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Goldstein N, McLean C, Gaddah A, Doua J, Keshinro B, Bus-Jacobs L, Hendriks J, Luhn K, Robinson C, Douoguih M. Lot-to-lot consistency, immunogenicity, and safety of the Ad26.ZEBOV, MVA-BN-Filo Ebola virus vaccine regimen: A phase 3, randomized, double-blind, placebo-controlled trial. Hum Vaccin Immunother 2024; 20:2327747. [PMID: 38523332 DOI: 10.1080/21645515.2024.2327747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/05/2024] [Indexed: 03/26/2024] Open
Abstract
This phase-3, double-blind, placebo-controlled study (NCT04228783) evaluated lot-to-lot consistency of the Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. Participants were randomized (6:6:6:1) to receive the two-dose regimen from three consecutively manufactured lots of Ad26.ZEBOV on Day 1 paired with three consecutively manufactured lots of MVA-BN-Filo on Day 57 (Groups 1-3) or two doses of placebo (Group 4). An additional cohort also received an Ad26.ZEBOV booster or placebo 4 months post-dose 2. Equivalence of the immunogenicity at 21 days post-dose 2 between any two groups was demonstrated if the 95% confidence interval (CI) of the Ebola virus glycoprotein (EBOV GP)-binding antibody geometric mean concentration (GMC) ratio was entirely within the prespecified margin of 0.5-2.0. Lot-to-lot consistency (i.e., consecutive lots can be consistently manufactured) was accomplished if equivalence was shown for all three pairwise comparisons. Results showed that the primary objective in the per-protocol immunogenicity subset (n = 549) was established for each pairwise comparison (Group 1 vs 2: GMC ratio = 0.9 [95% CI: 0.8, 1.1], Group 1 vs 3: 0.9 [0.8, 1.1], Group 2 vs 3: 1.0 [0.9, 1.2]). Equivalence of the three groups for the Ad26.ZEBOV component only was also demonstrated at 56 days post-dose 1. EBOV GP-binding antibody responses (post-vaccination concentrations >2.5-fold from baseline) were observed in 419/421 (99.5%) vaccine recipients at 21 days post-dose 2 and 445/460 (96.7%) at 56 days post-dose 1. In the booster cohort (n = 39), GMCs increased 9.0- and 11.8-fold at 7 and 21 days post-booster, respectively, versus pre-booster. Ad26.ZEBOV, MVA-BN-Filo was well tolerated, and no safety issues were identified.
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Affiliation(s)
- Neil Goldstein
- Janssen Vaccines & Prevention B.V, Leiden, The Netherlands
| | - Chelsea McLean
- Janssen Vaccines & Prevention B.V, Leiden, The Netherlands
| | | | | | | | | | - Jenny Hendriks
- Janssen Vaccines & Prevention B.V, Leiden, The Netherlands
| | - Kerstin Luhn
- Janssen Vaccines & Prevention B.V, Leiden, The Netherlands
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2
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Wiedemann A, Lhomme E, Huchon M, Foucat E, Bérerd-Camara M, Guillaumat L, Yaradouno M, Tambalou J, Rodrigues C, Ribeiro A, Béavogui AH, Lacabaratz C, Thiébaut R, Richert L, Lévy Y. Long-term cellular immunity of vaccines for Zaire Ebola Virus Diseases. Nat Commun 2024; 15:7666. [PMID: 39227399 PMCID: PMC11372064 DOI: 10.1038/s41467-024-51453-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/07/2024] [Indexed: 09/05/2024] Open
Abstract
Recent Ebola outbreaks underscore the importance of continuous prevention and disease control efforts. Authorized vaccines include Merck's Ervebo (rVSV-ZEBOV) and Johnson & Johnson's two-dose combination (Ad26.ZEBOV/MVA-BN-Filo). Here, in a five-year follow-up of the PREVAC randomized trial (NCT02876328), we report the results of the immunology ancillary study of the trial. The primary endpoint is to evaluate long-term memory T-cell responses induced by three vaccine regimens: Ad26-MVA, rVSV, and rVSV-booster. Polyfunctional EBOV-specific CD4+ T-cell responses increase after Ad26 priming and are further boosted by MVA, whereas minimal responses are observed in the rVSV groups, declining after one year. In-vitro expansion for eight days show sustained EBOV-specific T-cell responses for up to 60 months post-prime vaccination with both Ad26-MVA and rVSV, with no decline. Cytokine production analysis identify shared biomarkers between the Ad26-MVA and rVSV groups. In secondary endpoint, we observed an elevation of pro-inflammatory cytokines at Day 7 in the rVSV group. Finally, we establish a correlation between EBOV-specific T-cell responses and anti-EBOV IgG responses. Our findings can guide booster vaccination recommendations and help identify populations likely to benefit from revaccination.
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Affiliation(s)
- Aurélie Wiedemann
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | - Edouard Lhomme
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- Univ. Bordeaux, INSERM, Institut Bergonié, CHU de Bordeaux, CIC-EC 1401, Euclid/F-CRIN clinical trials platform, Bordeaux, France
- Univ. Bordeaux, Inserm, Population Health Research Center, UMR 1219, INRIA SISTM, Bordeaux, France
| | - Mélanie Huchon
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- Univ. Bordeaux, Inserm, Population Health Research Center, UMR 1219, INRIA SISTM, Bordeaux, France
| | - Emile Foucat
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | | | - Lydia Guillaumat
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | | | | | - Cécile Rodrigues
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | - Alexandre Ribeiro
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | - Abdoul Habib Béavogui
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR), Maferinyah, Guinea
| | - Christine Lacabaratz
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France
| | - Rodolphe Thiébaut
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- Univ. Bordeaux, INSERM, Institut Bergonié, CHU de Bordeaux, CIC-EC 1401, Euclid/F-CRIN clinical trials platform, Bordeaux, France
- Univ. Bordeaux, Inserm, Population Health Research Center, UMR 1219, INRIA SISTM, Bordeaux, France
| | - Laura Richert
- Vaccine Research Institute, Université Paris-Est, Créteil, France
- Univ. Bordeaux, INSERM, Institut Bergonié, CHU de Bordeaux, CIC-EC 1401, Euclid/F-CRIN clinical trials platform, Bordeaux, France
- Univ. Bordeaux, Inserm, Population Health Research Center, UMR 1219, INRIA SISTM, Bordeaux, France
| | - Yves Lévy
- Vaccine Research Institute, Université Paris-Est, Créteil, France.
- INSERM U955, Institut Mondor de Recherche Biomedicale (IMRB), Team Lévy, Créteil, France.
- Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, Créteil, France.
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3
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Larivière Y, Matuvanga TZ, Osang'ir BI, Milolo S, Meta R, Kimbulu P, Robinson C, Katwere M, McLean C, Lemey G, Matangila J, Maketa V, Mitashi P, Van Geertruyden JP, Van Damme P, Muhindo-Mavoko H. Ad26.ZEBOV, MVA-BN-Filo Ebola virus disease vaccine regimen plus Ad26.ZEBOV booster at 1 year versus 2 years in health-care and front-line workers in the Democratic Republic of the Congo: secondary and exploratory outcomes of an open-label, randomised, phase 2 trial. THE LANCET. INFECTIOUS DISEASES 2024; 24:746-759. [PMID: 38552653 DOI: 10.1016/s1473-3099(24)00058-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Health-care providers and front-line workers are at risk of contracting Ebola virus disease during an Ebola virus outbreak and consequently of becoming drivers of the disease. We aimed to assess the long-term immunogenicity of the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen and the safety of and immune memory response to an Ad26.ZEBOV booster vaccination at 1 year or 2 years after the first dose in this at-risk population. METHODS This open-label, single-centre, randomised, phase 2 trial was conducted at one study site within a hospital in Boende, Democratic Republic of the Congo. Adult health-care providers and front-line workers, excluding those with a known history of Ebola virus disease, were vaccinated with a two-dose heterologous regimen administered at a 56-day interval via a 0·5 mL intramuscular injection in the deltoid muscle, comprising Ad26.ZEBOV as the first dose and MVA-BN-Filo as the second dose. After the initial vaccination on day 1, participants were randomly assigned (1:1) via randomisation envelopes, opened in a sequential order, to receive an Ad26.ZEBOV booster vaccination at 1 year (group 1) or 2 years (group 2) after the first dose. We present the secondary and exploratory objectives of the trial-results of the primary objective have been published elsewhere. We measured immunogenicity at six timepoints per group as geometric mean concentrations (GMCs) of Ebola virus glycoprotein-specific IgG binding antibodies, using the Filovirus Animal Non-Clinical Group ELISA. We assessed serious adverse events occurring up to 6 months after the last dose and local and systemic solicited and unsolicited adverse events reported for 7 days after the booster vaccination. Antibody responses were analysed per protocol, serious adverse events per full analysis set (FAS), and adverse events for all boosted FAS participants. This trial is registered as completed on ClinicalTrials.gov (NCT04186000). FINDINGS Between Dec 18, 2019, and Feb 8, 2020, 699 health-care providers and front-line workers were enrolled and 698 were randomly assigned (350 to group 1 and 348 to group 2 [FAS]); 534 (77%) participants were male and 164 (23%) were female. 319 in group 1 and 317 in group 2 received the booster. 29 (8%) in group 1 and 26 (7%) in group 2 did not complete the study, mostly due to loss to follow-up or moving out of the study area. In both groups, injection-site pain or tenderness (87 [27%] of 319 group 1 participants vs 90 [28%] of 317 group 2 participants) and headache (91 [29%] vs 93 [29%]) were the most common solicited adverse events related to the investigational product. One participant (in group 2) had a related serious adverse event after booster vaccination (fever of ≥40·0°C). Before booster vaccination, Ebola virus glycoprotein-specific IgG binding antibody GMCs were 279·9 ELISA units (EU) per mL (95% CI 250·6-312·7) in 314 group 1 participants (1 year after first dose) and 274·6 EU/mL (242·1-311·5) in 310 group 2 participants (2 years after first dose). These values were 5·2 times higher in group 1 and 4·9 times higher in group 2 than before vaccination on day 1. 7 days after booster vaccination, these values increased to 10 781·6 EU/mL (9354·4-12 426·4) for group 1 and 10 746·9 EU/mL (9208·7-12 542·0) for group 2, which were approximately 39 times higher than before booster vaccination in both groups. 1 year after booster vaccination in 299 group 1 participants, a GMC that was 7·6-times higher than before booster vaccination was still observed (2133·1 EU/mL [1827·7-2489·7]). INTERPRETATION Overall, the vaccine regimen and booster dose were well tolerated. A similar and robust humoral immune response was observed for participants boosted 1 year and 2 years after the first dose, supporting the use of the regimen and flexibility of booster dose administration for prophylactic vaccination in at-risk populations. FUNDING Innovative Medicines Initiative 2 Joint Undertaking and Coalition for Epidemic Preparedness Innovations.
