Developing effective vaccines against Neisseria meningitidis serogroup B has 
been challenging for several reasons, including the fact that the capsular 
polysaccharide of N. meningitidis serogroup B is a poor antigen. Therefore, 
studies have focused on developing vaccines that target capsular protein 
meningococcal antigens using reverse vaccinology, a technique that predicts 
likely vaccine candidates using computational analysis of the whole bacterial 
genome. This has resulted in a multicomponent, recombinant, meningococcal 
serogroup B vaccine: 4CMenB (Bexsero(®), Novartis Vaccines & Diagnostics, NC, 
USA), containing four main immunogenic components: two recombinant fusion 
proteins (Neisseria heparin-binding antigen-GNA1030 and factor H-binding 
protein-GNA2091); recombinant Neisserial adhesion A; and detergent-treated outer 
membrane vesicles derived from the meningococcal NZ98/254 strain, where porin A 
1.4 is the major immunodominant antigen. In this article, we summarize the 
available clinical data on 4CMenB in healthy infants, adolescents and adults, 
and discuss the methods available for assessing vaccine efficacy.