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Asawapaithulsert P, Ngamprasertchai T, Kitro A. Japanese Encephalitis Vaccine Acceptance and Strategies for Travelers: Insights from a Scoping Review and Practitioners in Endemic Countries. Vaccines (Basel) 2023; 11:1683. [PMID: 38006016 PMCID: PMC10674921 DOI: 10.3390/vaccines11111683] [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: 10/09/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Japanese encephalitis (JE) remains the cause of vaccine-preventable encephalitis in individuals living in endemic areas and international travelers. Although rare, the disease's high fatality rate emphasizes the need for effective immunization. This review aims to provide updated data on the JE burden between 2017 and 2023, vaccine acceptance, and vaccine strategies for travelers. We prospectively identified studies, using MEDLINE and PubMed, published through 2023. JE incidence has decreased in local populations and remains low among travelers from non-endemic countries. The local JE risk cannot be utilized to determine traveler risk. Adult travelers naïve to JEV infection or immunization may be at potentially higher risk. The JE vaccine acceptance rates among international travelers visiting JE endemic areas range from 0.2% to 28.5%. The cost of the vaccine and low risk perception could be barriers to JE vaccination. For travelers, an accelerated two-dose regimen of inactivated Vero cell JE vaccine (JE-VC) or a single dosage of live attenuated JE vaccine (JE-LV) may be an option. In conclusion, the JE burden among residents and travelers is lower, but the risk is not negligible. Practitioners should prioritize sharing knowledge, increasing awareness, and promoting vaccinations and preventive measures to reduce tourists' risk of JE along their journey.
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Affiliation(s)
- Punyisa Asawapaithulsert
- Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Thundon Ngamprasertchai
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Amornphat Kitro
- Department of Community Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Shi T, Meng L, Li D, Jin N, Zhao X, Zhang X, Liu Y, Zheng H, Zhao X, Li J, Shen X, Ren X. Effect of different vaccine strategies for the control of Japanese encephalitis in mainland China from 1961 to 2020: A quantitative analysis. Vaccine 2022; 40:6243-6254. [PMID: 36137902 DOI: 10.1016/j.vaccine.2022.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND We aimed to quantify the impact of each vaccine strategy (including the P3-inactivated vaccine strategy [1968-1987], the SA 14-14-2 live-attenuated vaccine strategy [1988-2007], and the Expanded Program on Immunization [EPI, 2008-2020]) on the incidence of Japanese encephalitis (JE) in regions with different economic development levels. METHODS The JE incidence in mainland China from 1961 to 2020 was summarized by year, then modeled and analyzed using an interrupted time series analysis. RESULTS After the P3-inactivated vaccine was used, the JE incidence in Eastern China, Central China, Western China and Northeast China in 1968 decreased by 39.80 % (IRR = 0.602, P < 0.001), 7.80 % (IRR = 0.922, P < 0.001), 10.80 % (IRR = 0.892, P < 0.001) and 31.90 % (IRR = 0.681, P < 0.001); the slope/trend of the JE incidence from 1968 to 1987 decreased by 30.80 % (IRR = 0.692, P < 0.001), 29.30 % (IRR = 0.707, P < 0.001), 33.00 % (IRR = 0.670, P < 0.001) and 41.20 % (IRR = 0.588, P < 0.001). After the SA 14-14-2 live-attenuated vaccine was used, the JE incidence in Eastern China and Northeast China in 1988 decreased by 2.60 % (IRR = 0.974, P = 0.009) and 14.70 % (IRR = 0.853, P < 0.001); the slope/trend of the JE incidence in Eastern China and Central China from 1988 to 2007 decreased by 4.60 % (IRR = 0.954, P < 0.001) and 4.70 % (IRR = 0.953, P < 0.001). After the EPI was implemented, the JE incidence in Eastern China, Central China and Western China in 2008 decreased by 10.50 % (IRR = 0.895, P = 0.013), 18.00 % (IRR = 0.820, P < 0.001) and 24.20 % (IRR = 0.758, P < 0.001), the slope/trend of the JE incidence in Eastern China from 2008 to 2020 decreased by 17.80 % (IRR = 0.822, P < 0.001). CONCLUSIONS Each vaccine strategy has different effects on the JE incidence in regions with different economic development. Additionally, some economically underdeveloped regions have gradually become the main areas of the JE outbreak. Therefore, mainland China should provide economic assistance to areas with low economic development and improve JE vaccination plans in the future to control the epidemic of JE.
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Affiliation(s)
- Tianshan Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Lei Meng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China
| | - Donghua Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Na Jin
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China
| | - Xiangkai Zhao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiaoshu Zhang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China
| | - Yanchen Liu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Hongmiao Zheng
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xin Zhao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Juansheng Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiping Shen
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiaowei Ren
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China.
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Islam N, Xu C, Lau CL, Mills DJ, Clark J, Devine GJ, Hugo LE, Gyawali N, Thalib L, Furuya-Kanamori L. Persistence of antibodies, boostability, and interchangeability of Japanese encephalitis vaccines: A systematic review and dose-response meta-analysis. Vaccine 2022; 40:3546-3555. [PMID: 35568587 DOI: 10.1016/j.vaccine.2022.04.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The burden of Japanese encephalitis (JE) is substantial and is arguably one of the most serious viral encephalitic diseases with high case fatality and no specific treatment. JE vaccines are the only available mean to prevent the disease; however, the long-term persistence of antibodies, boostability, and interchangeability between different vaccine classes are not well understood. METHODS To summarise the evidence, PubMed, Embase, and Cochrane CENTRAL were systematically searched from their inception to March 2021. Dose-response meta-analysis was utilised to synthesise the proportion of individuals who were seropositive over time after a primary vaccination course and a booster dose. Proportion meta-analysis was conducted to estimate the proportion of individuals who were seropositive as well as those who reported adverse events following a booster dose with a different vaccine class. RESULTS Of 1053 publications retrieved, 27 studies with 4,558 participants were included. Of these, 11 studies assessed persistence of antibodies, 14 studies boostability, and 8 vaccine class interchangeability. The pooled seropositivity, 1-year after primary vaccination was 83.4% (95 %CI 78.2-89.5%) and remained stable for up to 5 years (82.7%; 95 %CI 76.1-89.4%). Rapid anamnestic response was observed 10 days post-booster dose, the proportion of individuals who were seropositive reached 96.9% (95 %CI 95.9-97.8%) and remained > 95% for up to 6 years. Inactivated mouse brain-derived vaccines followed by a booster dose of a different vaccine class was effective (i.e. seropositive 99%) and well tolerated. CONCLUSIONS A booster dose after the primary vaccination is effective and further booster doses may be needed after 7 years. Inactivated mouse brain-derived vaccine followed by a booster with a newer vaccine class is effective and safe; although, there is a paucity of data related to newer classes of vaccines interchangeability.
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Affiliation(s)
- Nazmul Islam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Chang Xu
- Ministry of Education, Key Laboratory for Population Health Across-Life Cycle, Anhui Medical University, Anhui, China
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia; Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia; Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Gregor J Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Leon E Hugo
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Lukman Thalib
- Department of Biostatistics, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia.
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Sharma A, Sharma RP, Kaur R, Sharma R, Singh S. A comprehensive insight on the COVID-19 vaccine candidates. J Family Med Prim Care 2021; 10:2457-2466. [PMID: 34568120 PMCID: PMC8415645 DOI: 10.4103/jfmpc.jfmpc_1570_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/29/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
The world is currently facing a pandemic triggered by the novel corona virus (SARS - CoV2), which causes a highly infectious infection that predominantly affects the lungs, resulting in a variety of clinical symptoms some cases may be asymptomatic while others may result in to severe respiratory disorder, if the infection is left unattended it may result in multi-organ failure and eventually death of the patient. The transmission of infection is by droplet and fomites of the infected person. The incubation period of virus is from 2 to 14 days. Most common symptoms resemble flu-like but later progress to pneumonia along with dyspnoea and worsening of oxygen saturation, thus requiring ventilator support. The diagnostic modalities include Reverse transcriptase real time PCR (Quantitative Reverse transcriptase polymerase chain reaction) which is recommended method used for diagnosis of the COVID-19 infection using oro-pharyngeal or nasopharyngeal swabs of the patients. Recently serological tests for antigen and antibody detection has been approved by ICMR. Till now, nine COVID-19 vaccines are granted emergency approval for prevention and for the management of infection symptomatic and supportive measures are being adopted. Globally major pharmaceutical firms are engrossed for development of a potent vaccine candidate. This review highlights on various vaccine candidates under clinical trials.
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Affiliation(s)
- Anu Sharma
- Department of Microbiology, Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India
| | - Ravi Prakash Sharma
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rimplejeet Kaur
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ria Sharma
- MBBS Student, S. N. Medical College, Jodhpur, Rajasthan, India
| | - Surjit Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Vadrevu KM, Potula V, Khalatkar V, Mahantshetty NS, Shah A, Ella R. Persistence of Immune Responses With an Inactivated Japanese Encephalitis Single-Dose Vaccine, JENVAC and Interchangeability With a Live-Attenuated Vaccine. J Infect Dis 2021; 222:1478-1487. [PMID: 31858116 PMCID: PMC7529014 DOI: 10.1093/infdis/jiz672] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/18/2019] [Indexed: 12/03/2022] Open
Abstract
Background This study reports immunogenicity, safety, and interchangeability of a single-dose, inactivated, Vero-cell derived, JENVAC to the live-attenuated SA 14-14-2 vaccine in healthy children. Methods This phase 4, multicenter, open-label, randomized, control trial enrolled 360 children who were equally randomized to receive a single dose of either JENVAC or SA 14-14-2. Children were followed at various time points, until 2 years (day 720) postvaccination, upon which a subset from each group was divided and allocated to a receive a booster dose or the other vaccine. Results At all time points, immunological measures were statistically higher in the JENVAC group. In the interchangeability study, children receiving 2 doses of JENVAC reported significantly higher response compared with 2 doses of SA 14-14-2. No difference in adverse events was observed. These corroborate with excellent seroprotection after the first dose of an earlier JENVAC study. Conclusions A single-dose vaccination with JENVAC induces protective titers that persist up to 1 year. We report appreciable interchangeability between both vaccines, with JENVAC/JENVAC combination exhibiting the highest immune response. JENVAC is now licensed as a single-dose Japanese encephalitis vaccine.