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Affiliation(s)
- Ynke Larivière
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium.
| | - Trésor Zola Matuvanga
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium; Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bernard Isekah Osang'ir
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Primo Kimbulu
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Gwen Lemey
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium; Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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4
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Ake JA, Paolino K, Hutter JN, Cicatelli SB, Eller LA, Eller MA, Costanzo MC, Paquin-Proulx D, Robb ML, Tran CL, Anova L, Jagodzinski LL, Ward LA, Kilgore N, Rusnak J, Bounds C, Badorrek CS, Hooper JW, Kwilas SA, Ilsbroux I, Anumendem DN, Gaddah A, Shukarev G, Bockstal V, Luhn K, Douoguih M, Robinson C. Safety and Immunogenicity of an Accelerated Ebola Vaccination Schedule in People with and without Human Immunodeficiency Virus: A Randomized Clinical Trial. Vaccines (Basel) 2024; 12:497. [PMID: 38793748 PMCID: PMC11125575 DOI: 10.3390/vaccines12050497] [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: 03/20/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
The safety and immunogenicity of the two-dose Ebola vaccine regimen MVA-BN-Filo, Ad26.ZEBOV, 14 days apart, was evaluated in people without HIV (PWOH) and living with HIV (PLWH). In this observer-blind, placebo-controlled, phase 2 trial, healthy adults were randomized (4:1) to receive MVA-BN-Filo (dose 1) and Ad26.ZEBOV (dose 2), or two doses of saline/placebo, administered intramuscularly 14 days apart. The primary endpoints were safety (adverse events (AEs)) and immunogenicity (Ebola virus (EBOV) glycoprotein-specific binding antibody responses). Among 75 participants (n = 50 PWOH; n = 25 PLWH), 37% were female, the mean age was 44 years, and 56% were Black/African American. AEs were generally mild/moderate, with no vaccine-related serious AEs. At 21 days post-dose 2, EBOV glycoprotein-specific binding antibody responder rates were 100% among PWOH and 95% among PLWH; geometric mean antibody concentrations were 6286 EU/mL (n = 36) and 2005 EU/mL (n = 19), respectively. A total of 45 neutralizing and other functional antibody responses were frequently observed. Ebola-specific CD4+ and CD8+ T-cell responses were polyfunctional and durable to at least 12 months post-dose 2. The regimen was well tolerated and generated robust, durable immune responses in PWOH and PLWH. Findings support continued evaluation of accelerated vaccine schedules for rapid deployment in populations at immediate risk. Trial registration: NCT02598388 (submitted 14 November 2015).
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Affiliation(s)
- Julie A. Ake
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Kristopher Paolino
- Clinical Trials Center, Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Jack N. Hutter
- Clinical Trials Center, Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | | | - Leigh Anne Eller
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Michael A. Eller
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Margaret C. Costanzo
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Dominic Paquin-Proulx
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Merlin L. Robb
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Chi L. Tran
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Lalaine Anova
- U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Linda L. Jagodzinski
- Diagnostics and Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Lucy A. Ward
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical, U.S. Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, Fort Detrick, MD 21702, USA
| | - Nicole Kilgore
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical, U.S. Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, Fort Detrick, MD 21702, USA
| | - Janice Rusnak
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical, U.S. Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, Fort Detrick, MD 21702, USA
| | - Callie Bounds
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical, U.S. Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, Fort Detrick, MD 21702, USA
| | - Christopher S. Badorrek
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical, U.S. Department of Defense Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense, Fort Detrick, MD 21702, USA
| | - Jay W. Hooper
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD 21702, USA
| | - Steven A. Kwilas
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD 21702, USA
| | - Ine Ilsbroux
- Janssen Research & Development, 2340 Beerse, Belgium
| | | | | | - Georgi Shukarev
- Janssen Vaccines & Prevention B.V., 2333 Leiden, The Netherlands
| | - Viki Bockstal
- Janssen Vaccines & Prevention B.V., 2333 Leiden, The Netherlands
| | - Kerstin Luhn
- Janssen Vaccines & Prevention B.V., 2333 Leiden, The Netherlands
| | - Macaya Douoguih
- Janssen Vaccines & Prevention B.V., 2333 Leiden, The Netherlands
| | - Cynthia Robinson
- Janssen Vaccines & Prevention B.V., 2333 Leiden, The Netherlands
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5
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Larivière Y, Garcia-Fogeda I, Zola Matuvanga T, Isekah Osang'ir B, Milolo S, Meta R, Kimbulu P, Robinson C, Katwere M, McLean C, Hens N, Matangila J, Maketa V, Mitashi P, Muhindo-Mavoko H, Van geertruyden JP, Van Damme P. Safety and Immunogenicity of the Heterologous 2-Dose Ad26.ZEBOV, MVA-BN-Filo Vaccine Regimen in Health Care Providers and Frontliners of the Democratic Republic of the Congo. J Infect Dis 2024; 229:1068-1076. [PMID: 37673423 PMCID: PMC11011182 DOI: 10.1093/infdis/jiad350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND In response to recent Ebola epidemics, vaccine development against the Zaire ebolavirus (EBOV) has been fast-tracked in the past decade. Health care providers and frontliners working in Ebola-endemic areas are at high risk of contracting and spreading the virus. METHODS This study assessed the safety and immunogenicity of the 2-dose heterologous Ad26.ZEBOV, MVA-BN-Filo vaccine regimen (administered at a 56-day interval) among 699 health care providers and frontliners taking part in a phase 2, monocentric, randomized vaccine trial in Boende, the Democratic Republic of Congo. The first participant was enrolled and vaccinated on 18 December 2019. Serious adverse events were collected up to 6 months after the last received dose. The EBOV glycoprotein FANG ELISA (Filovirus Animal Nonclinical Group enzyme-linked immunosorbent assay) was used to measure the immunoglobulin G-binding antibody response to the EBOV glycoprotein. RESULTS The vaccine regimen was well tolerated with no vaccine-related serious adverse events reported. Twenty-one days after the second dose, an EBOV glycoprotein-specific binding antibody response was observed in 95.2% of participants. CONCLUSIONS The 2-dose vaccine regimen was well tolerated and led to a high antibody response among fully vaccinated health care providers and frontliners in Boende.
