NHS and local government to roll out world-first vaccine programme to prevent gonorrhoea

Thousands of gonorrhoea cases could be prevented over the next decade thanks to the NHS’ world-first vaccination programme against the infection.

Eligible patients, which includes gay and bisexual men who have a recent history of multiple sexual partners or a sexually transmitted infection (STI), will start to be offered the vaccine through local authority-commissioned sexual health services from early August.

It comes after the government accepted the Joint Committee on Vaccination and Immunisation’s (JCVI) advice for an NHS roll out of the vaccine amid a record high 85,000 gonorrhoea diagnoses in England in 2023 –  3 times higher than in 2012.

People who receive the jab – an existing vaccine for meningococcal B disease, 4CMenB – could be protected from gonorrhoea by up to 40% and help tackle the increasing levels of antibiotic resistant strains of the disease, according to UK Health Security Agency (UKHSA) research. UKHSA is supporting NHS England with the programme’s rollout.

Analysis led by Imperial College London has suggested the vaccine known as 4CMenB could avert up to 100,000 cases of gonorrhoea and save the NHS over £7.9 million over the next decade, if high uptake is achieved and an ongoing programme is confirmed.

Local providers will identify and contact those eligible through sexual health services, with vaccinations starting from early August.

Eligible people will also be offered mpox, hepatitis A and B and human papillomavirus (HPV) vaccinations when attending their appointment for the gonorrhoea vaccine.

NHS England’s National Director for Primary Care and Community Services Dr Amanda Doyle said: “The launch of a world-first routine vaccination for gonorrhoea is a huge step forward for sexual health and will be crucial in protecting individuals, helping to prevent the spread of infection and reduce the rising rates of antibiotic resistant strains of the bacteria.

“NHS teams across the country are now working hard to plan the rollout and ensure we hit the ground running, while the routine mpox vaccination programme builds on the vital progress the NHS has made in recent months in reaching as many eligible people as possible.

“Vaccination is so important in helping to keep each other safe, so I would urge anyone eligible to take up the offer later this year when NHS staff start delivering these vaccines”.

Gonorrhoea is an STI passed on through sex and if not treated, can cause serious health problems such as and infections in the eyes, testicles or prostate.

It is the second most commonly diagnosed STI in England, but not everyone gets symptoms of gonorrhoea. Symptoms include a burning pain when you pee, fluid or discharge coming out of your genitals, and pain in your testicles or lower abdomen.

Symptoms usually start around 2 weeks after infection, but an infected person may have no symptoms and can still transmit the infection.

Using a condom every time you have sex with new or casual partners is the best way to protect you and your partner from gonorrhoea and other STIs.

Minister for Public Health and Prevention Ashley Dalton said: “This world-first vaccine programme represents a significant breakthrough for public health, and once again our NHS is leading the way.

“It could not come at a more critical time – after years of neglect of public health services, we inherited gonorrhoea diagnoses at record levels, triple what they were in 2012. By targeting those most at risk, we can reduce transmission rates from this unpleasant disease that is becoming harder to treat and prevent thousands of cases over the next few years.

“I would encourage all those eligible to take up the vaccine when it is offered later this year, to not only keep each other safe but help tackle the growing threat of antibiotic resistance. This groundbreaking initiative will play a key role as we shift the health service from sickness to prevention under our Plan for Change”.

Dr Sema Mandal, Consultant Epidemiologist and Deputy Director at the UK Health Security Agency, said: “This vaccination programme is a hugely welcome intervention at a time when we’re seeing very concerning levels of gonorrhoea, including antibiotic resistant gonorrhoea. In 2023 we saw gonorrhoea diagnoses reach their highest since records began in 1918.

“Not only will this rollout provide much needed protection to those that need it most, but it will make the UK the first country in the world to offer this protection and a world leader in protecting people against gonorrhoea.

“STIs aren’t just an inconvenience – they can have a major impact on your health and that of any sexual partners, so please, if you are offered the vaccine do take the opportunity to protect yourself and your partners”.

In January, the NHS made mpox vaccinations available in every region for those at increased risk of getting the infection.

Mpox can be passed on from person to person through any close physical contact with mpox blisters or scabs. Once infected with mpox, it usually takes between 5 and 21 days for the first symptoms to appear.

The first symptoms of mpox include a high temperature, headache, muscle aches and backache, swollen glands, shivering, exhaustion and joint pain. A rash usually appears 1 to 5 days after the first symptoms and can be on any part of the body.

More information on treatment and symptoms of mpox  and gonorrhoea is available on the NHS website.

Alice Wiseman, Vice President of the Association of Directors of Public Health, said: “We welcome the rollout of this groundbreaking vaccination programme which will help to tackle the huge increase in gonorrhoea diagnoses over recent years, which disproportionately affect gay, bisexual and other men who have sex with other men.

“Staff on the ground do an amazing job to provide support in a safe, non-judgemental environment but we need further commitment to provide locally coordinated programmes to prevent infections, reduce the health inequalities in our communities and reverse the increasing numbers of STIs resulting from people going untreated”.

James Woolgar, Chair of English HIV and Sexual Health Commissioners’ Group, said: “Introducing the world’s first gonorrhoea vaccine programme into England’s sexual health services is a major milestone for public health. This initiative has the potential, as proven in multiple studies, to reduce the cases of gonorrhoea in specific groups by an average of 35%. It is a much-needed intervention, and one that public health leads and commissioners will work hard to embed within sexual health services locally to reduce the number of diagnoses nationally”.

Professor Matt Phillips, President of the British Association for Sexual Health and HIV, said: “This is excellent news and a landmark moment for sexual health in England. A new gonorrhoea vaccination programme – alongside continued rollout of mpox vaccination – forms a vital part of our efforts to address the significant inequalities we are seeing in sexual health outcomes. Gonorrhoea diagnoses are at their highest since records began and this has the potential to help us to turn that around”.

Dr Will Nutland, Director at The Love Tank, said: “The Love Tank has campaigned for the introduction of both of these vaccines to be available on a routine basis. As such, we are delighted to see the announcement of the new targeted vaccination programmes. This will contribute to STI reductions, especially in groups of people currently most impacted by mpox and gonorrhoea”.

Richard Angell OBE, Chief Executive of Terrence Higgins Trust, said: “As worries grow about antibiotic-resistant gonorrhoea strains, it is brilliant news that a vaccine is available and a game changer that the government will roll this out within months. This alone could cut 40% of new gonorrhoea cases.

“We have been calling for the gonorrhoea vaccine rollout since the JCVI first advised it and are so pleased the new government has listened and moved at speed. It is important to test regularly for HIV and STIs and stay in charge of your sexual health. Vaccines are a key tool. We will work to ensure that people understand how they could benefit from and access vaccinations for gonorrhoea, mpox, HPV and hepatitis so that existing health inequalities are not exacerbated. We must not let good news like this be a secret”.

Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Local authority commissioned sexual health services have played a vital role at detecting, treating and managing the growing number of cases of gonorrhoea across the country. The targeted rollout of the vaccine, which could be a game-changer and dramatically reduce transmission of gonorrhoea is good news.

“Sexual health clinics are on the front line of the STI outbreaks. It is vital that we have a strong and well-funded health protection system to support the vaccine rollout.

“It is important that eligible people across England are able to access vaccines easily, when the vaccine becomes available, please come forward and get protected”.