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Affiliation(s)
| | | | - Vasant Khalatkar
- Colours Children Hospital, Jasleen, Pachsheel Square, Nagpur, India
| | | | | | - Raches Ella
- Bharat Biotech International Limited, Genome Valley, Shameerpet, Hyderabad, India
- Correspondence: Raches Ella, MBBS, MS, Bharat Biotech International Ltd., Genome Valley, Turakapally, Shameerpet, Hyderabad, Telangana 500078, India ()
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Abstract
Purpose of review As an eminently vaccine-preventable disease, encephalitis caused by Japanese encephalitis virus (JEV) has attracted an unusually high degree of attention from those seeking to develop viral vaccines. Since the 1950s, all types of JEV vaccines including inactivated, recombinant and live attenuated ones have been licensed. As an example of an extremely successful endeavour, the time is ripe for reviewing the development of JEV vaccines and probing the reasons behind their uniform success. Recent findings Vaccines against JEV have come a long way since the first licensing in the mid-1950s of the mouse brain-grown-inactivated virus preparations, to the present day live-attenuated virus vaccines. A survey of the various inactivated and live vaccines developed against JEV provides a striking insight into the impressive safety and efficacy of all the vaccines available to prevent encephalitis from JEV. This review juxtaposes studies to understand naturally acquired immunity against JEV that have mostly been published post-2000, compares these with those elicited by vaccines and highlights the paucity of data on cell-mediated immune responses elicited by JEV vaccines. Summary This article not only seeks to make available the immense salient literature on this endeavour in one collection, but also queries the basis for the remarkable success of JEV vaccines, not least of which may be the ease of protecting against encephalitis caused by JEV. To conclude, the true test of the ingenuity of those dedicated to the pursuit of viral vaccines would be success against viral diseases such as HIV-AIDS and dengue that pose a far greater challenge to scientists.
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Affiliation(s)
- Vijaya Satchidanandam
- Room SA07, Biology Building, Department of Microbiology and Cell Biology, Indian Institute of Science, Sir C.V. Raman Avenue, Bangalore, Karnataka 560012 India
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Stephenson KE, Tan CS, Walsh SR, Hale A, Ansel JL, Kanjilal DG, Jaegle K, Peter L, Borducchi EN, Nkolola JP, Makoni T, Fogel R, Bradshaw C, Tyler A, Moseley E, Chandrashekar A, Yanosick KE, Seaman MS, Eckels KH, De La Barrera RA, Thompson J, Dawson P, Thomas SJ, Michael NL, Modjarrad K, Barouch DH. Safety and immunogenicity of a Zika purified inactivated virus vaccine given via standard, accelerated, or shortened schedules: a single-centre, double-blind, sequential-group, randomised, placebo-controlled, phase 1 trial. THE LANCET. INFECTIOUS DISEASES 2020; 20:1061-1070. [PMID: 32618279 PMCID: PMC7472641 DOI: 10.1016/s1473-3099(20)30085-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/23/2019] [Accepted: 02/07/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The development of an effective vaccine against Zika virus remains a public health priority. A Zika purified inactivated virus (ZPIV) vaccine candidate has been shown to protect animals against Zika virus challenge and to be well tolerated and immunogenic in humans up to 8 weeks of follow-up. We aimed to assess the safety and immunogenicity of ZPIV in humans up to 52 weeks of follow-up when given via standard or accelerated vaccination schedules. METHODS We did a single-centre, double-blind, randomised controlled, phase 1 trial in healthy adults aged 18-50 years with no known history of flavivirus vaccination or infection at Beth Israel Deaconess Medical Center in Boston, MA, USA. Participants were sequentially enrolled into one of three groups: ZPIV given at weeks 0 and 4 (standard regimen), weeks 0 and 2 (accelerated regimen), or week 0 alone (single-dose regimen). Within each group, participants were randomly assigned using a computer-generated randomisation schedule to receive an intramuscular injection of 5 μg ZPIV or saline placebo, in a ratio of 5:1. The sponsor, clinical staff, investigators, participants, and laboratory personnel were masked to treatment assignment. The primary endpoint was safety up to day 364 after final dose administration, and secondary endpoints were proportion of participants with positive humoral immune responses (50% microneutralisation titre [MN50] ≥100) and geometric mean MN50 at observed peak response (ie, the highest neutralising antibody level observed for an individual participant across all timepoints) and week 28. All participants who received at least one dose of ZPIV or placebo were included in the safety population; the analysis of immunogenicity at observed peak included all participants who received at least one dose of ZPIV or placebo and had any adverse events or immunogenicity data after dosing. The week 28 immunogenicity analysis population consisted of all participants who received ZPIV or placebo and had immunogenicity data available at week 28. This trial is registered with ClinicalTrials.gov, NCT02937233. FINDINGS Between Dec 8, 2016, and May 17, 2017, 12 participants were enrolled into each group and then randomly assigned to vaccine (n=10) or placebo (n=2). There were no serious or grade 3 treatment-related adverse events. The most common reactions among the 30 participants who received the vaccine were injection-site pain (24 [80%]), fatigue (16 [53%]), and headache (14 [46%]). A positive response at observed peak titre was detected in all participants who received ZPIV via the standard regimen, in eight (80%) of ten participants who received ZPIV via the accelerated regimen, and in none of the ten participants who received ZPIV via the single-dose regimen. The geometric mean of all individual participants' observed peak values was 1153·9 (95% CI 455·2-2925·2) in the standard regimen group, 517·7 (142·9-1875·6) in the accelerated regimen group, and 6·3 (3·7-10·8) in the single-dose regimen group. At week 28, a positive response was observed in one (13%) of eight participants who received ZPIV via the standard regimen and in no participant who received ZPIV via the accelerated (n=7) or single-dose (n=10) regimens. The geomteric mean titre (GMT) at this timepoint was 13·9 (95% CI 3·5-55·1) in the standard regimen group and 6·9 (4·0-11·9) in the accelerated regimen group; antibody titres were undetectable at 28 weeks in participants who received ZPIV via the single-dose regimen. For all vaccine schedules, GMTs peaked 2 weeks after the final vaccination and declined to less than 100 by study week 16. There was no difference in observed peak GMTs between the standard 4-week and the accelerated 2-week boosting regimens (p=0·4494). INTERPRETATION ZPIV was safe and well tolerated in humans up to 52 weeks of follow-up. ZPIV immunogenicity required two doses and was not durable. Additional studies of ZPIV to optimise dosing schedules are ongoing. FUNDING The Henry M Jackson Foundation for the Advancement of Military Medicine.
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Affiliation(s)
- Kathryn E Stephenson
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA; Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Chen Sabrina Tan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stephen R Walsh
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andrew Hale
- University of Vermont Medical Center, Burlington, VT, USA; Larner College of Medicine, Burlington, VT, USA
| | - Jessica L Ansel
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Diane G Kanjilal
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kate Jaegle
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Lauren Peter
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Erica N Borducchi
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph P Nkolola
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Tatenda Makoni
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rachel Fogel
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Connor Bradshaw
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Anna Tyler
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Edward Moseley
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Katherine E Yanosick
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael S Seaman
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | | | | | | | | | | | | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA; Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA.
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Lin L, Lyke KE, Koren M, Jarman RG, Eckels KH, Lepine E, McArthur MA, Currier JR, Friberg H, Moris P, Keiser PB, De La Barrera R, Vaughn DW, Paris RM, Thomas SJ, Schmidt AC. Safety and Immunogenicity of an AS03 B-Adjuvanted Inactivated Tetravalent Dengue Virus Vaccine Administered on Varying Schedules to Healthy U.S. Adults: A Phase 1/2 Randomized Study. Am J Trop Med Hyg 2020; 103:132-141. [PMID: 32342848 PMCID: PMC7356407 DOI: 10.4269/ajtmh.19-0738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/25/2020] [Indexed: 01/05/2023] Open
Abstract
Dengue disease and its causative agents, the dengue viruses (DENV-1-4), cause high morbidity in tropical and subtropical regions. We evaluated three dosing regimens of the investigational tetravalent AS03B-adjuvanted dengue-purified inactivated vaccine (DPIV+AS03B). In this phase 1/2, observer-blind, placebo-controlled study (NCT02421367), 140 healthy adults were randomized 1:1:2 to receive DPIV+AS03B according to the following regimens: 0-1 month (M), 0-1-6 M, or 0-3 M. Participants received DPIV+AS03B or placebo at M0, M1, M3, and M6 according to their dosing schedule. Primary objectives were 1) to evaluate the safety of DPIV+AS03B for 28 days (D) after each dose; 2) to demonstrate the added value of a booster dose (0-1-6 M versus 0-1 M) based on neutralizing antibody titers to each DENV type (DENV-1-4) at 28 D after the last dose; and, if this objective was met, 3) to demonstrate the benefit of a longer interval between the first and second doses (0-1 M versus 0-3 M). Adverse events (AEs) within 7 D after vaccination tended to be more frequent after DPIV+AS03B doses than placebo; the number of grade 3 AEs was low (≤ 4.5% after DPIV+AS03B; ≤ 2.9% after placebo), with no obvious differences across groups. Within 28 D following each dose, the frequency of unsolicited AEs after DPIV+AS03B appeared higher for three-dose (0-1-6 M) than two-dose (0-1 M and 0-3 M) regimens. No serious AEs were considered related to vaccination, and no potential immune-mediated diseases were reported during the study. All three schedules were well tolerated. Both primary immunogenicity objectives were demonstrated. The 0-3 M and 0-1-6 M regimens were more immunogenic than the 0-1 M regimen.