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Affiliation(s)
- Ynke Larivière
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Irene Garcia-Fogeda
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Trésor Zola Matuvanga
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bernard Isekah Osang'ir
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Primo Kimbulu
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Niel Hens
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics, UHasselt, Diepenbeek, Belgium
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Pierre Van geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk
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6
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Barry H, Lhomme E, Surénaud M, Nouctara M, Robinson C, Bockstal V, Valea I, Somda S, Tinto H, Meda N, Greenwood B, Thiébaut R, Lacabaratz C. Helminth exposure and immune response to the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. PLoS Negl Trop Dis 2024; 18:e0011500. [PMID: 38603720 PMCID: PMC11037528 DOI: 10.1371/journal.pntd.0011500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 04/23/2024] [Accepted: 02/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The exposure to parasites may influence the immune response to vaccines in endemic African countries. In this study, we aimed to assess the association between helminth exposure to the most prevalent parasitic infections, schistosomiasis, soil transmitted helminths infection and filariasis, and the Ebola virus glycoprotein (EBOV GP) antibody concentration in response to vaccination with the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen in African and European participants using samples obtained from three international clinical trials. METHODS/PRINCIPAL FINDINGS We conducted a study in a subset of participants in the EBL2001, EBL2002 and EBL3001 clinical trials that evaluated the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen against EVD in children, adolescents and adults from the United Kingdom, France, Burkina Faso, Cote d'Ivoire, Kenya, Uganda and Sierra Leone. Immune markers of helminth exposure at baseline were evaluated by ELISA with three commercial kits which detect IgG antibodies against schistosome, filarial and Strongyloides antigens. Luminex technology was used to measure inflammatory and activation markers, and Th1/Th2/Th17 cytokines at baseline. The association between binding IgG antibodies specific to EBOV GP (measured on day 21 post-dose 2 and on Day 365 after the first dose respectively), and helminth exposure at baseline was evaluated using a multivariable linear regression model adjusted for age and study group. Seventy-eight (21.3%) of the 367 participants included in the study had at least one helminth positive ELISA test at baseline, with differences of prevalence between studies and an increased prevalence with age. The most frequently detected antibodies were those to Schistosoma mansoni (10.9%), followed by Acanthocheilonema viteae (9%) and then Strongyloides ratti (7.9%). Among the 41 immunological analytes tested, five were significantly (p < .003) lower in participants with at least one positive helminth ELISA test result: CCL2/MCP1, FGFbasic, IL-7, IL-13 and CCL11/Eotaxin compared to participants with negative helminth ELISA tests. No significant association was found with EBOV-GP specific antibody concentration at 21 days post-dose 2, or at 365 days post-dose 1, adjusted for age group, study, and the presence of any helminth antibodies at baseline. CONCLUSIONS/SIGNIFICANCE No clear association was found between immune markers of helminth exposure as measured by ELISA and post-vaccination response to the Ebola Ad26.ZEBOV/ MVA-BN-Filo vaccine regimen. TRIAL REGISTRATION NCT02416453, NCT02564523, NCT02509494. ClinicalTrials.gov.
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Affiliation(s)
- Houreratou Barry
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
| | - Edouard Lhomme
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
- CHU Bordeaux, Department of Medical Information, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Mathieu Surénaud
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Moumini Nouctara
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
| | | | - Viki Bockstal
- Janssen Vaccines & Prevention B.V., Leiden, Netherlands
| | - Innocent Valea
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Santé/Unité de Recherche Clinique de Nanoro, Burkina Faso
| | - Serge Somda
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Université Nazi BONI, UFR Sciences Exactes et Appliquées, Bobo-Dioulasso, Burkina Faso
| | - Halidou Tinto
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Santé/Unité de Recherche Clinique de Nanoro, Burkina Faso
| | - Nicolas Meda
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- UFR Sciences de la santé, Université joseph Ki Zerbo, Ouagadougou, Burkina Faso
| | - Brian Greenwood
- London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
- CHU Bordeaux, Department of Medical Information, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
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Puri A, Pollard AJ, Schmidt-Mutter C, Lainé F, PrayGod G, Kibuuka H, Barry H, Nicolas JF, Lelièvre JD, Sirima SB, Kamala B, Manno D, Watson-Jones D, Gaddah A, Keshinro B, Luhn K, Robinson C, Douoguih M. Long-Term Clinical Safety of the Ad26.ZEBOV and MVA-BN-Filo Ebola Vaccines: A Prospective, Multi-Country, Observational Study. Vaccines (Basel) 2024; 12:210. [PMID: 38400193 PMCID: PMC10892482 DOI: 10.3390/vaccines12020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/01/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
In this prospective, observational study (ClinicalTrials.gov Identifier: NCT02661464), long-term safety information was collected from participants previously exposed to the Ebola vaccines Ad26.ZEBOV and/or MVA-BN-Filo while enrolled in phase 1, 2, or 3 clinical studies. The study was conducted at 15 sites in seven countries (Burkina Faso, France, Kenya, Tanzania, Uganda, the United Kingdom, and the United States). Adult participants and offspring from vaccinated female participants who became pregnant (estimated conception ≤28 days after vaccination with MVA-BN-Filo or ≤3 months after vaccination with Ad26.ZEBOV) were enrolled. Adults were followed for 60 months after their first vaccination, and children born to female participants were followed for 60 months after birth. In the full analysis set (n = 614 adults; median age [range]: 32.0 [18-65] years), 49 (8.0%) had ≥1 serious adverse event (SAE); the incidence rate of any SAE was 27.4 per 1000 person-years (95% confidence interval: 21.0, 35.2). The unrelated SAEs of malaria were reported in the two infants in the full analysis set, aged 11 and 18 months; both episodes were resolved. No deaths or life-threatening SAEs occurred during the study. Overall, no major safety issues were identified; one related SAE was reported. These findings support the long-term clinical safety of the Ad26.ZEBOV and MVA-BN-Filo vaccines.
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Affiliation(s)
- Adeep Puri
- Hammersmith Medicines Research Limited, Cumberland Avenue, London NW10 7EW, UK;
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), and NIHR Oxford Biomedical Research Centre, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK;
| | | | - Fabrice Lainé
- Inserm CIC 1414, CHU Rennes, Rue Henri Le Guillou, 35033 Rennes, France;
| | - George PrayGod
- Mwanza Research Center, National Institute for Medical Research, Isamilo Road, Mwanza P.O. Box 1462, Tanzania;
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Plot 42 Nakasero Road, Kampala P.O. Box 16524, Uganda;
| | - Houreratou Barry
- Centre MURAZ, 2054 Avenue Mamadou Konaté, Bobo Dioulasso 01 BP 390, Burkina Faso;
| | - Jean-François Nicolas
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon I, 69364 Lyon, France;
| | - Jean-Daniel Lelièvre
- INSERM U955, Vaccine Research Institute, CHU Henri Mondor 1 rue Gustave Eiffel, 94000 Créteil, France;
| | | | - Beatrice Kamala
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza P.O. Box 11936, Tanzania; (B.K.); (D.W.-J.)
| | - Daniela Manno
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK;
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza P.O. Box 11936, Tanzania; (B.K.); (D.W.-J.)
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK;
| | - Auguste Gaddah
- Janssen Research & Development, Turnhoutseweg 30, B-2340 Beerse, Belgium;
| | - Babajide Keshinro
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands; (K.L.); (C.R.); (M.D.)
| | - Kerstin Luhn
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands; (K.L.); (C.R.); (M.D.)
| | - Cynthia Robinson
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands; (K.L.); (C.R.); (M.D.)
| | - Macaya Douoguih
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands; (K.L.); (C.R.); (M.D.)
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Yin J, Zhang L, Wang C, Qin C, Miao M. Immunogenicity and safety of ebolavirus vaccines in healthy adults: a systematic review and meta-analysis of randomized controlled trials. Expert Rev Vaccines 2024; 23:148-159. [PMID: 38112249 DOI: 10.1080/14760584.2023.2296937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND This review aimed to systematically evaluate the immunogenicity and safety of the candidate Ebola virus vaccine (EVV). METHODS We searched five databases for randomized controlled trials (RCTs) evaluating the effects of EVV on healthy adults. The primary outcomes were relative risk (RR) of sero-conversion or sero-response of EVV in healthy adults between the groups that received EVV and the controls. RESULTS Twenty-nine RCTs (n = 23573) were included. There was a significant difference in RR of sero-conversion of EVV (RR 13.18; 95% CI 11.28-15.41; I2 = 33%; P < 0.01) between the two groups. There was a significant difference in RR of adverse events (AEs) of EVV (RR 1.49; 95% CI 1.27-1.74; I2 = 88%; P < 0.01), although no difference in RR of serious AE (SAE) between the two groups. Subgroup analysis showed that there was no significant difference in RR of AEs for DNAEBO, EBOV-GP, MVA, and rVSVN4CT1 vaccines, compared with controls. CONCLUSIONS The DNAEBO, EBOV-GP, MVA, and rVSVN4CT1 vaccines are likely to be safe and immunogenic, tending to support the vaccination against Ebola disease. These findings should provide much-needed evidence for public health policy makers to develop preventive measures based on disease prevalence features and socio-economic conditions.
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Affiliation(s)
- Juntao Yin
- Department of Pharmacy, Huaihe Hospital, Henan University, Kaifeng, Henan, China
- National International Cooperation Base of Chinese Medicine, Henan University of Chinese Medicine, zhengzhou, Henan, China
| | - Liang Zhang
- School of Medicine, Henan Technical Institute, Zhengzhou, China
| | - Chaoyang Wang
- Department of General Surgery, Huaihe Hospital, Henan University, Kaifeng, Henan, China
| | - Changjiang Qin
- Department of General Surgery, Huaihe Hospital, Henan University, Kaifeng, Henan, China
| | - Mingsan Miao
- National International Cooperation Base of Chinese Medicine, Henan University of Chinese Medicine, zhengzhou, Henan, China
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Alexandre M, Prague M, McLean C, Bockstal V, Douoguih M, Thiébaut R. Prediction of long-term humoral response induced by the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo vaccine against Ebola. NPJ Vaccines 2023; 8:174. [PMID: 37940656 PMCID: PMC10632397 DOI: 10.1038/s41541-023-00767-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
The persistence of the long-term immune response induced by the heterologous Ad26.ZEBOV, MVA-BN-Filo two-dose vaccination regimen against Ebola has been investigated in several clinical trials. Longitudinal data on IgG-binding antibody concentrations were analyzed from 487 participants enrolled in six Phase I and Phase II clinical trials conducted by the EBOVAC1 and EBOVAC2 consortia. A model based on ordinary differential equations describing the dynamics of antibodies and short- and long-lived antibody-secreting cells (ASCs) was used to model the humoral response from 7 days after the second vaccination to a follow-up period of 2 years. Using a population-based approach, we first assessed the robustness of the model, which was originally estimated based on Phase I data, against all data. Then we assessed the longevity of the humoral response and identified factors that influence these dynamics. We estimated a half-life of the long-lived ASC of at least 15 years and found an influence of geographic region, sex, and age on the humoral response dynamics, with longer antibody persistence in Europeans and women and higher production of antibodies in younger participants.
