Gonorrhea spreads in Quebec as first vaccine is launched

A first gonorrhea vaccine, hailed as a "historic moment for sexual health," will be launched in England, as cases of sexually transmitted and blood-borne infections (STBBIs) reach record highs worldwide. And Quebec is no exception. Could we soon see the arrival of this antidote in the province?

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The world's first vaccination campaign against gonorrhea — commonly known as "the clap" — comes at a time when the disease is exploding across the planet, particularly in Western countries.

Never before have so many cases of STIs been recorded in England as in 2023. And the situation is no different in Quebec.

The reported case rates in 2022 and those projected for 2023 were the highest ever observed in the province, according to the most recent data from the Institut national de santé publique du Québec (INSPQ).

Nearly 9,900 people reported contracting gonorrhea during the first 32 weeks of 2023, 5% more than INSPQ projections.

"These data suggest an acceleration in the number of cases during the last months of 2023," specifies the Portrait of sexually transmitted and blood-borne infections (STBBIs) in Quebec published in July 2024.

Symptoms of gonorrhea include green or yellow discharge, pain when urinating, and pain in the rectum. In women, they may also include lower abdominal pain or bleeding between periods.

However, many people remain asymptomatic.

Relative efficiency

The growth in gonorrhea cases worldwide is mainly due to the disease's increasing resistance to drugs normally used as first treatments.

This means that the bacteria responsible for STIs have developed the ability to survive and multiply, even when exposed to certain antibiotics.

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Two strains of gonorrhea resistant to one of these treatments were identified in Quebec in 2024, according to a report by microbiologist Brigitte Lefebvre of the INSPQ.

The first gonorrhea vaccine is timely, therefore, even though it will not completely eliminate the risk of contracting the disease.

Its effectiveness is between 33% and 42%, according to studies conducted by the Joint Committee on Vaccination and Immunisation (JCVI) in the United Kingdom.

Vaccination would still be beneficial, the JCVI assures, because it is believed that a previous infection with gonorrhoea offers only weak protection against future contamination.

Quebec will have to wait

While the gonorrhea vaccination in England is a world first, the vaccine itself is not new.

"The vaccine that will be used [is known as] 4CMenB or Bexsero was designed to prevent meningococcal infections [responsible for meningitis and septicemia], not gonorrhea," says Nicholas Brousseau, a specialist in public health and preventive medicine at the INSPQ.

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However, this product is not authorized in Canada for the prevention of STIs.

"Some studies have not been able to conclude on its effectiveness against gonorrhea. For the moment, we are waiting for more solid data on the effectiveness of this strategy before recommending it here," says the man who is also a member of the Quebec Immunization Committee (CIQ).