1
|
Rosa Duque JS, Cheng SMS, Cohen CA, Leung D, Wang X, Mu X, Chung Y, Lau TM, Wang M, Zhang W, Zhang Y, Wong HHW, Tsang LCH, Chaothai S, Kwan TC, Li JKC, Chan KCK, Luk LLH, Ho JCH, Li WY, Lee AMT, Lam JHY, Chan SM, Wong WHS, Tam IYS, Mori M, Valkenburg SA, Peiris M, Tu W, Lau YL. Superior antibody and membrane protein-specific T-cell responses to CoronaVac by intradermal versus intramuscular routes in adolescents. World J Pediatr 2024; 20:353-370. [PMID: 38085470 PMCID: PMC11052846 DOI: 10.1007/s12519-023-00764-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/18/2023] [Indexed: 04/29/2024]
Abstract
BACKGROUND Optimising the immunogenicity of COVID-19 vaccines to improve their protection against disease is necessary. Fractional dosing by intradermal (ID) administration has been shown to be equally immunogenic as intramuscular (IM) administration for several vaccines, but the immunogenicity of ID inactivated whole severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the full dose is unknown. This study (NCT04800133) investigated the superiority of antibody and T-cell responses of full-dose CoronaVac by ID over IM administration in adolescents. METHODS Participants aged 11-17 years received two doses of IM or ID vaccine, followed by the 3rd dose 13-42 days later. Humoral and cellular immunogenicity outcomes were measured post-dose 2 (IM-CC versus ID-CC) and post-dose 3 (IM-CCC versus ID-CCC). Doses 2 and 3 were administered to 173 and 104 adolescents, respectively. RESULTS Spike protein (S) immunoglobulin G (IgG), S-receptor-binding domain (RBD) IgG, S IgG Fcγ receptor IIIa (FcγRIIIa)-binding, SNM [sum of individual (S), nucleocapsid protein (N), and membrane protein (M) peptide pool]-specific interleukin-2 (IL-2)+CD4+, SNM-specific IL-2+CD8+, S-specific IL-2+CD8+, N-specific IL-2+CD4+, N-specific IL-2+CD8+ and M-specific IL-2+CD4+ responses fulfilled the superior and non-inferior criteria for ID-CC compared to IM-CC, whereas IgG avidity was inferior. For ID-CCC, S-RBD IgG, surrogate virus neutralisation test, 90% plaque reduction neutralisation titre (PRNT90), PRNT50, S IgG avidity, S IgG FcγRIIIa-binding, M-specific IL-2+CD4+, interferon-γ+CD8+ and IL-2+CD8+ responses were superior and non-inferior to IM-CCC. The estimated vaccine efficacies were 49%, 52%, 66% and 79% for IM-CC, ID-CC, IM-CCC and ID-CCC, respectively. The ID groups reported more local, mild adverse reactions. CONCLUSION This is the first study to demonstrate superior antibody and M-specific T-cell responses by ID inactivated SARS-CoV-2 vaccination and serves as the basis for future research to improve the immunogenicity of inactivated vaccines.
Collapse
Affiliation(s)
- Jaime S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Samuel M S Cheng
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Carolyn A Cohen
- School of Public Health, The University of Hong Kong, Hong Kong, China
- HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Daniel Leung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiwei Wang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiaofeng Mu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuet Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Tsun Ming Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Manni Wang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Wenyue Zhang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Yanmei Zhang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Howard H W Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Leo C H Tsang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Sara Chaothai
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Tsz Chun Kwan
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - John K C Li
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Karl C K Chan
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Leo L H Luk
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Jenson C H Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Wing Yan Li
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Amos M T Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Jennifer H Y Lam
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Sau Man Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Issan Y S Tam
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Masashi Mori
- Research Institute for Bioresources and Biotechnology, Ishikawa Prefectural University, Nonoichi, Japan
| | - Sophie A Valkenburg
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- HKU-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong, China.
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection, and Immunity, University of Melbourne, Melbourne, VIC, Australia.
| | - Malik Peiris
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- Center for Immunology and Infection C2i, Hong Kong, China.
| | - Wenwei Tu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.
| | - Yu Lung Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
2
|
Immunogenicity and reactogenicity of SARS-CoV-2 vaccines BNT162b2 and CoronaVac in healthy adolescents. Nat Commun 2022; 13:3700. [PMID: 35764637 PMCID: PMC9240007 DOI: 10.1038/s41467-022-31485-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/17/2022] [Indexed: 12/25/2022] Open
Abstract
We present an interim analysis of a registered clinical study (NCT04800133) to establish immunobridging with various antibody and cellular immunity markers and to compare the immunogenicity and reactogenicity of 2-dose BNT162b2 and CoronaVac in healthy adolescents as primary objectives. One-dose BNT162b2, recommended in some localities for risk reduction of myocarditis, is also assessed. Antibodies and T cell immune responses are non-inferior or similar in adolescents receiving 2 doses of BNT162b2 (BB, N = 116) and CoronaVac (CC, N = 123) versus adults after 2 doses of the same vaccine (BB, N = 147; CC, N = 141) but not in adolescents after 1-dose BNT162b2 (B, N = 116). CC induces SARS-CoV-2 N and N C-terminal domain seropositivity in a higher proportion of adolescents than adults. Adverse reactions are mostly mild for both vaccines and more frequent for BNT162b2. We find higher S, neutralising, avidity and Fc receptor-binding antibody responses in adolescents receiving BB than CC, and a similar induction of strong S-specific T cells by the 2 vaccines, in addition to N- and M-specific T cells induced by CoronaVac but not BNT162b2, possibly implying differential durability and cross-variant protection by BNT162b2 and CoronaVac, the 2 most used SARS-CoV-2 vaccines worldwide. Our results support the use of both vaccines in adolescents. There are adverse events associated with COVID-19 vaccines, such as myocarditis for adolescents following receipt of SARS-CoV-2 mRNA vaccines. Here the authors compare the immunogenicity and reactogenicity of two widely available SARS-CoV-2 vaccines (BNT162b2, an mRNA vaccine, and CoronaVac, a whole-virus inactivated vaccine) in healthy adolescents.