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Affiliation(s)
- Marie Alexandre
- Department of Public Health, Bordeaux University, Inserm UMR 1219 Bordeaux Population Health Research Center, Inria SISTM, Bordeaux, France
- Vaccine Research Institute, Créteil, France
| | - Mélanie Prague
- Department of Public Health, Bordeaux University, Inserm UMR 1219 Bordeaux Population Health Research Center, Inria SISTM, Bordeaux, France
- Vaccine Research Institute, Créteil, France
| | - Chelsea McLean
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
- ExeVir, Ghent, Belgium
| | | | - Rodolphe Thiébaut
- Department of Public Health, Bordeaux University, Inserm UMR 1219 Bordeaux Population Health Research Center, Inria SISTM, Bordeaux, France.
- Vaccine Research Institute, Créteil, France.
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10
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Blengio F, Hocini H, Richert L, Lefebvre C, Durand M, Hejblum B, Tisserand P, McLean C, Luhn K, Thiebaut R, Levy Y. Identification of early gene expression profiles associated with long-lasting antibody responses to the Ebola vaccine Ad26.ZEBOV/MVA-BN-Filo. Cell Rep 2023; 42:113101. [PMID: 37691146 DOI: 10.1016/j.celrep.2023.113101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/24/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023] Open
Abstract
Ebola virus disease is a severe hemorrhagic fever with a high fatality rate. We investigate transcriptome profiles at 3 h, 1 day, and 7 days after vaccination with Ad26.ZEBOV and MVA-BN-Filo. 3 h after Ad26.ZEBOV injection, we observe an increase in genes related to antigen presentation, sensing, and T and B cell receptors. The highest response occurs 1 day after Ad26.ZEBOV injection, with an increase of the gene expression of interferon-induced antiviral molecules, monocyte activation, and sensing receptors. This response is regulated by the HESX1, ATF3, ANKRD22, and ETV7 transcription factors. A plasma cell signature is observed on day 7 post-Ad26.ZEBOV vaccination, with an increase of CD138, MZB1, CD38, CD79A, and immunoglobulin genes. We have identified early expressed genes correlated with the magnitude of the antibody response 21 days after the MVA-BN-Filo and 364 days after Ad26.ZEBOV vaccinations. Our results provide early gene signatures that correlate with vaccine-induced Ebola virus glycoprotein-specific antibodies.
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Affiliation(s)
- Fabiola Blengio
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Hakim Hocini
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Laura Richert
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France; University Bordeaux, Department of Public Health, INSERM Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, Bordeaux, France; CHU de Bordeaux, Pôle de Santé Publique, Service d'Information Médicale, Bordeaux, France
| | - Cécile Lefebvre
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Mélany Durand
- University Bordeaux, Department of Public Health, INSERM Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, Bordeaux, France; CHU de Bordeaux, Pôle de Santé Publique, Service d'Information Médicale, Bordeaux, France
| | - Boris Hejblum
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France; University Bordeaux, Department of Public Health, INSERM Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, Bordeaux, France; CHU de Bordeaux, Pôle de Santé Publique, Service d'Information Médicale, Bordeaux, France
| | - Pascaline Tisserand
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Chelsea McLean
- Janssen Vaccines & Prevention, B.V. Archimediesweg, Leiden, the Netherlands
| | - Kerstin Luhn
- Janssen Vaccines & Prevention, B.V. Archimediesweg, Leiden, the Netherlands
| | - Rodolphe Thiebaut
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France; University Bordeaux, Department of Public Health, INSERM Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, Bordeaux, France; CHU de Bordeaux, Pôle de Santé Publique, Service d'Information Médicale, Bordeaux, France.
| | - Yves Levy
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France; Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, Créteil, France.
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11
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McLean C, Dijkman K, Gaddah A, Keshinro B, Katwere M, Douoguih M, Robinson C, Solforosi L, Czapska-Casey D, Dekking L, Wollmann Y, Volkmann A, Pau MG, Callendret B, Sadoff J, Schuitemaker H, Zahn R, Luhn K, Hendriks J, Roozendaal R. Persistence of immunological memory as a potential correlate of long-term, vaccine-induced protection against Ebola virus disease in humans. Front Immunol 2023; 14:1215302. [PMID: 37727795 PMCID: PMC10505757 DOI: 10.3389/fimmu.2023.1215302] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction In the absence of clinical efficacy data, vaccine protective effect can be extrapolated from animals to humans, using an immunological biomarker in humans that correlates with protection in animals, in a statistical approach called immunobridging. Such an immunobridging approach was previously used to infer the likely protective effect of the heterologous two-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. However, this immunobridging model does not provide information on how the persistence of the vaccine-induced immune response relates to durability of protection in humans. Methods and results In both humans and non-human primates, vaccine-induced circulating antibody levels appear to be very stable after an initial phase of contraction and are maintained for at least 3.8 years in humans (and at least 1.3 years in non-human primates). Immunological memory was also maintained over this period, as shown by the kinetics and magnitude of the anamnestic response following re-exposure to the Ebola virus glycoprotein antigen via booster vaccination with Ad26.ZEBOV in humans. In non-human primates, immunological memory was also formed as shown by an anamnestic response after high-dose, intramuscular injection with Ebola virus, but was not sufficient for protection against Ebola virus disease at later timepoints due to a decline in circulating antibodies and the fast kinetics of disease in the non-human primates model. Booster vaccination within three days of subsequent Ebola virus challenge in non-human primates resulted in protection from Ebola virus disease, i.e. before the anamnestic response was fully developed. Discussion Humans infected with Ebola virus may benefit from the anamnestic response to prevent disease progression, as the incubation time is longer and progression of Ebola virus disease is slower as compared to non-human primates. Therefore, the persistence of vaccine-induced immune memory could be considered as a potential correlate of long-term protection against Ebola virus disease in humans, without the need for a booster.
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Affiliation(s)
| | - Karin Dijkman
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jerry Sadoff
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | - Roland Zahn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, Netherlands
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Perdiguero B, Pérez P, Marcos-Villar L, Albericio G, Astorgano D, Álvarez E, Sin L, Elena Gómez C, García-Arriaza J, Esteban M. Highly attenuated poxvirus-based vaccines against emerging viral diseases. J Mol Biol 2023:168173. [PMID: 37301278 DOI: 10.1016/j.jmb.2023.168173] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
Although one member of the poxvirus family, variola virus, has caused one of the most devastating human infections worldwide, smallpox, the knowledge gained over the last 30 years on the molecular, virological and immunological mechanisms of these viruses has allowed the use of members of this family as vectors for the generation of recombinant vaccines against numerous pathogens. In this review, we cover different aspects of the history and biology of poxviruses with emphasis on their application as vaccines, from first- to fourth-generation, against smallpox, monkeypox, emerging viral diseases highlighted by the World Health Organization (COVID-19, Crimean-Congo haemorrhagic fever, Ebola and Marburg virus diseases, Lassa fever, Middle East respiratory syndrome and severe acute respiratory syndrome, Nipah and other henipaviral diseases, Rift Valley fever and Zika), as well as against one of the most concerning prevalent virus, the Human Immunodeficiency Virus, the causative agent of AcquiredImmunodeficiency Syndrome. We discuss the implications in human health of the 2022 monkeypox epidemic affecting many countries, and the rapid prophylactic and therapeutic measures adopted to control virus dissemination within the human population. We also describe the preclinical and clinical evaluation of the Modified Vaccinia virus Ankara and New York vaccinia virus poxviral strains expressing heterologous antigens from the viral diseases listed above. Finally, we report different approaches to improve the immunogenicity and efficacy of poxvirus-based vaccine candidates, such as deletion of immunomodulatory genes, insertion of host-range genes and enhanced transcription of foreign genes through modified viral promoters. Some future prospects are also highlighted.
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Affiliation(s)
- Beatriz Perdiguero
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Patricia Pérez
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Laura Marcos-Villar
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Guillermo Albericio
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - David Astorgano
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Enrique Álvarez
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Laura Sin
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carmen Elena Gómez
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan García-Arriaza
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mariano Esteban
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain.
