LOGIC September 2017 Vol 16 No 3 | Page 15

was hope after all. Here is that story. Epidemiological evidence from Cuba, Brazil, and NZ demonstrated that meningococcal group B OMV vaccines can provide broad protection against meningococcal disease (Harder, Koch, Wichmann, & Hellenbrand, 2017). This led to the hypothesis that they may affect a more distantly related bacteria. Eyeball observation of graphed surveillance data make clear that incidence of gonorrhoea declined markedly in Cuba following implementation of their meningococcal OMV vaccine (VA-MENGOC-BC®). This was in contrast to syphilis and genital warts which remained the same(Pérez et al., 2009). A double peak and a lag before the decline can be observed in graphs which coincides with the mass catch up campaign and then the age of sexual onset in birth cohort (Pérez et al., 2009). Inspection of the reported gonorrhoea in NZ shows a decline during and after use of MeNZB™ before climbing again. No other sexually transmitted infections (STIs) reported in the NZ national surveillance reports September 2017 L.O.G.I.C Figure 1. Gonorrhoea rates in selected regions 1990-2014(The Institute of Environmental Science and Research Ltd, 2015) declined during this period. These ‘eyeball’ observations suggest that it is at least possible these OMV vaccines offered cross protection against gonorrhoea (The Institute of Environmental Science and Research Ltd, 2015). One of the legacies of the MeNZB™ programme is the National Immunisation Register (NIR). Every dose of MeNZB™ vaccine has been recorded in that database. This tool, along with the National Health Index Number that each New Zealander has, allowed the vaccine status of gonorrhoea cases to be verified. This provided us the opportunity to conduct two studies to see if MeNZB™ vaccine reduced the risk of getting gonorrhoea. The first study was a retrospective case-control study that examined the records from nearly 15,000 visitors to 11 Sexual Health Clinics across NZ who were eligible to have received the MeNZB™ vaccine between 2004 and 2008. Patients were confirmed to have either gonorrhoea, or chlamydia, or coinfection with both. Those who had gonorrhoea were significantly less likely to have received the MeNZB™ vaccine than those diagnosed with chlamydia. The difference in the odds ratio equated to a vaccine effectiveness of 31% against gonorrhoea (Petousis-Harris, Paynter, Morgan, Saxton, McArdle, et al., 2017). The second study has not yet been published but the findings 13