Serogroup B meningococcal (MenB) disease remains a serious public health problem 
for which a cross-protective vaccine effective against a wide range of MenB 
isolates has not been available. Novartis Vaccines has developed a vaccine for 
the prevention of MenB disease that contains four antigenic components: factor H 
binding protein (fHbp), neisserial adhesin A (NadA), Neisseria heparin binding 
antigen (NHBA) and outer membrane vesicles from a New Zealand epidemic strain 
(which provides PorA). This vaccine has been submitted for regulatory review in 
Europe so it is timely to review the design of the vaccine, results to date in 
clinical studies and the potential strain coverage provided by the vaccine. It 
is also critical to discuss the key issues for the long-term success of the 
vaccine which include strain coverage, potential persistence of protection, 
potential effects on carriage of MenB strains, potential for escape mutants and 
cost effectiveness.