Double Duty: Can the meningitis vaccine also protect against gonorrhea?

Can the meningitis vaccine do double duty against gonorrhea? We examine a fascinating randomized trial inspired by years of encouraging observational studies—and what happened when those earlier results were finally put to the test. Along the way, we discuss ecological studies, case-control studies, why statisticians distrust phrases like “trend toward significance,” how intention-to-treat differs from per-protocol analysis, and why no amount of statistical adjustment can fully substitute for randomization. Along the way we celebrate outrageously named clinical trials, ask whether “flirting with statistical significance” belongs in a romance novel or a medical journal, and discover that “practice safe statistics” may be the best advice of the episode. Statistical topics Case-control studies Confounding Ecological studies Generalizability Intention-to-treat Meta-analysis Null results Observational studies P-values Per-protocol analysis Randomized clinical trials Survival analysis Methodologic Morals “Don't mistake a p-value of 0.06 for a p-value of 0.04 with bad luck.”  “Practice safe statistics; randomize whenever possible.” References Seib KL, Donovan B, Jin F, et al. Meningococcal B Vaccine to Prevent Neisseria gonorrhoeae Infection. N Engl J Med. 2026; 395: 349-61.  Petousis-Harris H, Paynter J, Morgan J, et al. Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study. The Lancet. 2017; 390: 1603–10. Wang, B., Mohammed, H., Andraweera, P., McMillan, M., Marshall, H., 2024. Vaccine effectiveness and impact of meningococcal vaccines against gonococcal infections: A systematic review and meta-analysis. Journal of Infection. 2024; 89: 106225.  Molina JM, Bercot B, Assoumou, L, et al. Doxycycline prophylaxis and meningococcal group B vaccine to prevent bacterial sexually transmitted infections in France (ANRS 174 DOXYVAC): a multicentre, open-label, randomised trial with a 2 × 2 factorial design. The Lancet Infectious Diseases. 2024; 24: 1093–1104. Thng C, Eskandari S, Jin F, et al. Efficacy of the meningococcal vaccine against Neisseria gonorrhoeae: a randomised clinical trial (MenGO). npj Vaccines. 2026. Still Not Significant | Probable Error: List of funny disguises scientists use to describe p>.05 Kristin and Regina’s online courses:  Demystifying Data: A Modern Approach to Statistical Understanding   Clinical Trials: Design, Strategy, and Analysis  Medical Statistics Certificate Program   Writing in the Sciences  Epidemiology and Clinical Research Graduate Certificate Program  Programs that we teach in: Epidemiology and Clinical Research Graduate Certificate Program  Find us on: Kristin -  LinkedIn & Twitter/X Regina - LinkedIn & ReginaNuzzo.com (00:15) - - Introduction (00:51) - - The Claim: Can a Meningitis Vaccine Prevent Gonorrhea? (04:10) - - The Biology Behind the Idea (10:37) - - How Observational Studies Made the Link (14:44) - - Earlier Clinical Trials: MENGO and DOXYVAC (17:30) - - Flirting with Significance: A Statistical Rant (22:40) - - GoGoVax: Study Design and Analysis (33:31) - - The Shocking Null Result (35:38) - - Why These Results Don't Generalize (37:42) - - Rating the Claim