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Wang S, Liang B, Wang W, Li L, Feng N, Zhao Y, Wang T, Yan F, Yang S, Xia X. Viral vectored vaccines: design, development, preventive and therapeutic applications in human diseases. Signal Transduct Target Ther 2023; 8:149. [PMID: 37029123 PMCID: PMC10081433 DOI: 10.1038/s41392-023-01408-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 04/09/2023] Open
Abstract
Human diseases, particularly infectious diseases and cancers, pose unprecedented challenges to public health security and the global economy. The development and distribution of novel prophylactic and therapeutic vaccines are the prioritized countermeasures of human disease. Among all vaccine platforms, viral vector vaccines offer distinguished advantages and represent prominent choices for pathogens that have hampered control efforts based on conventional vaccine approaches. Currently, viral vector vaccines remain one of the best strategies for induction of robust humoral and cellular immunity against human diseases. Numerous viruses of different families and origins, including vesicular stomatitis virus, rabies virus, parainfluenza virus, measles virus, Newcastle disease virus, influenza virus, adenovirus and poxvirus, are deemed to be prominent viral vectors that differ in structural characteristics, design strategy, antigen presentation capability, immunogenicity and protective efficacy. This review summarized the overall profile of the design strategies, progress in advance and steps taken to address barriers to the deployment of these viral vector vaccines, simultaneously highlighting their potential for mucosal delivery, therapeutic application in cancer as well as other key aspects concerning the rational application of these viral vector vaccines. Appropriate and accurate technological advances in viral vector vaccines would consolidate their position as a leading approach to accelerate breakthroughs in novel vaccines and facilitate a rapid response to public health emergencies.
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Affiliation(s)
- Shen Wang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Bo Liang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Weiqi Wang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Ling Li
- China National Research Center for Exotic Animal Diseases, China Animal Health and Epidemiology Center, Qingdao, China
| | - Na Feng
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Yongkun Zhao
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Tiecheng Wang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Feihu Yan
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.
| | - Songtao Yang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.
| | - Xianzhu Xia
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.
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Manno D, Bangura A, Baiden F, Kamara AB, Ayieko P, Kallon J, Foster J, Conteh M, Connor NE, Koroma B, Njie Y, Borboh P, Keshinro B, Lawal BJ, Kroma MT, Otieno GT, Deen AT, Choi EML, Balami AD, Gaddah A, McLean C, Luhn K, Adetola HH, Deen GF, Samai M, Lowe B, Robinson C, Leigh B, Greenwood B, Watson-Jones D. Safety and immunogenicity of an Ad26.ZEBOV booster dose in children previously vaccinated with the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen: an open-label, non-randomised, phase 2 trial. THE LANCET. INFECTIOUS DISEASES 2023; 23:352-360. [PMID: 36273490 DOI: 10.1016/s1473-3099(22)00594-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/19/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children account for a substantial proportion of cases and deaths during Ebola virus disease outbreaks. We aimed to evaluate the safety and immunogenicity of a booster dose of the Ad26.ZEBOV vaccine in children who had been vaccinated with a two-dose regimen comprising Ad26.ZEBOV as dose one and MVA-BN-Filo as dose two. METHODS We conducted an open-label, non-randomised, phase 2 trial at one clinic in Kambia Town, Sierra Leone. Healthy children, excluding pregnant or breastfeeding girls, who had received the Ad26.ZEBOV and MVA-BN-Filo vaccine regimen in a previous study, and were aged 1-11 years at the time of their first vaccine dose, received an intramuscular injection of Ad26.ZEBOV (5 × 1010 viral particles) and were followed up for 28 days. Primary outcomes were safety (measured by adverse events) and immunogenicity (measured by Ebola virus glycoprotein-specific IgG binding antibody geometric mean concentration) of the booster vaccine dose. Safety was assessed in all participants who received the booster vaccination; immunogenicity was assessed in all participants who received the booster vaccination, had at least one evaluable sample after the booster, and had no major protocol deviations that could have influenced the immune response. This trial is registered with ClinicalTrials.gov, NCT04711356. FINDINGS Between July 8 and Aug 18, 2021, 58 children were assessed for eligibility and 50 (27 aged 4-7 years and 23 aged 9-15 years) were enrolled and received an Ad26.ZEBOV booster vaccination, more than 3 years after receiving dose one of the Ad26.ZEBOV and MVA-BN-Filo vaccine regimen. The booster was well tolerated. The most common solicited local adverse event during the 7 days after vaccination was injection site pain, reported in 18 (36%, 95% CI 23-51) of 50 participants. The most common solicited systemic adverse event during the 7 days after vaccination was headache, reported in 11 (22%, 12-36) of 50 participants. Malaria was the most common unsolicited adverse event during the 28 days after vaccination, reported in 25 (50%, 36-64) of 50 participants. No serious adverse events were observed during the study period. 7 days after vaccination, the Ebola virus glycoprotein-specific IgG binding antibody geometric mean concentration was 28 561 ELISA units per mL (95% CI 20 255-40 272), which was 44 times higher than the geometric mean concentration before the booster dose. 21 days after vaccination, the geometric mean concentration reached 64 690 ELISA units per mL (95% CI 48 356-86 541), which was 101 times higher than the geometric mean concentration before the booster dose. INTERPRETATION A booster dose of Ad26.ZEBOV in children who had received the two-dose Ad26.ZEBOV and MVA-BN-Filo vaccine regimen more than 3 years earlier was well tolerated and induced a rapid and robust increase in binding antibodies against Ebola virus. These findings could inform Ebola vaccination strategies in paediatric populations. FUNDING Innovative Medicines Initiative 2 Joint Undertaking. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Daniela Manno
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Agnes Bangura
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Frank Baiden
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Abu Bakarr Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Philip Ayieko
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Joseph Kallon
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Julie Foster
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Musa Conteh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Nicholas Edward Connor
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Bockarie Koroma
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Yusupha Njie
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Paul Borboh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | | | - Bolarinde Joseph Lawal
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Mattu Tehtor Kroma
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Godfrey Tuda Otieno
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Abdul Tejan Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Edward Man-Lik Choi
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ahmed Dahiru Balami
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | | | | | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Hammed Hassan Adetola
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia Town, Kambia District, Sierra Leone
| | - Gibrilla Fadlu Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Brett Lowe
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Brian Greenwood
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Deborah Watson-Jones
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Nyombayire J, Ingabire R, Magod B, Mazzei A, Mazarati JB, Noben J, Katwere M, Parker R, Nsanzimana S, Wall KM, Sayinzoga F, Tichacek A, Robinson C, Hammoud N, Priddy F, Allen S, Karita E. Monitoring of Adverse Events in Recipients of the 2-Dose Ebola Vaccine Regimen of Ad26.ZEBOV Followed by MVA-BN-Filo in the UMURINZI Ebola Vaccination Campaign. J Infect Dis 2023; 227:268-277. [PMID: 35776140 PMCID: PMC9833427 DOI: 10.1093/infdis/jiac283] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND From 2019 to 2021, Rwandan residents of the border with the Democratic Republic of the Congo were offered the Ad26.ZEBOV (adenovirus type 26 vector vaccine encoding Ebola virus glycoprotein) and MVA-BN-Filo (modified vaccinia virus Ankara vector vaccine, encoding glycoproteins from Ebola, Sudan, Marburg, and nucleoprotein from Tai Forest viruses) Ebola vaccine regimen. METHODS Nonpregnant persons aged ≥2 years were eligible. Unsolicited adverse events (UAEs) were reported through phone calls or visits, and serious adverse events (SAEs) were recorded per International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use guidelines. RESULTS Following Ad26.ZEBOV, UAEs were reported by 0.68% of 216 113 vaccinees and were more common in younger children (aged 2-8 years, 1.2%) compared with older children (aged 9-17 years, 0.4%) and adults (aged ≥18 years, 0.7%). Fever and headache were the most reported symptoms. All 17 SAEs related to vaccine were in children aged 2-8 years (10 postvaccination febrile convulsions ± gastroenteritis and 7 fever and/or gastroenteritis). The incidence of febrile seizures was 8 of 26 062 (0.031%) prior to initiation of routine acetaminophen in December 2020 and 2 of 15 897 (0.013%) thereafter. Nonobstetric SAEs were similar in males and females. All 20 deaths were unrelated to vaccination. Young girls and adult women with UAEs were less likely to receive the second dose than those without UAEs. Seven unrelated SAEs occurred in 203 267 MVA-BN-Filo recipients. CONCLUSIONS Postvaccination febrile convulsions in young children were rare but not previously described after Ad26.ZEBOV and were reduced with routine acetaminophen. The regimen was otherwise safe and well-tolerated.