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Affiliation(s)
- Leyi Lin
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Kirsten E. Lyke
- Center for Vaccine Development and Global Health (CVD), University of Maryland, Baltimore, Maryland
| | - Michael Koren
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | | | | | | | - Monica A. McArthur
- Center for Vaccine Development and Global Health (CVD), University of Maryland, Baltimore, Maryland
| | | | - Heather Friberg
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | | | - Paul B. Keiser
- Walter Reed Army Institute of Research, Silver Spring, Maryland
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Kling K, Harder T, Younger Z, Burchard G, Schmidt-Chanasit J, Wichmann O. Vaccination against Japanese encephalitis with IC51: systematic review on immunogenicity, duration of protection and safety. J Travel Med 2020; 27:5732465. [PMID: 32043122 DOI: 10.1093/jtm/taaa016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/28/2020] [Indexed: 01/04/2023]
Abstract
Japanese encephalitis is a disease caused by a flavivirus which is transmitted by mosquitos in endemic countries. Considering the potentially severe outcomes of the disease, vaccination is recommended for those at risk of exposure. During recent years, IC51 (IXIARO®, JESPECT®, JEVAL®) has increasingly been used to protect travellers from Europe and the USA. However, no systematic review exists that summarizes the currently available evidence on the immunogenicity and safety of this vaccine. We conducted a systematic review on the immunogenicity and safety of IC51, using the databases PubMed, MEDLINE, EMBASE and ClinicalTrials.gov (search date: 31 August 2019). Data extracted from included studies were grouped by outcomes and stratified by population and setting. Risk of bias (ROB) was assessed using the RoB 2 tool for randomized controlled trials (RCTs) and ROBINS-I for non-randomized studies. Due to high heterogeneity, meta-analysis was not performed. A total of 32 studies from 16 countries met the inclusion criteria (15 RCTs, 17 non-randomized studies). ROB was serious or high in the majority of studies. Seroprotection rates ranged from 93 to 100% in adults (seven studies) and from 91 to 100% in children (four studies). In the study involving adults aged 64 years and older, seroprotection was 65% with higher rates in persons who were previously vaccinated against tick-borne encephalitis virus. Safety was investigated in 27 studies. Rates of serious adverse events were below 5% in all age groups, with the majority not being causally related to the vaccine. IC51 is a safe vaccine with good seroprotective abilities in persons aged >2 months to <64 years. The body of evidence, however, is weakened by a large amount of heterogeneity in study and clinical trial methodology. Further well-designed RCTs with special risk groups are needed.
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Affiliation(s)
- Kerstin Kling
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Thomas Harder
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Zane Younger
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Gerd Burchard
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg 20359, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg 20359, Germany
- Faculty of Mathematics, Informatics and Natural Sciences, Universität Hamburg, Hamburg 22609, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
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10
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Hills SL, Walter EB, Atmar RL, Fischer M. Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2019; 68:1-33. [PMID: 31518342 PMCID: PMC6659993 DOI: 10.15585/mmwr.rr6802a1] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This report updates the 2010 recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) regarding prevention of Japanese encephalitis (JE) among U.S. travelers and laboratory workers (Fischer M, Lindsey N, Staples JE, Hills S. Japanese encephalitis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010;59[No. RR-1]). The report summarizes the epidemiology of JE, describes the JE vaccine that is licensed and available in the United States, and provides recommendations for its use among travelers and laboratory workers.JE virus, a mosquitoborne flavivirus, is the most common vaccine-preventable cause of encephalitis in Asia. JE occurs throughout most of Asia and parts of the western Pacific. Approximately 20%-30% of patients die, and 30%-50% of survivors have neurologic, cognitive, or behavioral sequelae. No antiviral treatment is available.Inactivated Vero cell culture-derived JE vaccine (Ixiaro [JE-VC]) is the only JE vaccine that is licensed and available in the United States. In 2009, the U.S. Food and Drug Administration (FDA) licensed JE-VC for use in persons aged ≥17 years; in 2013, licensure was extended to include children aged ≥2 months.Most travelers to countries where the disease is endemic are at very low risk for JE. However, some travelers are at increased risk for infection on the basis of their travel plans. Factors that increase the risk for JE virus exposure include 1) traveling for a longer period; 2) travel during the JE virus transmission season; 3) spending time in rural areas; 4) participating in extensive outdoor activities; and 5) staying in accommodations without air conditioning, screens, or bed nets. All travelers to countries where JE is endemic should be advised to take precautions to avoid mosquito bites to reduce the risk for JE and other vectorborne diseases. For some persons who might be at increased risk for JE, the vaccine can further reduce the risk for infection. The decision about whether to vaccinate should be individualized and consider the 1) risks related to the specific travel itinerary, 2) likelihood of future travel to countries where JE is endemic, 3) high morbidity and mortality of JE, 4) availability of an effective vaccine, 5) possibility (but low probability) of serious adverse events after vaccination, and 6) the traveler's personal perception and tolerance of risk.JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (e.g., ≥1 month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (e.g., <1 month) travelers with an increased risk for JE on the basis of planned travel duration, season, location, activities, and accommodations and for travelers to JE-endemic areas who are uncertain about their specific travel duration, destinations, or activities. JE vaccine is not recommended for travelers with very low-risk itineraries, such as shorter-term travel limited to urban areas or outside of a well-defined JE virus transmission season.
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Persistence of the immune response after vaccination with the Japanese encephalitis vaccine, IXIARO® in healthy adults: A five year follow-up study. Vaccine 2019; 37:2529-2531. [PMID: 30962094 DOI: 10.1016/j.vaccine.2019.03.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/22/2022]
Abstract
Immunization with the Japanese encephalitis (JE) vaccine IXIARO® results in protective neutralizing antibody levels for one year. Since persistence of protective titer levels beyond one year was unknown, a 5 years follow-up study was conducted. Additionally, data were stratified to compare the persistence of protective neutralizing antibodies against JE in people with or without tick-borne encephalitis (TBE) vaccination. Four weeks after the primary series, the percentage of subjects with PRNT50 titer ≥1:10 in the intent-to-treat population was 99%; the rate after 5 years was 81.6%. By month 24, 36, 48 and 60, the percentages were still 90.7%, 91.7%, 90.1%, 85.9%, respectively in the population who had received TBE vaccine compared to 67.9%, 71.9%, 69.1%, 63.8% in the population who had not. No long-term safety concerns were identified. These data indicate that vaccination with IXIARO® is able to induce protective titers that persist up to 60 months after the primary immunization. Clinical trial registry number NCT00596102.
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12
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Analysis of the Full Economic Cost for Japanese Encephalitis Under Different Risk Scenarios for Business Travelers to Asia. J Occup Environ Med 2019; 61:16-20. [DOI: 10.1097/jom.0000000000001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Jia Q, Jia C, Liu Y, Yang Y, Qi J, Tong L, Chen H, Zhang M, Che J, Li B, Li Z. Clinical evidence for the immunogenicity and immune persistence of vaccination with yellow fever virus strain 17D in Chinese peacekeepers deployed to Africa. Antiviral Res 2018; 162:1-4. [PMID: 30529359 DOI: 10.1016/j.antiviral.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/21/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
Abstract
Yellow fever is a serious disease caused by infection with the yellow fever virus (YFV). A live-attenuated YFV vaccine strain, 17D (YFV-17D) is the only virus strain available for the production of the YFV vaccine. This study evaluated the immunogenicity and immune persistence of vaccination with YFV-17D and identified their influencing factors in Chinese peacekeepers deployed to Africa. Serum specimens were collected before and ≥21 days after primary vaccination with YFV-17D in 349 Chinese peacekeepers who were subsequently deployed to Africa for the first time from 2016 to 2017 (population 1). Serum specimens were collected from 1 to 11 years after vaccination with YFV-17D in 2062 returned Chinese peacekeepers who were deployed to Africa from 2005 to 2015 (population 2). We found that YFV-17D exhibited an excellent protective effect in the Chinese peacekeepers deployed to Africa early following vaccination. In the Chinese peacekeepers one year after vaccination, the serum antibody titer against YFV increased with increasing age at vaccination; in those two or more years after vaccination, the serum antibody titer against YFV decreased over years and was similar to but greater than the minimum protective level 11 years after vaccination. The number of peacekeeping missions exhibited an almost negligible influence on the serum antibody titer against YFV. (This study has been registered at International Clinical Trials Registry Platform (http://www.who.int/ictrp/en/) under registration Nos. ChiCTR1800017024.).
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Affiliation(s)
- Qingshuai Jia
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China.
| | - Chonglai Jia
- Beijing Bio-Institute Biological Products Co., Ltd., 6 Second Boxing Road, Economic and Technological Development Zone, Beijing, China
| | - Yuandong Liu
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
| | - Yunkai Yang
- Beijing Bio-Institute Biological Products Co., Ltd., 6 Second Boxing Road, Economic and Technological Development Zone, Beijing, China
| | - Jinrong Qi
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
| | - Libo Tong
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
| | - Haiping Chen
- China National Biotec Group Co., Ltd., 4 Huixin East Street, Chaoyang District, Beijing, China
| | - Min Zhang
- China National Biotec Group Co., Ltd., 4 Huixin East Street, Chaoyang District, Beijing, China
| | - Jibo Che
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
| | - Bing Li
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
| | - Zijian Li
- Jinan Military Region Center for Disease Control and Prevention, 36 Wenhua Road East, Lixia District, Jinan, Shandong, China
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14
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Antibody Persistence up to 3 Years After Primary Immunization With Inactivated Japanese Encephalitis Vaccine IXIARO in Philippine Children and Effect of a Booster Dose. Pediatr Infect Dis J 2018; 37:e233-e240. [PMID: 29912844 DOI: 10.1097/inf.0000000000002124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND An inactivated Vero cell culture derived Japanese encephalitis virus vaccine (IXIARO) requires a booster dose 1 year after primary schedule for long-term antibody persistence in adults. The aim of this study is to evaluate immunogenicity and safety of a booster dose in children 2 months to <18 years of age. METHODS This is a randomized, controlled open-label study in the Philippines. Three hundred children vaccinated with IXIARO in a previous trial were randomized 1:1 to receive either no booster or a booster 12 months after initiation of the primary series. Neutralizing antibody titers were assessed before and after the booster and up to 3 years after primary series. Safety endpoints included the rate of subjects with solicited adverse events (AEs), unsolicited AEs and serious AEs within 1 month after the booster. RESULTS Geometric mean titer declined by 1 year after the primary series, but titers remained above the established protective threshold in 85%-100% of children depending on age group. The booster led to a pronounced increase in geometric mean titer and 100% seroprotection rate in all age groups. The booster was well tolerated, with AE rates lower compared with the primary series. Most AEs were mild. CONCLUSIONS A booster dose of IXIARO administered 12 months after the primary immunization was well tolerated and highly immunogenic.