Collapse
|
3
|
Efficacy of an inactivated bivalent vaccine for enterovirus 71 and coxsackievirus A16 in mice immunized intradermally. Vaccine 2020; 39:596-604. [PMID: 33342637 DOI: 10.1016/j.vaccine.2020.11.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/06/2020] [Accepted: 11/29/2020] [Indexed: 01/20/2023]
Abstract
Human hand, foot, and mouth disease (HFMD), an important infectious disease in children, is caused mainly by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). In this study, a bivalent inactivated EV71/CA16 vaccine is developed and evaluated in immunized BALB/c mice injected through the intradermal route. Q-RT-PCR detection of the mRNA of immune signal molecules in local epithelial tissues inoculated with the vaccine indicates activation of innate immunity, which includes upregulation of immune-related chemokines, interferons and CD molecules. Further, the finding that neutralizing antibodies and specific T cellular responses were elicited in adult mice after two immunizations with the vaccine at a 28-day interval, which endowed offspring mice to defend a viral challenge, suggests the successful induction of specific protective antiviral immunity. All these data suggest that immunization with this bivalent EV71/CA16 vaccine via the intradermal route elicits effective immunity against EV71 and CA16 infection.
Collapse
|
4
|
Schnyder JL, De Pijper CA, Garcia Garrido HM, Daams JG, Goorhuis A, Stijnis C, Schaumburg F, Grobusch MP. Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis. Travel Med Infect Dis 2020; 37:101868. [PMID: 32898704 PMCID: PMC7474844 DOI: 10.1016/j.tmaid.2020.101868] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vaccine supply shortages are of global concern. We hypothesise that intradermal (ID) immunisation as an alternative to standard routes might augment vaccine supply utilisation without loss of vaccine immunogenicity and efficacy. METHODS We conducted a systematic review and meta-analysis searching Medline, Embase and Web of Science databases. Studies were included if: licensed, currently available vaccines were used; fractional dose of ID was compared to IM or SC immunisation; primary immunisation schedules were evaluated; immunogenicity, safety data and/or cost were reported. We calculated risk differences (RD). Studies were included in meta-analysis if: a pre-defined immune correlate of protection was assessed; WHO-recommend schedules and antigen doses were used in the control group; the same schedule was applied to both ID and control groups (PROSPERO registration no. CRD42020151725). RESULTS The primary search yielded 5,873 articles, of which 156 articles were included; covering 12 vaccines. Non-inferiority of immunogenicity with 20-60% of antigen used with ID vaccines was demonstrated for influenza (H1N1: RD -0·01; 95% CI -0·02, 0·01; I2 = 55%, H2N3: RD 0·00; 95% CI -0·01, 0·01; I2 = 0%, B: RD -0·00; 95% CI -0·02, 0·01; I2 = 72%), rabies (RD 0·00; 95% CI -0·02, 0·02; I2 = 0%), and hepatitis B vaccines (RD -0·01; 95% CI -0·04, 0·02; I2 = 20%). Clinical trials on the remaining vaccines yielded promising results, but are scarce. CONCLUSIONS There is potential for inoculum/antigen dose-reduction by using ID immunisation as compared to standard routes of administration for some vaccines (e.g. influenza, rabies). When suitable, vaccine trials should include an ID arm.
Collapse
Affiliation(s)
- Jenny L Schnyder
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands
| | - Cornelis A De Pijper
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands
| | - Hannah M Garcia Garrido
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands
| | - Joost G Daams
- Medical Library, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Abraham Goorhuis
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands
| | - Cornelis Stijnis
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149, Münster, Germany
| | - Martin P Grobusch
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, Netherlands.
