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For years there was no mening B vaccine
1) It was uncommon. Most meningitis cases not serotype B meningococcus
2) It was hard. Polysaccharide vaccines worked against A, C, W-135 but B’s polysaccharide capsule didn’t work. It was too similar to human neural adhesion molecules
Cuban researchers facing an outbreak in 1980s found a solution. They took a different route and produced outer membrane vesicles, rather than polysaccharide (carbohydrate) vaccines.
Their vaccine worked.
But given Cuban’s isolation the vaccine was not globally used.
Cuban vaccine was shared for research. It showed it could be done. Outbreaks to mening B were few and far between, though.
Others outbreaks in Norway and New Zealand led to the roll out other non-polysaccharide vaccines. Outbreaks in universities also prompted more use.
There are now meningitis B vaccines, particularly for those highest risk (immunocompromised, microbiologists, some university students) and in outbreaks.