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Wagner A, Garner-Spitzer E, Jasinska J, Kollaritsch H, Stiasny K, Kundi M, Wiedermann U. Age-related differences in humoral and cellular immune responses after primary immunisation: indications for stratified vaccination schedules. Sci Rep 2018; 8:9825. [PMID: 29959387 PMCID: PMC6026142 DOI: 10.1038/s41598-018-28111-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 06/08/2018] [Indexed: 12/12/2022] Open
Abstract
Immunosenescence is characterised by reduced B and T cell responses. Evidence shows that booster vaccinations are less effective in elderly people, but data on the efficacy of primary immunisation are sparse. We conducted a monocentric, open label, phase IV trial to compare immune responses to primary vaccinations using the inactivated, adjuvanted Japanese Encephalitis vaccine by 30 elderly people (mean 69, range 61-78 years) and 30 younger people (mean 24, range 18-30 years). Humoral and cellular immune responses were analysed in relation to age and cytomegalovirus (CMV) seropositivity. Vaccine-specific antibody titres were significantly lower in elderly participants and 47% of them were non- or low responders after the two doses of the vaccine neo-antigen. The reduced humoral immune responses in elderly people correlated with reduced cytokine production, such as interferon gamma (IFN-γ) in vitro, as well as higher frequencies of late-differentiated effector and effector memory T cells and T regulatory cells. These cellular changes and lower antibody titres were particularly prominent in CMV-seropositive elderly participants. If primary vaccination before the age of 60 is not possible, elderly patients may require different vaccination strategies to ensure sufficient long-lasting immunity, such as adapted or accelerated schedules and the use of different adjuvants.
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Affiliation(s)
- Angelika Wagner
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Erika Garner-Spitzer
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Joanna Jasinska
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Herwig Kollaritsch
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, 1090, Austria
| | - Karin Stiasny
- Center of Virology, Medical University of Vienna, Vienna, 1090, Austria
| | - Michael Kundi
- Institute of Environmental Health, Medical University of Vienna, Vienna, 1090, Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, 1090, Austria.
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Amicizia D, Zangrillo F, Lai PL, Iovine M, Panatto D. Overview of Japanese encephalitis disease and its prevention. Focus on IC51 vaccine (IXIARO ®). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E99-E107. [PMID: 29938245 DOI: 10.15167/2421-4248/jpmh2018.59.1.962] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/24/2018] [Indexed: 01/30/2023]
Abstract
Japanese encephalitis (JE) is a vector-borne disease caused by the Japanese encephalitis virus (JEV). JEV is transmitted by mosquitoes to a wide range of vertebrate hosts, including birds and mammals. Domestic animals, especially pigs, are generally implicated as reservoirs of the virus, while humans are not part of the natural transmission cycle and cannot pass the virus to other hosts. Although JEV infection is very common in endemic areas (many countries in Asia), less than 1% of people affected develop clinical disease, and severe disease affects about 1 case per 250 JEV infections. Although rare, severe disease can be devastating; among the 30,000-50,000 global cases per year, approximately 20-30% of patients die and 30-50% of survivors develop significant neurological sequelae. JE is a significant public health problem for residents in endemic areas and may constitute a substantial risk for travelers to these areas. The epidemiology of JE and its risk to travelers have changed, and continue to evolve. The rapid economic growth of Asian countries has led to a surge in both inbound and outbound travel, making Asia the second most-visited region in the world after Europe, with 279 million international travelers in 2015. The top destination is China, followed by Thailand, Hong Kong, Malaysia and Japan, and the number of travelers is forecast to reach 535 million by 2030 (+ 4.9% per year). Because of the lack of treatment and the infeasibility of eliminating the vector, vaccination is recognized as the most efficacious means of preventing JE. The IC51 vaccine (IXIARO®) is a purified, inactivated, whole virus vaccine against JE. It is safe, well tolerated, efficacious and can be administered to children, adults and the elderly. The vaccination schedule involves administering 2 doses four weeks apart. For adults, a rapid schedule (0-7 days) is available, which could greatly enhance the feasibility of its use. Healthcare workers should inform both short- and long-term travelers of the risk of JE in each period of the year and recommend vaccination. Indeed, it has been shown that short-term travelers are also at risk, not only in rural environments, but also in cities and coastal towns, especially in tourist localities where excursions to country areas are organized.
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Affiliation(s)
- D Amicizia
- Department of Health Sciences, University of Genoa, Italy
| | - F Zangrillo
- Department of Health Sciences, University of Genoa, Italy
| | - P L Lai
- Department of Health Sciences, University of Genoa, Italy
| | - M Iovine
- Department of Health Sciences, University of Genoa, Italy
| | - D Panatto
- Department of Health Sciences, University of Genoa, Italy
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17
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Long-term immunogenicity of an initial booster dose of an inactivated, Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) and the safety and immunogenicity of a second JE-VC booster dose in children previously vaccinated with an inactivated, mouse brain-derived Japanese encephalitis vaccine. Vaccine 2018; 36:1398-1404. [DOI: 10.1016/j.vaccine.2018.01.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/25/2018] [Accepted: 01/29/2018] [Indexed: 01/23/2023]
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18
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Immunogenicity of the Inactivated Japanese Encephalitis Virus Vaccine IXIARO in Children From a Japanese Encephalitis Virus-endemic Region. Pediatr Infect Dis J 2017; 36:898-904. [PMID: 28430748 DOI: 10.1097/inf.0000000000001615] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Japanese encephalitis (JE) is a major public health concern in Asia and poses a small but potentially fatal threat to travelers from nonendemic countries, including children. No JE vaccine for pediatric use has been available in Europe and the United States. METHODS Age-stratified cohorts of children between 2 months and 17 years received 2 doses of Vero cell-derived inactivated JE virus vaccine (IXIARO; Valneva Austria GmbH, Vienna, Austria) administered 28 days apart [<3 years, 0.25 mL (half adult dose); ≥3 years, 0.5 mL (full adult dose)]. Immunogenicity endpoints were seroconversion rate, 4-fold increase in JE neutralizing antibody titer and geometric mean titer assessed 56 days and 7 months after the first vaccination in 496 subjects of the intent-to-treat population. The immune response to JE virus at both time points was also analyzed according to prevaccination JE virus and dengue virus serostatus. RESULTS At day 56, seroconversion was attained in ≥99.2% of subjects with age-appropriate dosing, 4-fold increases in titer were reported for 77.4%-100% in various age groups, and geometric mean titers ranged from 176 to 687, with younger children having the strongest immune response. At month 7, seroconversion was maintained in 85.5%-100% of subjects. Pre-existing JE virus immunity did not impact on immune response at day 56; however, it led to a better persistence of protective antibody titers at month 7. CONCLUSIONS IXIARO is highly immunogenic at both doses tested in the pediatric population, leading to protective antibody titers at day 56 in >99% of subjects who received the age-appropriate dose.
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Schmidt AC, Lin L, Martinez LJ, Ruck RC, Eckels KH, Collard A, De La Barrera R, Paolino KM, Toussaint JF, Lepine E, Innis BL, Jarman RG, Thomas SJ. Phase 1 Randomized Study of a Tetravalent Dengue Purified Inactivated Vaccine in Healthy Adults in the United States. Am J Trop Med Hyg 2017; 96:1325-1337. [PMID: 28719287 PMCID: PMC5462566 DOI: 10.4269/ajtmh.16-0634] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The safety and immunogenicity of four formulations of an investigational tetravalent dengue purified inactivated vaccine (DPIV), formulated at 1 or 4 μg with aluminum hydroxide (alum) or at 1 μg with an adjuvant system (AS01E or AS03B), were evaluated in a first-time-in-human, placebo-controlled, randomized, observer-blind, phase 1 trial in the continental United States. Two doses of vaccine or placebo were administered intramuscularly 4 weeks apart to 100 healthy adults 18–39 years of age, randomized 1:1:1:1:1 to receive one of four DPIV formulations or saline placebo. The response to a third dose was evaluated in a subset of nine participants remote from primary vaccination. Humoral immunogenicity was assessed using a 50% microneutralization assay. All DPIV formulations were well tolerated. No vaccine-related serious adverse events were observed through 12 months after the second vaccine dose. In all DPIV groups, geometric mean antibody titers peaked at Day 56, waned through 6 months after the second vaccine dose, and then stabilized. In the nine subjects where boosting was evaluated, a strong anamnestic response was observed. These results support continuation of the clinical development of this dengue vaccine candidate (clinicaltrials.gov: NCT01666652).
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Affiliation(s)
| | - Leyi Lin
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Luis J Martinez
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Richard C Ruck
- Walter Reed Army Institute of Research, Silver Spring, Maryland
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20
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Hegde NR, Gore MM. Japanese encephalitis vaccines: Immunogenicity, protective efficacy, effectiveness, and impact on the burden of disease. Hum Vaccin Immunother 2017; 13:1-18. [PMID: 28301270 DOI: 10.1080/21645515.2017.1285472] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Japanese encephalitis (JE) is a serious public health concern in most of Asia. The disease is caused by JE virus (JEV), a flavivirus transmitted by Culex mosquitoes. Several vaccines have been developed to control JE in endemic areas as well as to protect travelers and military personnel who visit or are commissioned from non-endemic to endemic areas. The vaccines include inactivated vaccines produced in mouse brain or cell cultures, live attenuated vaccines, and a chimeric vaccine based on the live attenuated yellow fever virus 17D vaccine strain. All the marketed vaccines belong to the JEV genotype III, but have been shown to be efficacious against other genotypes and strains, with varying degrees of cross-neutralization, albeit at levels deemed to be protective. The protective responses have been shown to last three or more years, depending on the type of vaccine and the number of doses. This review presents a brief account of the different JE vaccines, their immunogenicity and protective ability, and the impact of JE vaccines in reducing the burden of disease in endemic countries.