| |
Collapse
|
5
|
Suragh TA, Hibbs B, Marquez P, McNeil MM. Age inappropriate influenza vaccination in infants less than 6 months old, 2010-2018. Vaccine 2020; 38:3747-3751. [PMID: 32273185 DOI: 10.1016/j.vaccine.2020.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/19/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Annual influenza vaccination is recommended for persons 6 months or older and vaccination in infants less than 6 months old is a vaccine administration error. There are limited safety studies in this population, particularly among infants less than 6 weeks old. METHODS We searched the U.S. Vaccine Adverse Event Reporting System (VAERS) database for reports of adverse events (AEs) following influenza vaccination in infants less than 6 months old for the 2010-2018 influenza seasons. We conducted a descriptive and qualitative analysis of reports to describe AEs and identify possible risk factors. RESULTS In total, 114 reports were identified; only 21 reported a specific AE. Pyrexia, irritability, crying and diarrhea were the most common symptoms. There were 12 reports involving newborns; the most common circumstance cited was confusion with the birth dose of hepatitis B vaccine. The following risk factors were identified: (1) individuals getting vaccinated together resulting in patient mix-ups; (2) healthcare provider not verifying the patient's information; (3) individual provider confusion due to similarities in vaccines' packaging and names of vaccines that sound alike. CONCLUSIONS Reports identified of influenza vaccination in infants less than 6 months old indicate that vaccination errors in this age group are occurring and healthcare providers who vaccinate infants should be aware of how to prevent such events. Our study adds to the existing literature by providing valuable information regarding the general absence of serious adverse events in the case of vaccination errors associated with inadvertent influenza vaccine within this population.
Collapse
Affiliation(s)
- Tiffany A Suragh
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, United States.
| | - Beth Hibbs
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, United States
| | - Paige Marquez
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, United States
| | - Michael M McNeil
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, United States
| |
Collapse
|
6
|
Singh M, Tanvir T, Nagoji D, Madan A, Gattem S, Singh H. Influenza vaccine: A viable option to protect pregnant women and infants from seasonal flu: A retrospective hospital-based study in India. Int J Clin Pract 2019; 73:e13361. [PMID: 31074182 DOI: 10.1111/ijcp.13361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/14/2019] [Accepted: 05/04/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Influenza is a highly contagious disease with global annual outbreaks of 3-5 million severe cases and 0.25-0.5 million deaths. The risk is greater in pregnant women that results in high morbidity and mortality. OBJECTIVE The objective of this study was to see the efficacy of influenza vaccine on pregnant women and their newborn upto 6 months. METHOD This was a retrospective study (January 2016-March 2018). Records of 346 pregnant women were included in this study (vaccinated: 288; unvaccinated: 58). Women and infants were categorised into Category A, B or C according to the guidelines issued by the Ministry of Health and Family Welfare, India on influenza. RESULTS The groups were comparable with respect to baseline characteristics. Greater number of women received influenza vaccine during the first trimester (n = 117). During the gestation period, majority of the women in the vaccinated group were symptom-free compared with the unvaccinated (92% vs 70.7%). Also, none of the vaccinated women were categorised into category C compared with one who was laboratory tested positive for influenza in the unvaccinated group. Similar results were seen postpartum and more number of infants remained symptom-free in the vaccinated group compared with unvaccinated (69.3% vs 25.9%). More number of infants were born pre-term in the unvaccinated group compared with vaccinated (15.5% vs 8.6%). CONCLUSIONS Immunisation with influenza vaccine in any trimester during pregnancy was found to protect the mother and infants upto 6 months of age against seasonal influenza without significant maternal adverse effects. In order to improve vaccination rates, there must be a national vaccination policy and incorporation of maternal immunisation in standard antenatal care.
Collapse
Affiliation(s)
- Meeta Singh
- Tanvir Hospital, Hyderabad, Telangana, India
| | | | - Dharani Nagoji
- SVS Medical College & Hospital, Mahbubnagar, Telangana, India
| | | | | | | |
Collapse
|
7
|
Nunes MC, Madhi SA. Prevention of influenza-related illness in young infants by maternal vaccination during pregnancy. F1000Res 2018; 7:122. [PMID: 29445450 PMCID: PMC5791002 DOI: 10.12688/f1000research.12473.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/15/2022] Open
Abstract
The influenza virus circulates yearly and causes global epidemics. Influenza infection affects all age groups and causes mild to severe illness, and young infants are at particular risk for serious disease. The most effective measure to prevent influenza disease is vaccination; however, no vaccine is licensed for use in infants younger than 6 months old. Thus, there is a crucial need for other preventive strategies in this high-risk age group. Influenza vaccination during pregnancy protects both the mothers and the young infants against influenza infection. Vaccination during pregnancy boosts the maternal antibodies and increases the transfer of immunoglobulin G from the mother to the fetus through the placenta, which confers protection against infection in infants too young to be vaccinated. Data from clinical trials and observational studies did not demonstrate adverse effects to the mother, the fetus, or the infant after maternal influenza vaccination. We present the current data on the effectiveness and safety of influenza vaccination during pregnancy in preventing disease in the young infant.