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Affiliation(s)
| | | | - Ben Magod
- Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Amelia Mazzei
- Center for Family Health Research, Kigali, Rwanda
- Department of Pathology, School of Medicine, Emory University,Atlanta, Georgia, USA
| | | | - Jozef Noben
- Janssen Global Public Health R&D, Beerse, Belgium
| | | | - Rachel Parker
- Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | | | - Kristin M Wall
- Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Amanda Tichacek
- Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | | | - Niina Hammoud
- Janssen Vaccines and Prevention, Leiden, The Netherlands
| | | | - Susan Allen
- Rwanda Zambia Health Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Etienne Karita
- Department of Pathology, School of Medicine, Emory University,Atlanta, Georgia, USA
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16
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Houser KV, Happe M, Bean R, Coates EE. Vaccines. Clin Immunol 2023. [DOI: 10.1016/b978-0-7020-8165-1.00087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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17
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Kieh M, Richert L, Beavogui AH, Grund B, Leigh B, D'Ortenzio E, Doumbia S, Lhomme E, Sow S, Vatrinet R, Roy C, Kennedy SB, Faye S, Lees S, Millimouno NP, Camara AM, Samai M, Deen GF, Doumbia M, Espérou H, Pierson J, Watson-Jones D, Diallo A, Wentworth D, McLean C, Simon J, Wiedemann A, Dighero-Kemp B, Hensley L, Lane HC, Levy Y, Piot P, Greenwood B, Chêne G, Neaton J, Yazdanpanah Y. Randomized Trial of Vaccines for Zaire Ebola Virus Disease. N Engl J Med 2022; 387:2411-2424. [PMID: 36516078 DOI: 10.1056/nejmoa2200072] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Questions remain concerning the rapidity of immune responses and the durability and safety of vaccines used to prevent Zaire Ebola virus disease. METHODS We conducted two randomized, placebo-controlled trials - one involving adults and one involving children - to evaluate the safety and immune responses of three vaccine regimens against Zaire Ebola virus disease: Ad26.ZEBOV followed by MVA-BN-Filo 56 days later (the Ad26-MVA group), rVSVΔG-ZEBOV-GP followed by placebo 56 days later (the rVSV group), and rVSVΔG-ZEBOV-GP followed by rVSVΔG-ZEBOV-GP 56 days later (the rVSV-booster group). The primary end point was antibody response at 12 months, defined as having both a 12-month antibody concentration of at least 200 enzyme-linked immunosorbent assay units (EU) per milliliter and an increase from baseline in the antibody concentration by at least a factor of 4. RESULTS A total of 1400 adults and 1401 children underwent randomization. Among both adults and children, the incidence of injection-site reactions and symptoms (e.g., feverishness and headache) was higher in the week after receipt of the primary and second or booster vaccinations than after receipt of placebo but not at later time points. These events were largely low-grade. At month 12, a total of 41% of adults (titer, 401 EU per milliliter) and 78% of children (titer, 828 EU per milliliter) had a response in the Ad26-MVA group; 76% (titer, 992 EU per milliliter) and 87% (titer, 1415 EU per milliliter), respectively, had a response in the rVSV group; 81% (titer, 1037 EU per milliliter) and 93% (titer, 1745 EU per milliliter), respectively, had a response in the rVSV-booster group; and 3% (titer, 93 EU per milliliter) and 4% (titer, 67 EU per milliliter), respectively, had a response in the placebo group (P<0.001 for all comparisons of vaccine with placebo). In both adults and children, antibody responses with vaccine differed from those with placebo beginning on day 14. CONCLUSIONS No safety concerns were identified in this trial. With all three vaccine regimens, immune responses were seen from day 14 through month 12. (Funded by the National Institutes of Health and others; PREVAC ClinicalTrials.gov number, NCT02876328; EudraCT numbers, 2017-001798-18 and 2017-001798-18/3rd; and Pan African Clinical Trials Registry number, PACTR201712002760250.).
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Affiliation(s)
- Mark Kieh
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Laura Richert
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Abdoul H Beavogui
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Birgit Grund
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Bailah Leigh
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Eric D'Ortenzio
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Seydou Doumbia
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Edouard Lhomme
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Samba Sow
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Renaud Vatrinet
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Céline Roy
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Stephen B Kennedy
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Sylvain Faye
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Shelley Lees
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Niouma P Millimouno
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Alseny M Camara
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Mohamed Samai
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Gibrilla F Deen
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Moussa Doumbia
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Hélène Espérou
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Jerome Pierson
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Deborah Watson-Jones
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Alpha Diallo
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Deborah Wentworth
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Chelsea McLean
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Jakub Simon
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Aurélie Wiedemann
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Bonnie Dighero-Kemp
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Lisa Hensley
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - H Clifford Lane
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Yves Levy
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Peter Piot
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Brian Greenwood
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Geneviève Chêne
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - James Neaton
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
| | - Yazdan Yazdanpanah
- From the Partnership for Research on Ebola Virus in Liberia, Monrovia (M.K., S.B.K.); Unité 1219, Bordeaux Population Health, Inria, Statistics in System Biology and Translational Medicine (L.R., E.L.), Euclid-French Clinical Research Infrastructure Network Clinical Trials Platform (L.R., E.L., C.R., G.C.), University of Bordeaux, INSERM, Institut Bergonié, Centre Hospitalier Universitaire de Bordeaux, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux (L.R., E.L., C.R., G.C.), INSERM (E.D., R.V., H.E., A.D., A.W., Y.L., Y.Y.), ANRS Emerging Infectious Diseases (France Recherche Nord&Sud Sida-HIV Hépatites) (E.D., A.D., Y.Y.), and Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales (E.D., Y.Y.), Paris, and the Vaccine Research Institute, Université Paris-Est Créteil, Henri Mondor Hospital, Créteil (A.W., Y.L.) - all in France; Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Maferinyah, Guinea (A.H.B.); the Schools of Public Health (D.W., J.N.) and Statistics (B. Grund), University of Minnesota, Minneapolis; the College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown (B.L., M.S., G.F.D.); University Clinical Research Center, University of Sciences, Techniques, and Technologies of Bamako (S.D.), and Centre pour le Développement des Vaccins, Ministère de la Santé (M.D.), Bamako, Mali; the Center for Vaccine Development and Global Health, University of Maryland, Baltimore (S.S.), and the National Institute of Allergy and Infectious Diseases, Bethesda (J.P., B.D.-K., L.H., H.C.L.) - both in Maryland; Département de Sociologie, Faculté des Lettres et Sciences Humaines, Université Cheikh Anta Diop (S.F.), and the Alliance for International Medical Action (N.P.M., A.M.C.) - both in Dakar, Senegal; London School of Hygiene and Tropical Medicine, London (S.L., D.W.-J., P.P., B. Greenwood); Janssen Vaccines and Prevention, Leiden, the Netherlands (C.M.); and Merck Sharp and Dohme, Kenilworth, NJ (J.S.)
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Non-human primate to human immunobridging demonstrates a protective effect of Ad26.ZEBOV, MVA-BN-Filo vaccine against Ebola. NPJ Vaccines 2022; 7:156. [PMID: 36450746 PMCID: PMC9712521 DOI: 10.1038/s41541-022-00564-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
Without clinical efficacy data, vaccine protective effect may be extrapolated from animals to humans using an immunologic marker that correlates with protection in animals. This immunobridging approach was used for the two-dose Ebola vaccine regimen Ad26.ZEBOV, MVA-BN-Filo. Ebola virus (EBOV) glycoprotein binding antibody data obtained from 764 vaccinated healthy adults in five clinical studies (NCT02416453, NCT02564523, NCT02509494, NCT02543567, NCT02543268) were used to calculate mean predicted survival probability (with preplanned 95% confidence interval [CI]). We used a logistic regression model based on EBOV glycoprotein binding antibody responses in vaccinated non-human primates (NHPs) and NHP survival after EBOV challenge. While the protective effect of the vaccine regimen in humans can be inferred in this fashion, the extrapolated survival probability cannot be directly translated into vaccine efficacy. The primary immunobridging analysis evaluated the lower limit of the CI against predefined success criterion of 20% and passed with mean predicted survival probability of 53.4% (95% CI: 36.7-67.4).
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Bockstal V, Shukarev G, McLean C, Goldstein N, Bart S, Gaddah A, Anumenden D, Stoop JN, Marit de Groot A, Pau MG, Hendriks J, De Rosa SC, Cohen KW, McElrath MJ, Callendret B, Luhn K, Douoguih M, Robinson C. First-in-human study to evaluate safety, tolerability, and immunogenicity of heterologous regimens using the multivalent filovirus vaccines Ad26.Filo and MVA-BN-Filo administered in different sequences and schedules: A randomized, controlled study. PLoS One 2022; 17:e0274906. [PMID: 36197845 PMCID: PMC9534391 DOI: 10.1371/journal.pone.0274906] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/22/2022] [Indexed: 11/05/2022] Open
Abstract
Background Though clinically similar, Ebola virus disease and Marburg virus disease are caused by different viruses. Of the 30 documented outbreaks of these diseases in sub-Saharan Africa, eight were major outbreaks (≥200 cases; five caused by Zaire ebolavirus [EBOV], two by Sudan ebolavirus [SUDV], and one by Marburg virus [MARV]). Our purpose is to develop a multivalent vaccine regimen protecting against each of these filoviruses. This first-in-human study assessed the safety and immunogenicity of several multivalent two-dose vaccine regimens that contain Ad26.Filo and MVA-BN-Filo. Methods Ad26.Filo combines three vaccines encoding the glycoprotein (GP) of EBOV, SUDV, and MARV. MVA-BN-Filo is a multivalent vector encoding EBOV, SUDV, and MARV GPs, and Taï Forest nucleoprotein. This Phase 1, randomized, double-blind, placebo-controlled study enrolled healthy adults (18–50 years) into four groups, randomized 5:1 (active:placebo), to assess different Ad26.Filo and MVA-BN-Filo vaccine directionality and administration intervals. The primary endpoint was safety; immune responses against EBOV, SUDV, and MARV GPs were also assessed. Results Seventy-two participants were randomized, and 60 (83.3%) completed the study. All regimens were well tolerated with no deaths or vaccine-related serious adverse events (AEs). The most frequently reported solicited local AE was injection site pain/tenderness. Solicited systemic AEs most frequently reported were headache, fatigue, chills, and myalgia; most solicited AEs were Grade 1–2. Solicited/unsolicited AE profiles were similar between regimens. Twenty-one days post-dose 2, 100% of participants on active regimen responded to vaccination and exhibited binding antibodies against EBOV, SUDV, and MARV GPs; neutralizing antibody responses were robust against EBOV (85.7–100%), but lower against SUDV (35.7–100%) and MARV (0–57.1%) GPs. An Ad26.Filo booster induced a rapid further increase in humoral responses. Conclusion This study demonstrates that heterologous two-dose vaccine regimens with Ad26.Filo and MVA-BN-Filo are well tolerated and immunogenic in healthy adults. ClinicalTrials.gov NCT02860650.
