Title : Immunogenicity and safety of pentavalent meningococcal MenABCWY vaccine in adolescents and young adults: A systematic review and meta-analysis

Background: The investigational pentavalent meningococcal ABCWY (MenABCWY) vaccine aims to provide protection against the serogroups A, B, C, W, and Y by combining both MenB and MenACWY components. However, there is limited evidence regarding its immunogenicity and safety compared to existing vaccines. We conducted a systematic review and meta-analysis to compare the immunogenicity and safety of MenABCWY with MenB and MenACWY in healthy adolescents and adults.

Methods: For this systematic review and meta-analysis, we searched MEDLINE, Cochrane, and ClinicalTrials.gov from database inception through March 20, 2026, for randomised trials comparing the immunogenicity or safety of the MenABCWY vaccine with the MenACWY vaccine or the MenB vaccine in adolescents and young adults aged 10–25 years. Randomized trials assessing immunogenicity or safety outcomes were included. We conducted meta-analyses using a random-effects model, with results presented as risk ratios (RR) and 95% confidence intervals (CI). Heterogeneity was evaluated using the I² statistic.

Results: Eight randomized controlled trials were included, with outcome-specific sample sizes varying across analyses. Compared with MenACWY vaccines, MenABCWY showed significantly higher seroprotection against serogroup A (hSBA ≥1:8; RR 1.24, 95% CI 1.10–1.40), while most other serogroup comparisons were non-significant. Compared with MenB vaccines, MenABCWY showed significantly higher seroprotection against serogroup Y (hSBA ≥1:8; RR 3.56, 95% CI 2.76–4.60; RR 3.67, 95% CI 3.06–4.41). MenABCWY induced significantly higher MenB antigen responses versus MenACWY vaccines, including fHbp, NadA, NHBA, and OMV (PorA), with no differences observed versus MenB vaccines. Regarding safety, MenABCWY showed increased local and systemic reactogenicity compared with MenACWY vaccines, while no significant differences were observed in serious adverse events or in comparisons with MenB vaccines.

Conclusion: MenABCWY provides broad immunogenicity with acceptable safety, but increased reactogenicity compared with MenACWY vaccines, and no increase in serious adverse events.

Muhammad Omer is a medical student at King Edward Medical University, Lahore. He has a growing interest in clinical research and is keen to contribute to evidence-based advancements in medicine, with a focus on immunology and public health