Collapse
Affiliation(s)
- Marta C Nunes
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
8
|
Weissmueller NT, Marsay L, Schiffter HA, Carlisle RC, Rollier CS, Prud’homme RK, Pollard AJ. Alternative vaccine administration by powder injection: Needle-free dermal delivery of the glycoconjugate meningococcal group Y vaccine. PLoS One 2017; 12:e0183427. [PMID: 28837693 PMCID: PMC5570268 DOI: 10.1371/journal.pone.0183427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/03/2017] [Indexed: 11/30/2022] Open
Abstract
Powder-injectors use gas propulsion to deposit lyophilised drug or vaccine particles in the epidermal and sub epidermal layers of the skin. We prepared dry-powder (Tg = 45.2 ± 0.5°C) microparticles (58.1 μm) of a MenY-CRM197 glyconjugate vaccine (0.5% wt.) for intradermal needle-free powder injection (NFPI). SFD used ultrasound atomisation of the liquid vaccine-containing excipient feed, followed by lyophilisation above the glass transition temperature (Tg' = - 29.9 ± 0.3°C). This resulted in robust particles (density~ 0.53 ±0.09 g/cm3) with a narrow volume size distribution (mean diameter 58.1 μm, and span = 1.2), and an impact parameter (ρvr ~ 11.5 kg/m·s) sufficient to breach the Stratum corneum (sc). The trehalose, manitol, dextran (10 kDa), dextran (150 kDa) formulation, or TMDD (3:3:3:1), protected the MenY-CRM197 glyconjugate during SFD with minimal loss, no detectable chemical degradation or physical aggregation. In a capsular group Y Neisseria meningitidis serum bactericidal assay (SBA) with human serum complement, the needle free vaccine, which contained no alum adjuvant, induced functional protective antibody responses in vivo of similar magnitude to the conventional vaccine injected by hypodermic needle and syringe and containing alum adjuvant. These results demonstrate that needle-free vaccination is both technically and immunologically valid, and could be considered for vaccines in development.
Collapse
Affiliation(s)
- Nikolas T. Weissmueller
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford and the NIHR Oxford Biomedical Research Institute, Oxford, Oxfordshire, United Kingdom
- Department of Biological and Chemical Engineering, Princeton University, Princeton, New Jersey, United States of America
- Institute of Biomedical Engineering, Biomedical Ultrasonics, Biotherapy & Biopharmaceuticals Laboratory (BUBBL), Oxford, Oxfordshire, United Kingdom
| | - Leanne Marsay
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford and the NIHR Oxford Biomedical Research Institute, Oxford, Oxfordshire, United Kingdom
| | - Heiko A. Schiffter
- Institute of Biomedical Engineering, Biomedical Ultrasonics, Biotherapy & Biopharmaceuticals Laboratory (BUBBL), Oxford, Oxfordshire, United Kingdom
| | - Robert C. Carlisle
- Institute of Biomedical Engineering, Biomedical Ultrasonics, Biotherapy & Biopharmaceuticals Laboratory (BUBBL), Oxford, Oxfordshire, United Kingdom
| | - Christine S. Rollier
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford and the NIHR Oxford Biomedical Research Institute, Oxford, Oxfordshire, United Kingdom
| | - Robert K. Prud’homme
- Department of Biological and Chemical Engineering, Princeton University, Princeton, New Jersey, United States of America
| | - Andrew J. Pollard
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford and the NIHR Oxford Biomedical Research Institute, Oxford, Oxfordshire, United Kingdom
| |
Collapse
|
9
|
Sugimura T, Nagai T, Kobayashi H, Ozaki Y, Yamakawa R, Hirata R. Effectiveness of maternal influenza immunization in young infants in Japan. Pediatr Int 2016; 58:709-13. [PMID: 26670462 DOI: 10.1111/ped.12888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 12/04/2015] [Accepted: 12/09/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infants with influenza, particularly those younger than 1 year of age, are at high risk of developing a severe case or of dying. Recently, owing to the spread of pandemic influenza A (H1N1) 2009, the Advisory Committee on Immunization Practices recommended maternal immunization to reduce the risk of influenza infection in pregnant women and infants. Such reporting is rare in Japan. The aim of this study was therefore to investigate the effect on the newborn of influenza vaccination of pregnant women in Japan. METHODS The study included 200 infants who were born to healthy mothers at Kobayashi Ladies Clinic during influenza season from November 2010 to April 2011. The incidence of fever and laboratory-confirmed influenza was assessed in the infants for the 6 months after their birth. RESULTS Of the 200 infants, four were excluded from this study due to loss to follow up. The 106 infants in the group whose mothers received the influenza vaccine (vaccinated group) before parturition were compared with the 90 infants in the group whose mothers did not receive the influenza vaccine (non-vaccinated group). Fever was noted in 36 infants (34.0%) in the vaccinated group and in 47 infants (52.2%) in the non-vaccinated group (P < 0.007), and the incidence of influenza was 0 (0%) and 5 (5.6%), respectively (P = 0.019). The incidence of fever and influenza among infants was significantly lower in the vaccinated group compared with the non-vaccinated group. CONCLUSIONS Maternal influenza immunization should be actively recommended in Japan to protect newborns from influenza viruses.
