Introduction of a second MenB vaccine into Europe - needs and opportunities for public health

Introduction: Invasive meningococcal disease (IMD) can be devastating; it is associated with high case fatality rates and long-term sequelae among many survivors. Five serogroups (A, B, C, W, and Y) cause nearly all IMD cases worldwide, and serogroup B (MenB) is the most prevalent in Europe. The European Medicines Agency approved the use of MenB-fHbp (Trumenba (R); Pfizer Ltd, Sandwich, UK) in individuals >= 10 years of age for the prevention of MenB IMD in May 2017. MenB-fHbp contains two lipidated recombinant fHbp variants from two different fHbp subfamilies that help provide broad coverage against circulating meningococcal strains and may also improve antibody response compared to a nonlipidated antigen. Areas covered: This review summarizes the latest epidemiology evaluating the disease burden of MenB in Europe, introduces MenB-fHbp (the vaccine most recently approved in the European Union for the prevention of MenB IMD), and provides an overview of its development. Expert opinion: MenB is by far the most prevalent meningococcal serogroup in Europe, and its epidemiology is not currently addressed by European immunization recommendations. New strategies to prevent MenB IMD in Europe will continue to develop with the growing use of vaccines to prevent MenB disease, with increasing support through national immunization programs.