Abstract

On 01 August 2025, the United Kingdom became the first country in the world to implement a targeted immunisation programme using a meningococcal vaccine (4CMenB) for protection against gonorrhoea. 4CMenB is a recombinant, protein-based vaccine licensed for prevention of serogroup B meningococcal disease but, because Neisseria meningitidis is genetically closely related to Neisseria gonorrhoeae, observational studies estimate that the vaccine also provides some (30-41%) protection against gonorrhoea. Given the rising incidence of gonorrhoea and increasing antimicrobial resistance, the UK programme will offer 4CMenB through specialist sexual health services clinics primarily to gay, bisexual and other men who have sex with men (GBMSM) who are at high risk of infection. A comprehensive national surveillance programme is in place to assess vaccine uptake as well as effectiveness and impact of vaccination on symptomatic disease, asymptomatic infection, recurrent infections, co-infections with other sexually transmitted infections and duration of protection. Microbiological surveillance will monitor trends in antimicrobial resistance and help elucidate mechanisms of vaccine protection, including identification of potential antigenic targets for next-generation vaccines. It is hoped that the data collected will provide an evidence base for other countries considering implementing a similar immunisation programme for their populations at high risk of gonorrhoea.