Collapse
Affiliation(s)
- Tetsu Sugimura
- Department of Pediatrics and Allergology, Sugimura Children's Medical Clinic, Chikugo, Fukuoka, Japan
| | - Takao Nagai
- Department of Pediatrics, Nagai Children's Clinic, Takamatsu, Kagawa, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics, Gynecology and Anesthesiology, Kobayashi Ladies Clinic, Chikugo, Fukuoka, Japan
| | - Yukiko Ozaki
- Department of Pediatrics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Rumi Yamakawa
- Department of Pediatrics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Rumiko Hirata
- Department of Pediatrics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| |
Collapse
|
10
|
Intranasal Immunization of Mice to Avoid Interference of Maternal Antibody against H5N1 Infection. PLoS One 2016; 11:e0157041. [PMID: 27280297 PMCID: PMC4900595 DOI: 10.1371/journal.pone.0157041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 05/24/2016] [Indexed: 12/03/2022] Open
Abstract
Maternally-derived antibodies (MDAs) can protect offspring against influenza virus infection but may also inhibit active immune responses. To overcome MDA- mediated inhibition, active immunization of offspring with an inactivated H5N1 whole-virion vaccine under the influence of MDAs was explored in mice. Female mice were vaccinated twice via the intraperitoneal (IP) or intranasal (IN) route with the vaccine prior to mating. One week after birth, the offspring were immunized twice via the IP or IN route with the same vaccine and then challenged with a lethal dose of a highly homologous virus strain. The results showed that, no matter which immunization route (IP or IN) was used for mothers, the presence of MDAs severely interfered with the active immune response of the offspring when the offspring were immunized via the IP route. Only via the IN immunization route did the offspring overcome the MDA interference. These results suggest that intranasal immunization could be a suitable inoculation route for offspring to overcome MDA interference in the defense against highly pathogenic H5N1 virus infection. This study may provide references for human and animal vaccination to overcome MDA-induced inhibition.
Collapse
|
11
|
Moriarty LF, Omer SB. Infants and the seasonal influenza vaccine. A global perspective on safety, effectiveness, and alternate forms of protection. Hum Vaccin Immunother 2016; 10:2721-8. [PMID: 25483664 DOI: 10.4161/hv.29669] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Seasonal influenza is a substantial cause of severe illness among infants under 6 months of age globally. There are multiple methods of vaccination against influenza, including inactivated and live vaccines that are approved and recommended for children and adults over 6 months of age, but there is no vaccine that protects against seasonal influenza for children <6 months of age. This group is at a high risk of severe illness and is associated with higher rates of hospitalization and mortality during the influenza season. In absence of an available vaccine, approaches protecting young infants from influenza must be taken seriously. These methods include vaccinating pregnant women for influenza as a method of protecting mothers and the fetus as well as vaccinating caregivers and close contacts of individuals in this age group.
Collapse
Affiliation(s)
- Leah F Moriarty
- a Hubert Department of Global Health; Rollins School of Public Health ; Emory University ; Atlanta , GA USA
| | | |
Collapse
|
12
|
Abstract
Intradermal (ID) vaccination induces a more potent immune response and requires lower vaccine doses as compared with standard vaccination routes. To deliver ID vaccines effectively and consistently, an ID delivery device has been developed and is commercially available for adults. The clinical application of ID vaccines for infants and children is much anticipated because children receive several vaccines, on multiple occasions, during infancy and childhood. However, experience with ID vaccines is limited and present evidence is sparse and inconsistent. ID delivery devices are not currently available for infants and children, but recent studies have examined skin thickness in this population and reported that it did not differ in proportion to body size in infants, children, and adults. These results are helpful in developing new ID devices and for preparing new vaccines in infants and children.
Collapse
Affiliation(s)
- Akihiko Saitoh
- a Department of Pediatrics , Niigata University Graduate School of Medical and Dental Sciences , Niigata , Japan
| | - Yuta Aizawa
- a Department of Pediatrics , Niigata University Graduate School of Medical and Dental Sciences , Niigata , Japan
| |
Collapse
|
13
|
Zhang L, Wang W, Wang S. Effect of vaccine administration modality on immunogenicity and efficacy. Expert Rev Vaccines 2015; 14:1509-23. [PMID: 26313239 DOI: 10.1586/14760584.2015.1081067] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The many factors impacting the efficacy of a vaccine can be broadly divided into three categories: features of the vaccine itself, including immunogen design, vaccine type, formulation, adjuvant and dosing; individual variations among vaccine recipients and vaccine administration-related parameters. While much literature exists related to vaccines, and recently systems biology has started to dissect the impact of individual subject variation on vaccine efficacy, few studies have focused on the role of vaccine administration-related parameters on vaccine efficacy. Parenteral and mucosal vaccinations are traditional approaches for licensed vaccines; novel vaccine delivery approaches, including needless injection and adjuvant formulations, are being developed to further improve vaccine safety and efficacy. This review provides a brief summary of vaccine administration-related factors, including vaccination approach, delivery route and method of administration, to gain a better understanding of their potential impact on the safety and immunogenicity of candidate vaccines.
