Publication date: Jun 21, 2025
Vaccination for UK men who have sex with men (MSM) at increased gonorrhea risk has been advised, but not yet implemented. Effective targeting is essential for cost-effectiveness, but previously-examined approaches have disadvantages: Vaccination-on-Diagnosis has low coverage (limiting impact), and Vaccination-according-to-Risk requires asking about sexual behavior to identify at-risk individuals, which is not always feasible. We developed a transmission-dynamic model to evaluate novel strategies offering vaccination based on information readily available to clinicians (diagnostic/vaccination history, if the patient is seeking care due to partner notification). Offering vaccination to MSM who are notified partners of gonorrhea cases or were diagnosed themselves in the past 2 years averts 1. 6x more cases and is more cost-effective than Vaccination-on-Diagnosis. If vaccination provides 20% protection for 1. 5 years after primary vaccination and 3 years after revaccination then at lb18/dose administered, all considered strategies have ≥50 and ≥90% probabilities of positive net monetary benefit compared with no vaccination with a quality-adjusted life year valued at lb20,000 and lb30,000 respectively, thus meeting the UK criteria for cost-effectiveness. All novel strategies considered achieve greater impact than Vaccination-on-Diagnosis without the feasibility issues of Vaccination-according-to-Risk.
Open Access PDF
| Concepts | Keywords |
|---|---|
| Clinicians | According |
| Men | Considered |
| Revaccination | Cost |
| Vaccination | Diagnosis |
| Effective | |
| Effectiveness | |
| Gonorrhea | |
| Men | |
| Msm | |
| Offering | |
| Risk | |
| Targeting | |
| Vaccination | |
| Vaccines | |
| Years |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | gonorrhea |
| drug | DRUGBANK | Isoxaflutole |
| drug | DRUGBANK | Dimethyl sulfone |
| disease | IDO | history |
| disease | IDO | quality |
| disease | MESH | meningitis |
| disease | MESH | infection |
| disease | MESH | uncertainty |
| drug | DRUGBANK | Coenzyme M |
| drug | DRUGBANK | Spinosad |
| drug | DRUGBANK | Ceftriaxone |
| disease | MESH | STIs |
| disease | IDO | site |
| disease | MESH | sequelae |
| disease | MESH | asymptomatic infections |
| drug | DRUGBANK | Aspartame |
| disease | IDO | bacteria |
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | IDO | algorithm |
| disease | MESH | trichomoniasis |
| drug | DRUGBANK | Doxycycline |
| disease | IDO | antibiotic resistance |
| drug | DRUGBANK | Cefixime |
| disease | MESH | HIV infections |
| disease | MESH | AIDS |
| disease | MESH | lifestyles |
| disease | MESH | papilloma |
| disease | MESH | COVID 19 |
| pathway | REACTOME | Reproduction |