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Affiliation(s)
- Nagendra R Hegde
- a Ella Foundation, Genome Valley , Turkapally, Shameerpet Mandal , Hyderabad , India
| | - Milind M Gore
- b National Institute of Virology, Indian Council of Medical Research , Pune , India
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21
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Abstract
Japanese encephalitis virus, as the most important vaccine-preventable cause of viral encephalitis in Asia, is estimated to cause over 68,000 clinical cases yearly. In endemic areas, most Japanese encephalitis infections occur in children younger than 10 y and clinical manifestation of this disease is critical, because there is no effective treatment available. As JEV infections are regarded as one of the most serious viral causes of encephalitis and mass immunization programmes are generally recommended for residents in endemic areas, a safe and effective JEV vaccine was needed to protect them as well as others at risk. Due to the safety concerns with the mouse brain derived vaccine, second generation vaccines against JE produced in cell culture like Vero cells were developed. IXIARO® is a purified, inactivated aluminum-adjuvanted JE vaccine, based on the SA14-14-2 virus strain, and is available in North America, Europe, Canada, Switzerland, Singapore, Hong Kong and Israel as well as in Australia & New Zealand (as JESPECT®).The safety, tolerability and immunogenicity profile of IXIARO® is well established through a number of clinical studies comparing IXIARO® with placebo as well as mouse brain derived vaccine. Recent data show that the global incidence of JE remains substantial, especially young children in endemic areas are most susceptible. As vaccination is the most feasible, reliable and cost effective tool for JE control, IXIARO® with confirmed excellent safety profile is highly recommendable, in particular for vaccination of children at risk. The European Commission as well as the FDA approved the extension of indication of IXIARO® to the pediatric segment (2 months of age and older) based on these data.
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Affiliation(s)
- Christa Firbas
- a Department of Clinical Pharmacology; Medical University of Vienna ; Vienna , Austria
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22
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Erra EO, Kantele A. The Vero cell-derived, inactivated, SA14-14-2 strain-based vaccine (Ixiaro) for prevention of Japanese encephalitis. Expert Rev Vaccines 2015; 14:1167-79. [PMID: 26162529 DOI: 10.1586/14760584.2015.1061939] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With an estimated 68,000 cases each year, Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia. Vaccination against the disease is recommended for endemic populations and also for travelers at risk. Recently, a Vero cell-derived, inactivated, SA14-14-2 strain-based JE vaccine (JE-VC) became available for travelers from non-endemic regions, replacing the traditional mouse brain-derived vaccines. First licensed in 2009, JE-VC is currently available in Europe, the USA, Canada, Australia and several other countries. In 2013, the vaccine was approved by the European Medicines Agency and the US Food and Drug Administration for use in children. This review summarizes current data on the immunogenicity, safety and clinical use of JE-VC.
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Affiliation(s)
- Elina O Erra
- Haartman Institute, University of Helsinki, Helsinki, Finland
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23
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Paulke-Korinek M, Kollaritsch H, Kundi M, Zwazl I, Seidl-Friedrich C, Jelinek T. Persistence of antibodies six years after booster vaccination with inactivated vaccine against Japanese encephalitis. Vaccine 2015; 33:3600-4. [PMID: 26036947 DOI: 10.1016/j.vaccine.2015.05.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/10/2015] [Accepted: 05/17/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Japanese Encephalitis (JE) virus occurs in wide regions of Asia with over 3 billion people living in areas at risk for JE. An estimated 68,000 clinical cases of JE occur every year, and vaccination is the most effective prophylactic measure. One internationally licensed vaccine containing the inactivated JE virus strain SA14-14-2 is Ixiaro (Valneva, Austria). According to recommendations, basic immunization consists of vaccinations on day 0, day 28, and a booster dose 12-24 months later. Protection in terms of neutralizing antibody titers has been assessed up to 12 months after the third dose of the vaccine. The current investigation was designed to evaluate antibody decline over time and to predict long-term duration of seroprotection after a booster dose. METHOD In a preceding trial, volunteers received basic immunization (day 0, day 28) and one booster dose against JE 15 months later. A follow up blood draw 6 years following their booster dose was carried out in 67 subjects. For antibody testing, a 50% plaque reduction neutralization test (PRNT50-test) was used. PRNT50 values of 10 and above are surrogate levels of protection according to WHO standards. RESULT Seventy-six months following the booster dose, 96% of the tested subjects had PRNT50 titers of 10 or higher. Geometric mean titer (GMT) was 148 (95% CI confidence interval: 107-207). Antibody titers were lower in volunteers 50 years of age and older. Vaccination history against other flaviviruses (yellow fever or tick borne encephalitis) did not significantly influence PRNT50 titers. A two-step log-linear decline model predicted protection against JE of approximately 14 years after the booster dose. CONCLUSION Six years after a booster dose against JE, long-term protection could be demonstrated. According to our results, further booster doses should be scheduled 10 years following the first booster dose.
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Affiliation(s)
- Maria Paulke-Korinek
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria; Federal Ministry of Health, Austria
| | - Herwig Kollaritsch
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria.
| | - Michael Kundi
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria
| | - Ines Zwazl
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria
| | - Claudia Seidl-Friedrich
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, A-1090, Vienna, Austria
| | - Tomas Jelinek
- Berlin Center for Travel and Tropical Medicine, Berlin, Germany
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24
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Singh A, Mitra M, Sampath G, Venugopal P, Rao JV, Krishnamurthy B, Gupta MK, Sri Krishna S, Sudhakar B, Rao NB, Kaushik Y, Gopinathan K, Hegde NR, Gore MM, Krishna Mohan V, Ella KM. A Japanese Encephalitis Vaccine From India Induces Durable and Cross-protective Immunity Against Temporally and Spatially Wide-ranging Global Field Strains. J Infect Dis 2015; 212:715-25. [PMID: 25601942 DOI: 10.1093/infdis/jiv023] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/06/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Japanese encephalitis (JE) is a vaccine-preventable acute disease. We report the results of a phase 2/3 trial of JENVAC, a Vero cell-derived vaccine developed using an Indian strain of JE virus (JEV). METHODS JENVAC was administered in 2 doses 28 days apart, and immunogenicity was compared to that from a single dose of SA-14-14-2, the only approved JE vaccine and regimen at the time in India. RESULTS After both the doses, seroconversion and seroprotection were >90% for JENVAC. For SA-14-14-2, seroconversion and seroprotection were 57.69% and 77.56%, respectively, on day 28 and 39.74% and 60.26%, respectively, on day 56. The geometric mean titers at day 28 and day 56 were 145.04 and 460.53, respectively, for JENVAC and 38.56 and 25.29, respectively, for SA-14-14-2. With a single dose of JENVAC, seroprotection titers lasted at least 12 months in >80% of the subjects. Following receipt of 2 doses, 61.17% of subjects retained seroprotection titers at 24 months, and immunogenicity criteria were higher than that for SA-14-14-2 at 12, 18, and 24 months each. Sera from JENVAC subjects neutralized JEV genotypes I, II, III, and IV equally well. Adverse events were not significantly different between the 2 vaccines. CONCLUSIONS JENVAC elicits long-lasting, broadly protective immunity. CLINICAL TRIALS REGISTRATION CTRI/2011/07/001855.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Milind M Gore
- Gorakhpur Unit, National Institute of Virology, India
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Safety and immunogenicity of a freeze-dried, Vero cell culture-derived, inactivated Japanese encephalitis vaccine (KD-287, ENCEVAC®) versus a mouse brain-derived inactivated Japanese encephalitis vaccine in children: a phase III, multicenter, double-blinded, randomized trial. BMC Infect Dis 2015; 15:7. [PMID: 25567119 PMCID: PMC4296691 DOI: 10.1186/s12879-014-0744-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 12/24/2014] [Indexed: 11/10/2022] Open
Abstract
Background Although mouse brain-derived, inactivated Japanese encephalitis vaccines (JE-MBs) have been successfully used for a long time, potential rare neurological complications have prompted the development of a Vero cell culture-derived inactivated vaccine (JE-VC). In a phase III clinical study, we aimed to compare the safety and immunogenicity of a JE-VC, KD-287 with a JE-MB, JEV-GCC, in children. Methods In this multicenter, double-blinded, randomized controlled trial, the study population consisted of 205 healthy Korean children aged 12–23 months. Each subject was subcutaneously vaccinated with either KD-287 or JEV-GCC twice at an interval of 2 weeks and then vaccinated once 12 months after the second vaccination. Neutralizing antibodies were measured by the plaque reduction neutralization test using the homologous and heterologous, as a post hoc analysis, challenge virus strains. Results The three-dose regimen of KD-287 showed a comparable safety profile with JEV-GCC except higher incidence of fever after the first dose (30.4% and 14.7%, respectively). Most of the fever was mild degree (61.3% and 66.7%, respectively). KD-287 fulfilled the non-inferiority criteria for seroconversion rate (SCR) and geometric mean titer (GMT) of the neutralizing antibody, which were the primary endpoints, at 4 weeks after the third vaccination (95% CI: −1.00, 3.10 for the SCR difference and 10.8, 17.6 for the GMT ratio). The SCRs of KD-287 were all 100% and the GMTs were higher in the KD-287 group than in the JEV-GCC group after the second vaccination and before and after the third vaccination (GMT ratio: 5.59, 20.13, and 13.79, respectively, p < 0.001 in all). GMTs were higher in the KD-287 group in the heterologous analysis also (GMT ratio: 4.05, 5.15, and 4.19, respectively, p < 0.001 in all). Conclusions This study suggests that the KD-287, a JE-VC is as safe as and may be more effective than the licensed MB-derived vaccine. KD-287 could thus be useful as a second-generation vaccine and substitute for the current JE-MB vaccine in Korean children. Trial registration ClinicalTrials.gov: NCT01150942 Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0744-4) contains supplementary material, which is available to authorized users.