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Affiliation(s)
- Viki Bockstal
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Georgi Shukarev
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Chelsea McLean
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
- * E-mail:
| | - Neil Goldstein
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Stephan Bart
- Optimal Research, LLC, Rockville, Maryland, United States of America
| | - Auguste Gaddah
- Janssen Infectious Diseases and Vaccines, Beerse, Belgium
| | | | - Jeroen N. Stoop
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | | | - Maria G. Pau
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Jenny Hendriks
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Stephen C. De Rosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kristen W. Cohen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - M. Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | | | - Kerstin Luhn
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Macaya Douoguih
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
| | - Cynthia Robinson
- Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
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20
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Orlova OV, Glazkova DV, Bogoslovskaya EV, Shipulin GA, Yudin SM. Development of Modified Vaccinia Virus Ankara-Based Vaccines: Advantages and Applications. Vaccines (Basel) 2022; 10:vaccines10091516. [PMID: 36146594 PMCID: PMC9503770 DOI: 10.3390/vaccines10091516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Modified vaccinia virus Ankara (MVA) is a promising viral vector for vaccine development. MVA is well studied and has been widely used for vaccination against smallpox in Germany. This review describes the history of the origin of the virus and its properties as a vaccine, including a high safety profile. In recent years, MVA has found its place as a vector for the creation of vaccines against various diseases. To date, a large number of vaccine candidates based on the MVA vector have already been developed, many of which have been tested in preclinical and clinical studies. We discuss data on the immunogenicity and efficacy of some of these vaccines.
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21
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Pantaleo G, Correia B, Fenwick C, Joo VS, Perez L. Antibodies to combat viral infections: development strategies and progress. Nat Rev Drug Discov 2022; 21:676-696. [PMID: 35725925 PMCID: PMC9207876 DOI: 10.1038/s41573-022-00495-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 12/11/2022]
Abstract
Monoclonal antibodies (mAbs) are appealing as potential therapeutics and prophylactics for viral infections owing to characteristics such as their high specificity and their ability to enhance immune responses. Furthermore, antibody engineering can be used to strengthen effector function and prolong mAb half-life, and advances in structural biology have enabled the selection and optimization of potent neutralizing mAbs through identification of vulnerable regions in viral proteins, which can also be relevant for vaccine design. The COVID-19 pandemic has stimulated extensive efforts to develop neutralizing mAbs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with several mAbs now having received authorization for emergency use, providing not just an important component of strategies to combat COVID-19 but also a boost to efforts to harness mAbs in therapeutic and preventive settings for other infectious diseases. Here, we describe advances in antibody discovery and engineering that have led to the development of mAbs for use against infections caused by viruses including SARS-CoV-2, respiratory syncytial virus (RSV), Ebola virus (EBOV), human cytomegalovirus (HCMV) and influenza. We also discuss the rationale for moving from empirical to structure-guided strategies in vaccine development, based on identifying optimal candidate antigens and vulnerable regions within them that can be targeted by antibodies to result in a strong protective immune response.
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Affiliation(s)
- Giuseppe Pantaleo
- University of Lausanne (UNIL), Lausanne University Hospital (CHUV), Service of Immunology and Allergy, and Center for Human Immunology Lausanne (CHIL), Lausanne, Switzerland
| | - Bruno Correia
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Craig Fenwick
- University of Lausanne (UNIL), Lausanne University Hospital (CHUV), Service of Immunology and Allergy, and Center for Human Immunology Lausanne (CHIL), Lausanne, Switzerland
| | - Victor S Joo
- University of Lausanne (UNIL), Lausanne University Hospital (CHUV), Service of Immunology and Allergy, and Center for Human Immunology Lausanne (CHIL), Lausanne, Switzerland
| | - Laurent Perez
- University of Lausanne (UNIL), Lausanne University Hospital (CHUV), Service of Immunology and Allergy, and Center for Human Immunology Lausanne (CHIL), Lausanne, Switzerland.
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22
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McCann N, O'Connor D, Lambe T, Pollard AJ. Viral vector vaccines. Curr Opin Immunol 2022; 77:102210. [PMID: 35643023 PMCID: PMC9612401 DOI: 10.1016/j.coi.2022.102210] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 01/06/2023]
Abstract
Over the past two years, the SARS-CoV-2 pandemic has highlighted the impact that emerging pathogens can have on global health. The development of new and effective vaccine technologies is vital in the fight against such threats. Viral vectors are a relatively new vaccine platform that relies on recombinant viruses to deliver selected immunogens into the host. In response to the SARS-CoV-2 pandemic, the development and subsequent rollout of adenoviral vector vaccines has shown the utility, impact, scalability and efficacy of this platform. Shown to elicit strong cellular and humoral immune responses in diverse populations, these vaccine vectors will be an important approach against infectious diseases in the future.
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Affiliation(s)
- Naina McCann
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Headington, Oxford OX3 7LE, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Daniel O'Connor
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Headington, Oxford OX3 7LE, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Teresa Lambe
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Headington, Oxford OX3 7LE, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Headington, Oxford OX3 7LE, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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23
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Taylor KL, Lanning L, Wolfraim L, Shrivastava Gales S, Sico C, Dowling WE, Ward LA, Florence WC, Nuzum E, Bryant PR. A U.S. Government-Coordinated Effort to Leverage Non-Human Primate Data to Facilitate Ebolavirus Vaccine Development. Vaccines (Basel) 2022; 10:vaccines10081201. [PMID: 36016089 PMCID: PMC9412622 DOI: 10.3390/vaccines10081201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023] Open
Abstract
A United States Government (USG) interagency group, the Filovirus Animal Non-Clinical Group (FANG), has been established to support the development of biodefense medical countermeasures (MCMs). As both vaccines and therapeutics are licensed using “non-traditional pathways”, such as the U.S. Food and Drug Administration’s (FDA) Animal Rule (AR), non-human primate (NHP) models and associated assays have been developed and standardized across BSL4 testing sites to evaluate candidate products. Vaccine candidates are evaluated using these NHP models, and through this public–private partnership, a meta-analysis of NHP control data has been conducted and submitted to the FDA as a master file. This is an example of how existing NHP control data can be leveraged in lieu of conducting separate natural history studies at multiple testing facilities to demonstrate the consistency of a standardized animal model for vaccine development. As a result, animal use can be minimized and the duplication of effort avoided, thus reducing the amount of time needed to conduct additional studies, as well as the cost of vaccine candidate development. This successful strategy may be applied to other pathogens of high consequence for vaccine development, and shows how strategic preparedness for biodefense can be leveraged in response to outbreaks and public health emergencies.
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Affiliation(s)
- Kimberly L. Taylor
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
- Correspondence:
| | - Lynda Lanning
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA;
| | - Lawrence Wolfraim
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
| | - Sonia Shrivastava Gales
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
| | - Colleen Sico
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
| | - William E. Dowling
- Coalition for Epidemic Preparedness Innovations, Washington, DC 20006, USA;
| | - Lucy A. Ward
- U.S. Department of Defense (DOD), Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND), Joint Project Manager for Chemical, Biological, Radiological and Nuclear Medical (JPM CBRN Medical), Fort Detrick, MD 21702, USA;
| | - William C. Florence
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
| | - Edwin Nuzum
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
| | - Paula R. Bryant
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; (L.W.); (S.S.G.); (C.S.); (W.C.F.); (E.N.); (P.R.B.)