Collapse
Affiliation(s)
- Lu Zhang
- a 1 Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China.,b 2 China-US Vaccine Research Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Wei Wang
- c 3 Wang Biologics, LLC, Chesterfield, MO 63017, USA ; Current affiliation: Bayer HealthCare, Berkeley, CA 94710, USA
| | - Shixia Wang
- d 4 Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
| |
Collapse
|
14
|
Saitoh A, Aizawa Y, Sato I, Hirano H, Sakai T, Mori M. Skin thickness in young infants and adolescents: Applications for intradermal vaccination. Vaccine 2015; 33:3384-91. [DOI: 10.1016/j.vaccine.2015.04.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 03/31/2015] [Accepted: 04/22/2015] [Indexed: 11/26/2022]
|
15
|
Levin Y, Kochba E, Hung I, Kenney R. Intradermal vaccination using the novel microneedle device MicronJet600: Past, present, and future. Hum Vaccin Immunother 2015; 11:991-7. [PMID: 25745830 PMCID: PMC4514308 DOI: 10.1080/21645515.2015.1010871] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 12/24/2014] [Accepted: 01/06/2015] [Indexed: 02/08/2023] Open
Abstract
Intradermal immunization has become a forefront of vaccine improvement, both scientifically and commercially. Newer technologies are being developed to address the need to reduce the dose required for vaccination and to improve the reliability and ease of injection, which have been major hurdles in expanding the number of approved vaccines using this route of administration. In this review, 7 y of clinical experience with a novel intradermal delivery device, the MicronJet600, which is a registered hollow microneedle that simplifies the delivery of liquid vaccines, are summarized. This device has demonstrated both significant dose-sparing and superior immunogenicity in various vaccine categories, as well as in diverse subject populations and age groups. These studies have shown that intradermal delivery using this device is safe, effective, and preferred by the subjects. Comparison with other intradermal devices and potential new applications for intradermal delivery that could be pursued in the future are also discussed.
Collapse
Key Words
- AE, adverse event
- BCG, Bacillus Calmette–Guérin
- BD, Becton Dickinson
- CDC, Center of Disease Control
- DTP, diphtheria, pertussis and tetanus
- EMEA, European Medicines Agency
- FDA, Food and Drug Administration
- GMT, geometric mean titer
- HA, hemagglutinin
- HBV, hepatitis B virus
- HIV, Human immunodeficiency virus
- HPV, human papilloma virus
- ID, intradermal
- IM, Intramuscular
- IPV, inactivated polio vaccine
- MEMS, Micro Electro Mechanical System
- Mantoux
- PPD, Purified protein derivative
- SAGE, Strategic Advisory Group of Experts
- SQ, subcutaneous
- WHO, World Health Organization
- dose-sparing
- icddr,b, International Center for Diarrheal Disease Research, Bangladesh
- immunogenicity
- influenza vaccine
- intradermal
- microneedles
- vaccine delivery
- vaccine device
Collapse
Affiliation(s)
| | | | - Ivan Hung
- State Key Laboratory for Emerging Infectious Diseases; Carol Yu's Center for Infection and Division of Infectious Diseases; The University of Hong Kong; Queen Mary Hospital;Hong Kong Special Administrative Region; Hong Kong, China
| | | |
Collapse
|
16
|
Levin Y, Kochba E, Kenney R. Clinical evaluation of a novel microneedle device for intradermal delivery of an influenza vaccine: are all delivery methods the same? Vaccine 2014; 32:4249-52. [PMID: 24930715 DOI: 10.1016/j.vaccine.2014.03.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 01/19/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
Abstract
The skin provides the largest immune barrier to infection and is a readily accessible site for vaccination, although intradermal (ID) injection can be challenging. The MicronJet™ microneedle is a novel device that consistently injects antigens very close to the skin's dendritic cells. A dose-sparing ID injection study was conducted in 280 healthy adult volunteers using trivalent virosomal adjuvanted influenza vaccine. ID injection of 3 μg using the MicronJet™ was well tolerated and showed a statistically higher geometric mean fold rise than the same dose ID using a conventional needle (Mantoux technique) for the H1N1 and B strains or a 15 μg intramuscular (IM) injection for the H3N2 strain. Thus, the immune response appears to partially depend on the delivery device and route of injection. The MicronJet™ may allow dose-sparing, yet give a superior response in influenza vaccination and warrants further clinical evaluation.
Collapse
Affiliation(s)
- Yotam Levin
- NanoPass Technologies Ltd., 3 Golda Meir Street, Nes Ziona 7403648, Israel.
| | - Efrat Kochba
- NanoPass Technologies Ltd., 3 Golda Meir Street, Nes Ziona 7403648, Israel.
| | - Richard Kenney
- Crucell Holland B.V., Archimedesweg 4, 2333 CN Leiden, The Netherlands.
| |
Collapse
|
17
|
Bonati M, Clavenna A. Seasonal influenza immunization in early infancy? BMC Public Health 2012; 12:873. [PMID: 23067010 PMCID: PMC3533639 DOI: 10.1186/1471-2458-12-873] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 10/10/2012] [Indexed: 01/26/2023] Open
|
18
|
Immunogenicity of protein aggregates--concerns and realities. Int J Pharm 2012; 431:1-11. [PMID: 22546296 DOI: 10.1016/j.ijpharm.2012.04.040] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 04/10/2012] [Accepted: 04/13/2012] [Indexed: 01/14/2023]
Abstract
Protein aggregation is one of the key challenges in the development of protein biotherapeutics. It is a critical product quality issue as well as a potential safety concern due to the increased immunogenicity potential of these aggregates. The overwhelming safety concern has led to an increased development effort and regulatory scrutiny in recent years. The main purposes of this review are to examine the literature data on the relationship between protein aggregates and immunogenicity, to highlight the linkage and existing inconsistencies/uncertainties, and to propose directions for future investigations/development.