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Hsu LC, Chen YJ, Hsu FK, Huang JH, Chang CM, Chou P, Lin IF, Chang FY. The incidence of Japanese encephalitis in Taiwan--a population-based study. PLoS Negl Trop Dis 2014; 8:e3030. [PMID: 25058573 PMCID: PMC4109885 DOI: 10.1371/journal.pntd.0003030] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 06/05/2014] [Indexed: 11/18/2022] Open
Abstract
Background A mass Japanese encephalitis (JE) vaccination program targeting children was launched in Taiwan in 1968, and the number of pediatric JE cases substantially decreased thereafter. The aim of this study was to elucidate the long-term trend of JE incidence, and to investigate the age-specific seroprevalence of JE-neutralizing antibodies. Methodology/Principal Findings A total of 2,948 laboratory-confirmed JE cases that occurred between 1966 and 2012 were analyzed using a mandatory notification system managed by the Centers for Disease Control, Taiwan. A total of 6,594 randomly-sampled serum specimens obtained in a nationwide population-based survey in 2002 were analyzed to estimate the seroprevalence of JE-neutralizing antibodies in the general population. The average annual JE incidence rate of the group aged 30 years and older was 0.167 cases per 100,000 people between 2001 and 2012, which was higher than the 0.052 cases per 100,000 people among those aged under 30 years. These seroepidemiological findings indicate that the cohort born between 1963 and 1975, who generally received two or three doses of the vaccine and were administered the last booster dose more than 20 years ago, exhibited the lowest positive rate of JE-neutralizing antibodies (54%). The highest and second highest antibody rates were observed, respectively, in the oldest unvaccinated cohort (86%) and in the youngest cohort born between 1981 and 1986, who received four doses 10–15 years ago (74%). Conclusion/Significance Over the past decade, the main age group of the confirmed JE cases in Taiwan shifted from young children to adults over 30 years of age. People who were born between 1963 and 1975 exhibited the lowest seroprevalence of JE-neutralizing antibodies. Thus, the key issue for JE control in Taiwan is to reduce adult JE cases through a cost-effective analysis of various immunization strategies. JE is one of the major public health problems in Asian and the Western Pacific regions, and most cases occur in children under the age of 14 years. A JE virus infection can cause severe sequelae such as an impairment of language ability, cognitive ability, or movement. Because humans are a dead-end host of the JE virus, the disease cannot be transmitted among people. Vaccination is currently the most effective method for preventing JE, and children in most endemic areas are vaccinated. After decades of mass vaccination, the number of confirmed JE cases has considerably declined in Taiwan, Japan, and South Korea. Most JE cases have occurred in adults rather than children in these countries, thus, the disease must be controlled by reducing the number of adult JE cases. Therefore, a prevention policy for the adult and elderly population should be implemented in the near future.
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Affiliation(s)
- Li-Ching Hsu
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Yu-Ju Chen
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
| | - Feng-Kuang Hsu
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
| | - Jyh-Hsiung Huang
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
| | - Chi-Ming Chang
- Epidemic Intelligence Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
| | - Pesus Chou
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
- Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - I-Feng Lin
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
- * E-mail: (IFL); (FYC)
| | - Feng-Yee Chang
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail: (IFL); (FYC)
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Jelinek T. IXIARO updated: overview of clinical trials and developments with the inactivated vaccine against Japanese encephalitis. Expert Rev Vaccines 2014; 12:859-69. [PMID: 23984958 DOI: 10.1586/14760584.2013.835638] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The mosquito-borne Japanese encephalitis virus causes an estimated 50,000 cases in Asia, accounting for at least 10,000 deaths and 15,000 cases of neuropsychiatric sequelae. IXIARO (Intercell AG, Vienna, Austria), an inactivated, Vero cell-derived vaccine against Japanese encephalitis was introduced in 2009. The vaccine is highly immunogenic, showing significantly higher geometric mean antibody titers compared with previous, mouse brain-derived vaccines. Postmarketing studies have confirmed the excellent safety profile. Studies on children aged 2 months to 18 years have been published. Based on these data, positive opinion from the EMA for vaccination of children has recently been given. Since a safe and effective vaccine against Japanese encephalitis is now available, outdated guidelines and recommendations have to be revised: travelers to rural areas of Asia should generally be recommended vaccination.
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Affiliation(s)
- Tomas Jelinek
- Berlin Center for Travel and Tropical Medicine, Jägerstrasse 67-69, 10117 Berlin, Germany.
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Sirivichayakul C, Sabchareon A, Limkittikul K, Yoksan S. Plaque reduction neutralization antibody test does not accurately predict protection against dengue infection in Ratchaburi cohort, Thailand. Virol J 2014; 11:48. [PMID: 24620925 PMCID: PMC3975240 DOI: 10.1186/1743-422x-11-48] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 03/07/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The plaque reduction neutralization test (PRNT) is currently the best and most widely accepted approach to measuring virus-neutralizing and protective antibodies to dengue virus, and in assessing the immunogenicity of a dengue vaccine. However, the correlation between presence of dengue-neutralizing antibody and protection from infection is not absolute. FINDINGS In a cohort study in Ratchaburi Province, Thailand, 48 subjects with serologically confirmed symptomatic dengue infection were tested for pre-existing dengue neutralizing antibody using PRNT. Nine subjects had quite high pre-existing PRNT50 titers (titer >90) to subsequent infecting dengue serotypes, but still had symptomatic infections. CONCLUSION This report provides evidence that PRNT may not be a good test for predicting protection against subsequent dengue infection.
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Affiliation(s)
- Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Arunee Sabchareon
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sutee Yoksan
- Center for Vaccine Development, Mahidol University, Nakhonpathom, Thailand
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Li X, Ma SJ, Liu X, Jiang LN, Zhou JH, Xiong YQ, Ding H, Chen Q. Immunogenicity and safety of currently available Japanese encephalitis vaccines: a systematic review. Hum Vaccin Immunother 2014; 10:3579-93. [PMID: 25668666 PMCID: PMC4514081 DOI: 10.4161/21645515.2014.980197] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/26/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
A number of Japanese encephalitis (JE) vaccines have been used for preventing Japanese encephalitis around the world. We here reviewed the immunogenicity and safety of the currently available Japanese encephalitis vaccines. We searched Pubmed, Embase, Web of Science, the Cochrane Library and other online databases up to March 25, 2014 for studies focusing on currently used JE vaccines in any language. The primary outcomes were the seroconversion rate against JEV and adverse events. Meta-analysis was performed for the primary outcome when available. A total of 51 articles were included. Studies were grouped on the basic types of vaccines. This systematic review led to 2 aspects of the conclusions. On one hand, all the currently available JE vaccines are safe and effective. On the other hand, the overall of JE vaccine evaluation is disorganized, the large variation in study designs, vaccine types, schedules, doses, population and few hand-to-hand trails, make direct comparisons difficult. In order to make a more evidence-based decision on optimizing the JE vaccine, it is warranted to standardize the JE vaccine evaluation research.
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Key Words
- ACIP, The Advisory Committee on Immunization Practices
- AEs, Adverse events
- CENTRAL, Cochrane Central Register of Controlled Trials
- CIs, Confidence intervals
- DARE, Database of Abstracts of Reviews of Effects
- GMTs, Geometric mean titers
- HAART, Highly active antiretroviral therapy
- JE, Japanese encephalitis
- JE-CV, Chimeric live-attenuated JE vaccine
- JEV, Japanese encephalitis virus
- Japanese encephalitis vaccine
- LILACS, Latin American and Caribbean Health Sciences Literature
- MBJEV, Mouse brain–derived inactivated vaccines
- MMR, Measles mumps rubella vaccine
- NIP, National Immunization Program
- NOS, Newcastle–Ottawa scale
- ORs, Odd ratios
- PHK, Primary hamster kidney cells
- PRNT50, Plaque-reduction neutralization tests
- RCTs, Randomized controlled trials
- TBE, Tick-borne encephalitis vaccine
- TGPO, Thai Governmental Pharmaceutical Organization
- WHO, World Health Organization
- YF-VAX, Yellow fever vaccine
- YFV, Yellow fever virus
- YFV17D, Yellow fever virus 17D vaccine strain
- immunogenicity
- meta-analysis
- safety
- systematic review
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Affiliation(s)
- Xing Li
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Shu-Juan Ma
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Xie Liu
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Li-Na Jiang
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Jun-Hua Zhou
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Yi-Quan Xiong
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Hong Ding
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Qing Chen
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
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Development of a small animal peripheral challenge model of Japanese encephalitis virus using interferon deficient AG129 mice and the SA14-14-2 vaccine virus strain. Vaccine 2013; 32:258-64. [PMID: 24252694 DOI: 10.1016/j.vaccine.2013.11.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/28/2013] [Accepted: 11/06/2013] [Indexed: 12/25/2022]
Abstract
Japanese encephalitis virus (JEV) is the most common cause of viral encephalitis in Asia, and it is increasingly a global public health concern due to its recent geographic expansion. While commercial vaccines are available and used in some endemic countries, JEV continues to be a public health problem, with 50,000 cases reported annually. Research with virulent JEV in mouse models to develop new methods of prevention and treatment is restricted to BSL-3 containment facilities, confining these studies to investigators with access to these facilities. We have developed an adult small animal peripheral challenge model using interferon-deficient AG129 mice and the JEV live-attenuated vaccine SA14-14-2, thus requiring only BSL-2 containment. A low dose of virus (10PFU/0.1ml) induced 100% morbidity in infected mice. Increased body temperatures measured by implantable temperature transponders correlated with an increase in infectious virus and viral RNA in serum, spleen and brain as well as an increase in pro-inflammatory markers measured by a 58-biomarker multi-analyte profile (MAP) constructed during the course of infection. In the future, the MAP measurements can be used as a baseline for comparison in order to better assess the inhibition of disease progression by other prophylactic and therapeutic agents. The use of the AG129/JEV SA14-14-2 animal model makes vaccine and therapeutic studies feasible for laboratories with limited biocontainment facilities.
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Erra EO, Askling HH, Yoksan S, Rombo L, Riutta J, Vene S, Lindquist L, Vapalahti O, Kantele A. Cross-protection elicited by primary and booster vaccinations against Japanese encephalitis: a two-year follow-up study. Vaccine 2013; 32:119-23. [PMID: 24176496 DOI: 10.1016/j.vaccine.2013.10.055] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/05/2013] [Accepted: 10/16/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND The inactivated Vero cell-derived vaccine (JE-VC, IXIARO) has replaced the traditional mouse brain-derived preparations (JE-MB) in travelers' vaccinations against Japanese encephalitis. We showed recently that a single JE-VC dose efficiently boosts immunity in JE-MB-primed vaccinees, and that JE-VC elicits cross-protective immunity against non-vaccine genotypes, including the emerging genotype I. While these studies only provided short-term data, the present investigation evaluates the longevity of seroprotection in the same volunteers. METHODS The study comprised 48 travelers who had received (1) JE-VC primary series, (2) JE-MB primary series followed by a single JE-VC booster dose, or (3) JE-MB primary series and a single JE-MB booster dose. Serum samples were collected two years after the last vaccine dose, and evaluated with the plaque-reduction neutralization test against seven Japanese encephalitis virus strains representing genotypes I-IV. PRNT50 titers ≥ 10 were considered protective. RESULTS Two years after the primary series with JE-VC, 87-93% of the vaccinees proved to be cross-protected against test strains representing genotypes II-IV and 73% against those of genotype I. After a single homologous or heterologous booster dose to JE-MB-primed subjects, the two-year seroprotection rates against genotype I-IV strains were 89-100%. CONCLUSIONS After JE-VC primary series, seroprotection appeared to wane first against genotype I. The first booster should not be delayed beyond two years. In JE-MB-primed subjects, a single JE-VC booster provided cross-protective immunity against genotype I-IV strains in almost all vaccinees, suggesting an interval of two years or even longer for the second booster. These data further support the use of a single JE-VC dose for boosting JE-MB immunity.
