The Spanish Agency for Medicines and Health Products (AEMPS) has just authorized the sale of a new vaccine against meningococcus B called Trumenba, which will be distributed by Pfizer laboratories and can be purchased at pharmacies with a prescription.
So far only the Bexsero vaccine, marketed by GSK, protected against meningitis B, but from now on we can also count on Trumenba, though its use is only indicated after 10 years.
Trumenba and Bexsero: two vaccines against meningitis B with certain differences
Since October 1, 2015, parents had a single vaccine to protect our children against menigitis B: Bexsero, which we have talked about several times in Babies and More.
But last January, the Interministerial Commission for Drug Prices (CIPM) authorized the sale of a new vaccine against meningitis B called Trumenba, which has been in the US market since 2014, being administered to children and young people between the ages of 10 and 25.
Therefore, as of now we will have in the pharmacies two vaccines available against this disease, although Trumenba and Bexsero have differences that we analyze:
Age and vaccine doses
Trumenba can only be given to 10 year olds or older, unlike Bexsero whose administration is indicated after two months of age.
In this regard, it should be remembered that although anyone can get the disease, it is the children under 5 years of age, adolescents, young adults and those over 65 who constitute the highest risk groups.
As for the vaccination schedule Two doses are recommended in healthy children and adolescents, and three doses in those with risk factors, compared to the four doses that are required of Bexsero if vaccination begins before five months.
Trumenba covers more strains
As reported, this new vaccine would cover more than 90% of meningococcal B strains circulating in Spain, compared to 69% coverage offered by the Bexsero vaccine.
María José Cilleruelo, deputy physician of the Pediatrics Service of the Puerta de Hierro University Hospital in Madrid, explains that meningococcus is a bacterium that has several proteins on its outer membrane, including a protein capable of binding to human factor H (fHbp , for its acronym in English).
In this sense, "The identification of the role of fHbp in the defense of meningococcus has been fundamental in the development of new vaccines against invasive meningococcal disease, since the protein is expressed in the outer membrane in more than 96% of invasive strains of meningococcus B ".
Trumenba contains the fHbp protein and prevents human H factor from binding to it, eliminating this protection system that uses the bacteria, and also it is the only vaccine against meningococcus B that contains a variant of each of the two subfamilies of fHbp, A and B, which ensures an antibody response against strains that express either of the two subfamilies.
It can be given with other vaccines
Another difference with respect to Bexsero is that Trumenba can be administered together with other vaccines of the official calendar, such as the vaccine against the human papillomavirus, the vaccine against diphtheria, tetanus and pertussis, or the ACWY meningococcal.
And we remember that Pediatricians do not recommend administering Bexsero with other vaccines., hence in many centers the first dose is delayed at three months, so as not to match the first vaccines that the baby receives at two months of age.
Financing
According to DiarioFarma, as with Bexsero, Trumenba will not have public funding at the moment, and users who wish to do so must purchase it in pharmacies with a prescription and paying the full cost of 106.15 euros per dose (the same price that Bexsero has).
However, as with Bexsero, there are certain risk groups for which immunization is funded.
Other data
The new vaccine has a safety profile backed by 11 clinical trials worldwide, and according to Cristina Méndez, medical director of the Pfizer Vaccine Unit:
"Trumenba is the vaccine against meningococcus B that has been studied in a greater number of individuals ten years of age and older to date and its safety profile is based on the analysis of more than 15,000 adolescent and adult subjects"
On the other hand, according to the Spanish Association against Meningitis, it should be noted that a priori, and in the absence of knowing the recommendations of the AEP Vaccine Advisory Committee, adolescents who have been vaccinated with Bexsero will not need to be vaccinated again with Trumenba.
Meningitis B: a life-threatening disease
Meningococcal serogroup B is currently the most common cause of bacterial meningitis and is responsible for seven out of ten cases of meningitis in Spain, according to the latest available data of the 2015-2016 campaign.
13 serogroups of the microorganism associated with meningococcal disease are known, although segrogroups B and C are the ones most frequently associated with pathology in Europe.Meningococcal disease is a condition uncommon but devastating, sudden and aggressive, which occurs without notice and at any age. The bacterium is transmitted from person to person through contact with respiratory or throat secretions of asymptomatic carriers or, exceptionally, by direct contact with patients with meningococcal disease.
This bacterium can cause both meningitis and meningococcal septicemia, both potentially fatal, since despite treatment with antibiotics approximately 10% of those affected by meningitis die, a death rate that reaches 40% in case of septicemia.
Of the patients who survive, more than 20% experience severe sequelae, including amputations, seizures, severe hearing loss and physical and mental disability.
The diagnostic difficulty and rapid disease progression doctors leave very little time to act, which highlights the need for prevention of the disease through vaccination. Recall, once again, that for serogroups B we currently have the Bexsero and Trumenba vaccines and for serogroup C, we have a vaccine included in the official calendar that is administered at 2 months.
Via The Interactive Doctor, AEP - CAV
Babies and More Meningitis: warning symptoms, Vaccine against meningits C: everything you need to know, The Meningitis B vaccine 'Bexsero': everything you need to know, They recommend vaccinating teenagers against meningococcal meningitis, Meningitis B 'Bexsero' vaccine may be less effective than expected