Collapse
|
19
|
Langley JM, Vanderkooi OG, Garfield HA, Hebert J, Chandrasekaran V, Jain VK, Fries L. Immunogenicity and Safety of 2 Dose Levels of a Thimerosal-Free Trivalent Seasonal Influenza Vaccine in Children Aged 6-35 Months: A Randomized, Controlled Trial. J Pediatric Infect Dis Soc 2012; 1:55-63. [PMID: 23687572 PMCID: PMC3656551 DOI: 10.1093/jpids/pis012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Improved influenza vaccine strategies for infants and preschool children are a high priority. METHODS The immunological response and safety of a thimerosal-free trivalent inactivated influenza vaccine at 2 different doses (0.50 mL vs 0.25 mL) was evaluated in children aged 6-35 months. The study was randomized, observer blind, multicenter, and stratified by age (6-23 months and 24-35 months), and it accounted for prior influenza immunization status. RESULTS Three hundred seventy-four children were in the total vaccinated cohort (study vaccine 0.25-mL dose, n = 164; 0.50-mL dose, n = 167; comparator 0.25 mL, n = 43). Regulatory criteria for immunogenicity of influenza vaccines in adults were met for all virus strains and doses for both age strata. A modest but not statistically significant improvement in immune responses was observed with the higher dose and reactogenicity, and safety of the 2 doses was not significantly different. CONCLUSIONS The 0.5-mL dose of the study vaccine, when administered to children aged 6-35 months, resulted in a modest but not statistically significant improvement in immunogenicity with clinically similar safety and reactogenicity compared with the 0.25-mL dose. Further studies comparing full- and half-dose influenza vaccine in young children are needed. CLINICAL TRIALS REGISTRATION NCT00778895.
Collapse
Affiliation(s)
- Joanne M Langley
- Canadian Center for Vaccinology Dalhousie University IWK Health Centre Halifax, Nova Scotia
| | | | | | - Jacques Hebert
- Allergy and Immunology, Centre Hospitalier Universitaire de Québec, Canada
| | | | - Varsha K Jain
- GlaxoSmithKline Biologicals, King of Prussia, Pennsylvania
| | - Louis Fries
- GlaxoSmithKline Biologicals, Columbia, Maryland
| |
Collapse
|
20
|
Icardi G, Orsi A, Ceravolo A, Ansaldi F. Current evidence on intradermal influenza vaccines administered by Soluvia™ licensed micro injection system. Hum Vaccin Immunother 2012; 8:67-75. [PMID: 22293531 PMCID: PMC3350142 DOI: 10.4161/hv.8.1.18419] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Among the several strategies explored for (1) the enhancement of the immune response to influenza immunization, (2) the improvement of the vaccine acceptability and (3) the overcoming of the egg-dependency for vaccine production, intradermal administration of influenza vaccine emerges as a promising alternative to conventional intramuscular route, thanks to the recent availability of new delivery devices and the perception of advantages in terms of immunogenicity, safety, reduction of antigen content and acceptability.
Data from clinical trials performed in children, adults <60 y and elderly people and post-marketing surveillance demonstrate that actually, licensed intradermal influenza vaccines, Intanza™ 9 and 15 µg and Fluzone™ Intradermal, administered by the microinjection system Soluvia™, show an excellent acceptability, tolerability and safety profile. Formulations containing 9 and 15 μg per strain demonstrate, respectively, comparable and superior immunogenicity than conventional intramuscular vaccines. Licensed intradermal influenza vaccines can be considered a valid alternative to standard intramuscular vaccination offering significant advantages in low-responder populations and helping to increase influenza vaccination coverage rates especially in people with fear of needles or high apprehension associated with annual vaccination.
Collapse
Affiliation(s)
- Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.
| | | | | | | |
Collapse
|
21
|
Esposito S, Daleno C, Picciolli I, Tagliaferri L, Scala A, Prunotto G, Montinaro V, Galeone C, Principi N. Immunogenicity and safety of intradermal influenza vaccine in children. Vaccine 2011; 29:7606-10. [PMID: 21855592 DOI: 10.1016/j.vaccine.2011.08.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/01/2011] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
Abstract
In order to compare the immunogenicity and safety of different doses of trivalent influenza vaccine (TIV) administered intradermallly (ID) with those evoked by a full dose of intramuscular (IM) virosomal-adjuvanted influenza vaccine (VA-TIV), 112 previously primed healthy children aged ≥ 3 years were randomised to receive 9 μg or 15 μg of each strain of ID-TIV, or a full IM dose (15 μg of each strain) of VA-TIV. The A/H1N1 and A/H3N2 seroconversion and seroprotection rates were ≥ 90% and geometric mean titres (GMTs) increased 3.2-14.9 times without any statistically significant between-group differences; however, the seroconversion and seroprotection rates against the B strain were significantly higher in the children receiving either ID-TIV dose (p<0.05) without any differences between them. GMT against B virus was significantly higher in the children receiving the highest dose (p<0.05). Local reactions were significantly more common among the children receiving either ID-TIV dose (p<0.05), but systemic reactions were relatively uncommon in all three groups. Our findings suggest that ID-TIV with 15 μg of each viral antigen can confer a significant better protection against influenza than that obtained with the same dose of IM TIV in already primed children aged ≥ 3 years with an acceptable safety profile. The lower dose of ID-TIV needs further evaluation to analyze persistence of protection.