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Affiliation(s)
- Elina O Erra
- Haartman Institute, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Helena Hervius Askling
- Karolinska Institutet, Department of Medicine/Solna, Unit for Infectious Diseases, Stockholm, Sweden
| | - Sutee Yoksan
- Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, Thailand
| | - Lars Rombo
- Karolinska Institutet, Department of Medicine/Solna, Unit for Infectious Diseases, Stockholm, Sweden; Centre for Clinical Research, Sörmland County Council, Eskilstuna, Sweden
| | - Jukka Riutta
- Aava Travel Clinic, Aava Medical Centre, Helsinki, Finland
| | - Sirkka Vene
- Swedish Institute for Communicable Disease Control, Solna, Sweden
| | - Lars Lindquist
- Karolinska Institutet, Department of Medicine/Huddinge, Unit for Infectious Diseases, Stockholm, Sweden
| | - Olli Vapalahti
- Haartman Institute, Faculty of Medicine, University of Helsinki, Helsinki, Finland; HUSLAB, Division of Virology and Immunology, Helsinki University Central Hospital, Helsinki, Finland; Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | - Anu Kantele
- Haartman Institute, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland; Aava Travel Clinic, Aava Medical Centre, Helsinki, Finland; Department of Medicine, University of Helsinki, Helsinki, Finland.
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Yun SI, Lee YM. Japanese encephalitis: the virus and vaccines. Hum Vaccin Immunother 2013; 10:263-79. [PMID: 24161909 PMCID: PMC4185882 DOI: 10.4161/hv.26902] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/14/2013] [Accepted: 10/22/2013] [Indexed: 12/11/2022] Open
Abstract
Japanese encephalitis (JE) is an infectious disease of the central nervous system caused by Japanese encephalitis virus (JEV), a zoonotic mosquito-borne flavivirus. JEV is prevalent in much of Asia and the Western Pacific, with over 4 billion people living at risk of infection. In the absence of antiviral intervention, vaccination is the only strategy to develop long-term sustainable protection against JEV infection. Over the past half-century, a mouse brain-derived inactivated vaccine has been used internationally for active immunization. To date, however, JEV is still a clinically important, emerging, and re-emerging human pathogen of global significance. In recent years, production of the mouse brain-derived vaccine has been discontinued, but 3 new cell culture-derived vaccines are available in various parts of the world. Here we review current aspects of JEV biology, summarize the 4 types of JEV vaccine, and discuss the potential of an infectious JEV cDNA technology for future vaccine development.
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Affiliation(s)
- Sang-Im Yun
- Department of Animal, Dairy, and Veterinary Sciences; Utah Science Technology and Research; College of Agriculture and Applied Sciences; Utah State University; Logan, UT USA
| | - Young-Min Lee
- Department of Animal, Dairy, and Veterinary Sciences; Utah Science Technology and Research; College of Agriculture and Applied Sciences; Utah State University; Logan, UT USA
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Abstract
PURPOSE OF REVIEW Vector-borne diseases (VBDs) are difficult to prevent and control because it is hard to predict the complex habits of mosquitoes, ticks and fleas; most vector-borne viruses or bacteria infect animals as well as humans, which further adds to this difficulty. Thus, prevention is the best protection against VBD. RECENT FINDINGS Vaccines are available for yellow fever, Japanese encephalitis and tick-borne encephalitis and several vaccines are in clinical trials for dengue fever. Antimalarial intermittent preventive therapy (sulfadoxine-pyrimethamine) and insecticide-treated mosquito nets are associated with a decreased risk of neonatal mortality and lower birth-weight. Permethrin-impregnated clothing for the prevention of tick bites has been shown effective in reducing tick bites. SUMMARY Much progress has been made in terms of development of preventive vaccines and medicines, but there is more work that needs to be done. Efforts still need to continue on raising awareness for prevention of VBD.
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Kant Upadhyay R. Japanese Encephalitis Virus Generated Neurovirulence, Antigenicity, and Host Immune Responses. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/830396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In response to a JE virus attack, infected body cells start secretion of different cytokines and activate innate immune response. Virus starts neuronal invasion by entering into nerve cells and inflecting the central nervous system. It avoids exposure of body’s natural immunity and generates neurotrophic effects. Virus causes acute susceptibility to CNS and establishes encephalitis syndrome that results in very high fatality in children. In survivors, JEV inhibits the growth and proliferation of NCPs and imposes permanent neuronal disorders like cognitive, motor, and behavioral impairments. However, body cells start TCR mediated interactions, to recognize viral antigens with class I MHC complex on specific target cells, and operate mass killing of virus infected cells by increased CTL activity. Thus, both cell mediated and antibody interactions plays a central role in protection against JEV. In the present review article virus generated neurovirulence, antigenicity, and host immune responses are described in detail. More emphasis is given on diagnosis, clinical care, and active immunization with well-designed potential antiflavivirus vaccines. Further, for achieving an elite success against JEV, global eradication strategies are to be needed for making vaccination program more responsible and effective in endemic areas.
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Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, D D U Gorakhpur University, Gorakhpur 273009, India
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35
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Jelinek T. IXIARO ® updated: overview of clinical trials and developments with the inactivated vaccine against Japanese encephalitis. Expert Rev Vaccines 2013:1-11. [PMID: 23718271 DOI: 10.1586/erv.13.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
The mosquito-borne Japanese encephalitis virus causes an estimated 50,000 cases in Asia, accounting for at least 10,000 deaths and 15,000 cases of neuropsychiatric sequelae. IXIARO® (Intercell AG, Vienna, Austria), an inactivated, Vero cell-derived vaccine against Japanese encephalitis was introduced in 2009. The vaccine is highly immunogenic, showing significantly higher geometric mean antibody titers compared with previous, mouse brain-derived vaccines. Postmarketing studies have confirmed the excellent safety profile. Studies on children aged 2 months to 18 years have been published. Based on these data, positive opinion from the EMA for vaccination of children has recently been given. Since a safe and effective vaccine against Japanese encephalitis is now available, outdated guidelines and recommendations have to be revised: travelers to rural areas of Asia should generally be recommended vaccination.
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Affiliation(s)
- Tomas Jelinek
- Berlin Center for Travel and Tropical Medicine, Jägerstrasse 67-69, 10117 Berlin, Germany.
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36
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Fan J, Liu Y, Xie X, Zhang B, Yuan Z. Inhibition of Japanese encephalitis virus infection by flavivirus recombinant E protein domain III. Virol Sin 2013; 28:152-60. [PMID: 23709058 DOI: 10.1007/s12250-013-3331-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 05/07/2013] [Indexed: 11/25/2022] Open
Abstract
Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus closely related to the human pathogens including yellow fever virus, dengue virus and West Nile virus. There are currently no effective antiviral therapies for all of the flavivirus and only a few highly effective vaccines are licensed for human use. In this paper, the E protein domain III (DIII) of six heterologous flaviviruses (DENV1-4, WNV and JEV) was expressed in Escherichia coli successfully. The proteins were purified after a solubilization and refolding procedure, characterized by SDS-PAGE and Western blotting. Competitive inhibition showed that all recombinant flavivirus DIII proteins blocked the entry of JEV into BHK-21 cells. Further studies indicated that antibodies induced by the soluble recombinant flavivirus DIII partially protected mice against lethal JEV challenge. These results demonstrated that recombinant flavivirus DIII proteins could inhibit JEV infection competitively, and immunization with proper folding flavivirus DIII induced cross-protection against JEV infection in mice, implying a possible role of DIII for the cross-protection among flavivirus as well as its use in antigens for immunization in animal models.
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Affiliation(s)
- Jingjing Fan
- Key Laboratory of Agricultural and Environmental Microbiology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
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Erra EO, Askling HH, Yoksan S, Rombo L, Riutta J, Vene S, Lindquist L, Vapalahti O, Kantele A. Cross-protective capacity of Japanese encephalitis (JE) vaccines against circulating heterologous JE virus genotypes. Clin Infect Dis 2012; 56:267-70. [PMID: 23074319 PMCID: PMC3526254 DOI: 10.1093/cid/cis883] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Current Japanese encephalitis vaccines are derived from strains of genotype III, yet heterologous genotypes are emerging in endemic areas. Inactivated vaccines given to European travelers were found to elicit protective levels of neutralizing antibodies against heterologous strains of genotypes I-IV.
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Affiliation(s)
- Elina O Erra
- Haartman Institute, University of Helsinki, Finland
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39
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Heinz FX, Stiasny K. Flaviviruses and flavivirus vaccines. Vaccine 2012; 30:4301-6. [PMID: 22682286 DOI: 10.1016/j.vaccine.2011.09.114] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/16/2011] [Accepted: 09/23/2011] [Indexed: 12/28/2022]
Abstract
Several human-pathogenic flaviviruses (including yellow fever, dengue, Japanese encephalitis, West Nile and tick-borne encephalitis viruses) have a significant public health impact in different parts of the world and the potential of emerging in previously non-endemic regions. For some viruses, the structure of the most important immunogen, the envelope protein E, has been determined to atomic resolution by X-ray crystallography, and the architecture of virus particles has been resolved by cryo-electron microscopy. Through the combination of structural and immunological investigations, we now have a detailed understanding of the mechanisms of virus neutralization and antibody-dependent enhancement (ADE) of infectivity at a molecular level. The latter phenomenon has been proposed to play an important role in the immunopathology of severe forms of dengue virus infections (hemorrhagic dengue fever and dengue shock syndrome) and is therefore of special relevance in the context of dengue vaccines. Effective human vaccines are in use for the prophylaxis of yellow fever (live attenuated), Japanese encephalitis (live attenuated and inactivated whole virus), and tick-borne encephalitis (inactivated whole virus). Although dengue is the most important flavivirus with respect to global disease incidence, the development and use of vaccines has been hampered so far by the theoretical risk of vaccine-related adverse events such as immune enhancement of infection and the requirement to induce a long-lasting protective immune response against all four dengue serotypes simultaneously. Currently, several kinds of dengue vaccines are in development, but only one of these candidates (a chimeric dengue-yellow fever live attenuated vaccine) has reached the stage of phase 3 clinical trials.
