in 8 years.
Unfortunately, RAMQ does not currently cover the Bexsero® vaccine. Several private insurances cover the Bexsero® vaccine. It is strongly recommended for people with multiple sexual partners or a history of an STI in the past 12 to 36 months. This is not an official recommendation. The use of the Bexsero® vaccine is still off-label.
Currently, we do not have data on the need for a booster for protection against gonorrhea. According to the product monograph, to maintain protection against group B meningococcus, it is recommended to give a booster dose 1 year after the first vaccination series and every 2-3 years thereafter if the risk of exposure to meningococcus persists.
The vaccine should not be administered to anyone who has had a severe reaction to another meningococcal vaccine.
The vaccine is not contraindicated in immunosuppressed individuals, although the immune response may be decreased in these individuals.
The vaccine may be ineffective in people with certain complement deficiencies or receiving treatment inhibiting terminal complement activation such as eculizumab. These individuals may develop disseminated or invasive disease caused by group B meningococcus despite vaccination and antibody development.
The cap of the Bexsero® vaccine contains natural rubber latex and may cause an allergic reaction in individuals sensitive to latex. The vaccine can still be administered to individuals WHO HAVE NOT HAD AN ANAPHYLACTIC REACTION. It must be administered by a healthcare professional experienced in removing the cap and managing allergic reactions. Removing the cap reduces the risk of an allergic reaction but does not eliminate it.