Collapse
Affiliation(s)
- Susanna Esposito
- Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Principi N, Esposito S, Marchisio P. Present and future of influenza prevention in pediatrics. Expert Opin Biol Ther 2011; 11:641-53. [DOI: 10.1517/14712598.2011.562495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
23
|
Ansaldi F, Durando P, Icardi G. Intradermal influenza vaccine and new devices: a promising chance for vaccine improvement. Expert Opin Biol Ther 2011; 11:415-27. [DOI: 10.1517/14712598.2011.557658] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
24
|
Amorij JP, Hinrichs WL, Frijlink HW, Wilschut JC, Huckriede A. Needle-free influenza vaccination. THE LANCET. INFECTIOUS DISEASES 2010; 10:699-711. [PMID: 20883966 DOI: 10.1016/s1473-3099(10)70157-2] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vaccination is the cornerstone of influenza control in epidemic and pandemic situations. Influenza vaccines are typically given by intramuscular injection. However, needle-free vaccinations could offer several distinct advantages over intramuscular injections: they are pain-free, easier to distribute, and easier to give to patients, and their use could reduce vaccination costs. Moreover, vaccine delivery via the respiratory tract, alimentary tract, or skin might elicit mucosal immune responses at the site of virus entry and better cellular immunity, thus improving effectiveness. Although various needle-free vaccination methods for influenza have shown preclinical promise, few have progressed to clinical trials-only live attenuated intranasal vaccines have received approval, and only in some countries. Further clinical investigation is needed to help realise the potential of needle-free vaccination for influenza.
Collapse
Affiliation(s)
- Jean-Pierre Amorij
- Department of Pharmaceutical Technology and Biopharmacy, University of Gröningen, Netherlands
| | | | | | | | | |
Collapse
|
25
|
Falsey AR. New emerging technologies and the intradermal route: the novel way to immunize against influenza. Vaccine 2010; 28 Suppl 4:D24-32. [DOI: 10.1016/j.vaccine.2010.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Vankerckhoven V, Van Damme P. Clinical studies assessing immunogenicity and safety of intradermally administered influenza vaccines. Expert Opin Drug Deliv 2010; 7:1109-25. [DOI: 10.1517/17425247.2010.507668] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
27
|
Pan CH, Greer CE, Hauer D, Legg HS, Lee EY, Bergen MJ, Lau B, Adams RJ, Polo JM, Griffin DE. A chimeric alphavirus replicon particle vaccine expressing the hemagglutinin and fusion proteins protects juvenile and infant rhesus macaques from measles. J Virol 2010; 84:3798-807. [PMID: 20130066 PMCID: PMC2849488 DOI: 10.1128/jvi.01566-09] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 12/21/2009] [Indexed: 11/20/2022] Open
Abstract
Measles remains a major cause of child mortality, in part due to an inability to vaccinate young infants with the current live attenuated virus vaccine (LAV). To explore new approaches to infant vaccination, chimeric Venezuelan equine encephalitis/Sindbis virus (VEE/SIN) replicon particles were used to express the hemagglutinin (H) and fusion (F) proteins of measles virus (MV). Juvenile rhesus macaques vaccinated intradermally with a single dose of VEE/SIN expressing H or H and F proteins (VEE/SIN-H or VEE/SIN-H+F, respectively) developed high titers of MV-specific neutralizing antibody and gamma-interferon (IFN-gamma)-producing T cells. Infant macaques vaccinated with two doses of VEE/SIN-H+F also developed neutralizing antibody and IFN-gamma-producing T cells. Control animals were vaccinated with LAV or with a formalin-inactivated measles vaccine (FIMV). Neutralizing antibody remained above the protective level for more than 1 year after vaccination with VEE/SIN-H, VEE/SIN-H+F, or LAV. When challenged with wild-type MV 12 to 17 months after vaccination, all vaccinated juvenile and infant monkeys vaccinated with VEE/SIN-H, VEE/SIN-H+F, and LAV were protected from rash and viremia, while FIMV-vaccinated monkeys were not. Antibody was boosted by challenge in all groups. T-cell responses to challenge were biphasic, with peaks at 7 to 25 days and at 90 to 110 days in all groups, except for the LAV group. Recrudescent T-cell activity coincided with the presence of MV RNA in peripheral blood mononuclear cells. We conclude that VEE/SIN expressing H or H and F induces durable immune responses that protect from measles and offers a promising new approach for measles vaccination. The viral and immunological factors associated with long-term control of MV replication require further investigation.
Collapse
Affiliation(s)
- Chien-Hsiung Pan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Catherine E. Greer
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Debra Hauer
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Harold S. Legg
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Eun-Young Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - M. Jeff Bergen
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Brandyn Lau
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Robert J. Adams
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - John M. Polo
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| | - Diane E. Griffin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21218, Novartis Vaccines and Diagnostics, Cambridge, Massachusetts 02139
| |
Collapse
|
28
|
Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|