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Affiliation(s)
- Franz X Heinz
- Department of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1095 Vienna, Austria.
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Vaccine-preventable diseases and their prophylaxis. Infect Dis Clin North Am 2012; 26:595-608. [PMID: 22963772 DOI: 10.1016/j.idc.2012.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Global uptake of new vaccines shapes the epidemiology of infections, and in turn this changing epidemiology guides vaccine development. Once introduced, surveillance and monitoring of the impact of vaccines on disease and adverse events is vital for further development. This article reviews the use of vaccines as part of routine health care, vaccines that may be required for entry into a destination country, and vaccines that are recommended because of risk during travel. Considerations and advances in the vaccination of travelers are addressed.
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Erra EO, Askling HH, Rombo L, Riutta J, Vene S, Yoksan S, Lindquist L, Pakkanen SH, Huhtamo E, Vapalahti O, Kantele A. A single dose of vero cell-derived Japanese encephalitis (JE) vaccine (Ixiaro) effectively boosts immunity in travelers primed with mouse brain-derived JE vaccines. Clin Infect Dis 2012; 55:825-34. [PMID: 22696017 PMCID: PMC3423932 DOI: 10.1093/cid/cis542] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The new Japanese encephalitis vaccine (JE-VC, Ixiaro) has replaced mouse brain–derived vaccines (JE-MB) associated with serious safety concerns. A single dose of JE-VC effectively boosted immunity in JE-MB–primed travelers. Current recommendations for booster vaccination should be reevaluated. Background. A significant part of the world population lives in areas with endemic Japanese encephalitis (JE). For travelers from nonendemic countries, Vero cell–derived vaccine (JE-VC; Ixiaro) has replaced traditional mouse brain–derived vaccines (JE-MB) associated with safety concerns. The 2 vaccines are derived from different viral strains: JE-VC from the SA14-14-2 strain and JE-MB from the Nakayama strain. No data exist regarding whether JE-VC can be used to boost immunity after a primary series of JE-MB; therefore, a primary series of JE-VC has been recommended to all travelers regardless of previous vaccination history. Methods. One hundred twenty travelers were divided into 4 groups: Volunteers with no prior JE vaccination received primary immunization with (group 1) JE-MB or (group 2) JE-VC, and those primed with JE-MB received a single booster dose of (group 3) JE-MB or (group 4) JE-VC. Immune responses were tested before and 4–8 weeks after vaccination using plaque reduction neutralization test (PRNT) against both vaccine strains. Results. In vaccine-naive travelers, the vaccination response rate for test strains Nakayama and SA14-14-2 was 100% and 87% after primary vaccination with JE-MB and 87% and 94% after JE-VC, respectively. Antibody levels depended on the target virus, with higher titers against homologous than heterologous PRNT50 target strain (P < .001). In travelers primed with JE-MB, vaccination response rates were 91% and 91%, and 98% and 95% after a booster dose of JE-MB or JE-VC, respectively. Subgroup analysis revealed that a higher proportion of primed (98%/95%) than nonprimed (39%/42%) volunteers responded to a single dose of JE-VC (P < .001). Conclusions. A single dose of JE-VC effectively boosted immunity in JE-MB–primed travelers. Current recommendations should be reevaluated. Clinical Trials Registration. NCT01386827.
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Affiliation(s)
- Elina O Erra
- Haartman Institute, Faculty of Medicine, University of Helsinki, Finland
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Woolpert T, Staples JE, Faix DJ, Nett RJ, Kosoy OI, Biggerstaff BJ, Johnson BW, Sracic M, Fischer M. Immunogenicity of one dose of Vero cell culture-derived Japanese encephalitis (JE) vaccine in adults previously vaccinated with mouse brain-derived JE vaccine. Vaccine 2012; 30:3090-6. [PMID: 22406277 DOI: 10.1016/j.vaccine.2012.02.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 02/08/2012] [Accepted: 02/22/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND There are no data on the use of inactivated Vero cell culture-derived Japanese encephalitis (JE) vaccine (JE-VC) as a booster among individuals who previously received inactivated mouse brain-derived JE vaccine (JE-MB). METHODS Military personnel who received ≥3 doses of JE-MB or were JE vaccine-naïve were vaccinated with 2 doses of JE-VC on days 0 and 28. Serum neutralizing antibodies were measured pre-vaccination and 28 days after each dose. Non-inferiority was evaluated for seroprotection rate and geometric mean titer (GMT) between previously vaccinated participants post-dose 1 and vaccine-naïve participants post-dose 2. RESULTS Fifty-three previously vaccinated and 70 JE vaccine-naïve participants were enrolled. Previously vaccinated participants had significantly higher GMTs pre-vaccination, post-dose 1, and post-dose 2. Seroprotection rates among previously vaccinated participants post-dose 1 (44/44, 100%) were noninferior to those achieved in previously naïve participants post-dose 2 (53/57, 93%). The GMT was significantly higher in previously vaccinated participants post-dose 1 (GMT 315; 95% CI 191-520) compared to previously naïve participants post-dose 2 (GMT 79; 95% CI 54-114). CONCLUSIONS Among military personnel previously vaccinated with ≥3 doses of JE-MB, a single dose of JE-VC adequately boosts neutralizing antibody levels and provides at least short-term protection. Additional studies are needed to confirm these findings in other populations and determine the duration of protection following a single dose of JE-VC in prior recipients of JE-MB.
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Affiliation(s)
- Tabitha Woolpert
- Department of Operational Infectious Diseases, Naval Health Research Center, San Diego, CA 92106, USA
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Chen LH, Hill DR, Wilder-Smith A. Vaccination of travelers: how far have we come and where are we going? Expert Rev Vaccines 2012; 10:1609-20. [PMID: 22043959 DOI: 10.1586/erv.11.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Vaccine recommendations are a prominent part of health preparations before international travel. We review progress made in the past decade regarding vaccines used primarily by persons traveling from high-income countries to low- and middle-income countries. The combined hepatitis A-B vaccine, the recently licensed Vero cell-derived Japanese encephalitis vaccine and conjugated quadrivalent meningococcal vaccines are discussed. This article provides updates on yellow fever vaccine-associated visceral and neurologic adverse events, indications for influenza vaccine in travelers, the rapid immunization schedule for tick-borne encephalitis vaccine, schedules for postexposure rabies prophylaxis, and new insights about oral cholera vaccines following the outbreak in Haiti. The future should bring vaccines for serogroup B Neiserria meningitidis, dengue and malaria, as well as an inactivated yellow fever vaccine.
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Affiliation(s)
- Lin H Chen
- Mount Auburn Hospital, Cambridge, MA, USA.
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Bharati K, Vrati S. Viral Vaccines in India: An Overview. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, INDIA. SECTION B 2012; 82:181-198. [PMID: 32226202 PMCID: PMC7100346 DOI: 10.1007/s40011-011-0014-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 11/14/2011] [Indexed: 01/27/2023]
Abstract
Viruses cause a large number of diseases in humans, some of which are fatal, while others are highly debilitating. A majority of viral diseases attack infants and young children, while others strike people in their prime. Development of preventive measures against viral diseases is, therefore, of paramount importance. Vaccination is the most cost-effective medical intervention for preventing mortality and morbidity against infectious diseases. A number of effective and safe vaccines are currently available against several viral diseases of significant medical importance. Many of these manufactured in India, are at par with international standards and are affordable. For many other viral diseases, for which vaccines are currently not available, research is underway at various national laboratories, as well as in the private sector companies in India. The present overview highlights the various vaccine preventable viral diseases that are of special importance to India and aims to provide a glimpse of the various vaccines that are currently available, or are under development in India.
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Affiliation(s)
| | - Sudhanshu Vrati
- Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, 496, Udyog Vihar Phase III, Gurgaon, 122016 India
- National Institute of Immunology, New Delhi, 110067 India
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Effectiveness of mouse brain-derived inactivated Japanese encephalitis vaccine in Thai National Immunization Program: a case-control study. Vaccine 2011; 30:361-7. [PMID: 22075090 DOI: 10.1016/j.vaccine.2011.10.083] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 09/18/2011] [Accepted: 10/28/2011] [Indexed: 11/22/2022]
Abstract
Mouse brain-derived, purified inactivated Japanese encephalitis vaccine (MB JEV) has been locally produced and introduced into Thai National Immunization Program (NIP) since 1990. However, MB JEV effectiveness has been concerned, since 30-40% of JE cases received JE vaccines were recently reported in two descriptive studies. Therefore, in 2010, a case-control study was designed to assess effectiveness of the MB JEV used in the NIP, among children aged 1 to <6 years. Subjects enrolled from all regions of the country, 26 cases were clinical encephalitis with laboratory-confirmed for JE IgM titer, while 103 controls had past illness free on encephalitis. For each case, four controls were enrolled from children living in the same community with the case. Individual health records of the subjects were used to verify JE immunization status. Among children aged ≥ 18 months old, the recommended age by the NIP, the effectiveness was estimated at 94.6% (95%CI, 79.6-98.6%) and adjusted effectiveness was 97.50% (95%CI, 88.60-99.50%). The study results suggest that the MB JEV used in the NIP is highly effective, even among children aged <18 months. Therefore, aggressive immunization using the MB JEV would greatly diminish disease burden.
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Schuller E, Klingler A, Dubischar-Kastner K, Dewasthaly S, Müller Z. Safety profile of the Vero cell-derived Japanese encephalitis virus (JEV) vaccine IXIARO®. Vaccine 2011; 29:8669-76. [DOI: 10.1016/j.vaccine.2011.08.117] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/22/2011] [Accepted: 08/28/2011] [Indexed: 11/16/2022]
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