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24
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Karita E, Nyombayire J, Ingabire R, Mazzei A, Sharkey T, Mukamuyango J, Allen S, Tichacek A, Parker R, Priddy F, Sayinzoga F, Nsanzimana S, Robinson C, Katwere M, Anumendem D, Leyssen M, Schaefer M, Wall KM. Safety, reactogenicity, and immunogenicity of a 2-dose Ebola vaccine regimen of Ad26.ZEBOV followed by MVA-BN-Filo in healthy adult pregnant women: study protocol for a phase 3 open-label randomized controlled trial. Trials 2022; 23:513. [PMID: 35725488 PMCID: PMC9207821 DOI: 10.1186/s13063-022-06360-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Risks to mother and fetus following Ebola virus infection are very high. Evaluation of safety and immunogenicity of non-replicating Ebola vaccine candidates is a priority for use in pregnant women. This is the protocol for a randomized, open-label, single-center phase 3 clinical trial of the safety, reactogenicity, and immunogenicity of the 2-dose Ebola vaccine regimen in healthy adult pregnant women. This 2-dose regimen has been shown to be safe, judged effective, and approved in non-pregnant populations. METHODS A total of 2000 adult (≥ 18 years of age) pregnant women will be enrolled from antenatal care facilities in Western Rwanda and randomized (1:1) to receive the 2-dose Ebola vaccine regimen (Ad26.ZEBOV, MVA-BN-Filo (group A)) or control (unvaccinated pregnant women (group B)). The primary objectives are to (1) assess adverse maternal/fetal outcomes in randomized pregnant women up to 1.5 months after delivery and (2) assess adverse neonatal/infant outcomes in neonates/infants born to randomized women up to 3.5 months after birth. The frequency and relatedness of all serious adverse events in women and newborns from randomization or birth, respectively, until study end will be reported. The reactogenicity and unsolicited adverse events of the 2-dose Ebola vaccine regimen in all vaccinated pregnant women (group A) will be reported. We will also assess the immunogenicity of the 2-dose Ebola vaccine regimen in 150 pregnant women who are anticipated to receive both vaccine doses within the course of their pregnancy (a subset of the 1000 pregnant vaccinated women from group A) compared to 150 non-pregnant women vaccinated after delivery (a subset of group B). The persistence of maternal antibodies in 75 infants born to women from the group A subset will be assessed. Exploratory analyses include assessment of acceptability of the 2-dose Ebola vaccine regimen among group A and assessment of maternal antibodies in breast milk in 50 women from group A and 10 controls (women from group B prior to vaccination). DISCUSSION This study is intended to support a label variation to relax restrictions on use in pregnant women, a vulnerable population with high medical need. TRIAL REGISTRATION Clinicaltrials.gov NCT04556526 . September 21, 2020.
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Affiliation(s)
- Etienne Karita
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Julien Nyombayire
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Rosine Ingabire
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Amelia Mazzei
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Tyronza Sharkey
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Jeannine Mukamuyango
- Rwanda Zambia Health Research Group, Center for Family Health Research/Projet San Francisco, Kigali, Rwanda
| | - Susan Allen
- Rwanda Zambia Health Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Amanda Tichacek
- Rwanda Zambia Health Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Rachel Parker
- Rwanda Zambia Health Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | | | | | | | | | | | | | | | - Malinda Schaefer
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, University of Pittsburgh Magee-Women's Hospital, Pittsburgh, PA, USA
| | - Kristin M Wall
- Rwanda Zambia Health Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA. .,Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, USA.
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25
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Wagstaffe HR, Anzala O, Kibuuka H, Anywaine Z, Sirima SB, Thiébaut R, Richert L, Levy Y, Lacabaratz C, Bockstal V, Luhn K, Douoguih M, Goodier MR. NK Cell Subset Redistribution and Antibody Dependent Activation after Ebola Vaccination in Africans. Vaccines (Basel) 2022; 10:vaccines10060884. [PMID: 35746491 PMCID: PMC9230153 DOI: 10.3390/vaccines10060884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022] Open
Abstract
Natural killer cells play an important role in the control of viral infections both by regulating acquired immune responses and as potent innate or antibody-mediated cytotoxic effector cells. NK cells have been implicated in control of Ebola virus infections and our previous studies in European trial participants have demonstrated durable activation, proliferation and antibody-dependent NK cell activation after heterologous two-dose Ebola vaccination with adenovirus type 26.ZEBOV followed by modified vaccinia Ankara-BN-Filo. Regional variation in immunity and environmental exposure to pathogens, in particular human cytomegalovirus, have profound impacts on NK cell functional capacity. We therefore assessed the NK cell phenotype and function in African trial participants with universal exposure to HCMV. We demonstrate a significant redistribution of NK cell subsets after vaccine dose two, involving the enrichment of less differentiated CD56dimCD57− and CD56dimFcεR1γ+ (canonical) cells and the increased proliferation of these subsets. Sera taken after vaccine dose two support robust antibody-dependent NK cell activation in a standard NK cell readout; these responses correlate strongly with the concentration of anti-Ebola glycoprotein specific antibodies. These sera also promote comparable IFN-γ production in autologous NK cells taken at baseline and post-vaccine dose two. However, degranulation responses of post-vaccination NK cells were reduced compared to baseline NK cells and these effects could not be directly attributed to alterations in NK cell phenotype after vaccination. These studies demonstrate consistent changes in NK cell phenotypic composition and robust antibody-dependent NK cell function and reveal novel characteristics of these responses after heterologous two dose Ebola vaccination in African individuals.
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Affiliation(s)
- Helen R. Wagstaffe
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
| | - Omu Anzala
- KAVI—Institute of Clinical Research University of Nairobi, Nairobi 19676, Kenya;
| | - Hannah Kibuuka
- Makerere University—Walter Reed Project, Kampala 16524, Uganda;
| | - Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe P.O. Box 49, Uganda;
| | - Sodiomon B. Sirima
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Unité de Recherche Clinique de Banfora, 1487 Avenue Kumda Yonré, Ouagadougou 01 BP 2208, Burkina Faso;
| | - Rodolphe Thiébaut
- Bordeaux Population Health Research Center, University Bordeaux, Inserm, UMR 1219, 33000 Bordeaux, France; (R.T.); (L.R.)
- CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000 Bordeaux, France
- Inria SISTM Team, F-33405 Talence, France
| | - Laura Richert
- Bordeaux Population Health Research Center, University Bordeaux, Inserm, UMR 1219, 33000 Bordeaux, France; (R.T.); (L.R.)
- CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000 Bordeaux, France
- Inria SISTM Team, F-33405 Talence, France
| | - Yves Levy
- Inserm U955, Vaccine Research Institute, Université Paris-Est Créteil, Hôpital Henri Mondor, 94010 Creteil, France; (Y.L.); (C.L.)
| | - Christine Lacabaratz
- Inserm U955, Vaccine Research Institute, Université Paris-Est Créteil, Hôpital Henri Mondor, 94010 Creteil, France; (Y.L.); (C.L.)
| | - Viki Bockstal
- Janssen Vaccines and Prevention, 2333 CP Leiden, The Netherlands; (V.B.); (K.L.); (M.D.)
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, 2333 CP Leiden, The Netherlands; (V.B.); (K.L.); (M.D.)
| | - Macaya Douoguih
- Janssen Vaccines and Prevention, 2333 CP Leiden, The Netherlands; (V.B.); (K.L.); (M.D.)
| | - Martin R. Goodier
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- Flow Cytometry and Immunology Platform, MRC Unit the Gambia at London School of Hygiene and Tropical Medicine, Banjul P.O. Box 273, The Gambia
- Correspondence:
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26
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Majhen D. Human adenovirus type 26 basic biology and its usage as vaccine vector. Rev Med Virol 2022; 32:e2338. [PMID: 35278248 DOI: 10.1002/rmv.2338] [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: 12/14/2021] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 11/10/2022]
Abstract
Due to their nature, adenoviruses have been recognised as promising candidates for vaccine vector development. Since they mimic natural infection, recombinant adenovirus vectors have been proven as ideal shuttles to deliver foreign transgenes aiming at inducing both humoral and cellular immune response. In addition, a potent adjuvant effect can be exerted due to the adenovirus inherent stimulation of various elements of innate and adaptive immunity. Due to its low seroprevalence in humans as well as induction of favourable immune response to inserted transgene, human adenovirus type 26 (HAdV-D26) has been recognised as a promising platform for vaccine vector development and is studied in number of completed or ongoing clinical studies. Very recently HAdV-D26 based Ebola and Covid-19 vaccines were approved for medical use. In this review, current state of the art regarding HAdV-D26 basic biology and its usage as vaccine vector will be discussed.
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Affiliation(s)
- Dragomira Majhen
- Division of Molecular Biology, Ruđer Bošković Institute, Zagreb, Croatia
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27
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Watson-Jones D, Kavunga-Membo H, Grais RF, Ahuka S, Roberts N, Edmunds WJ, Choi EM, Roberts CH, Edwards T, Camacho A, Lees S, Leyssen M, Spiessens B, Luhn K, Douoguih M, Hatchett R, Bausch DG, Muyembe JJ. Protocol for a phase 3 trial to evaluate the effectiveness and safety of a heterologous, two-dose vaccine for Ebola virus disease in the Democratic Republic of the Congo. BMJ Open 2022; 12:e055596. [PMID: 35260458 PMCID: PMC8905941 DOI: 10.1136/bmjopen-2021-055596] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Ebola virus disease (EVD) continues to be a significant public health problem in sub-Saharan Africa, especially in the Democratic Republic of the Congo (DRC). Large-scale vaccination during outbreaks may reduce virus transmission. We established a large population-based clinical trial of a heterologous, two-dose prophylactic vaccine during an outbreak in eastern DRC to determine vaccine effectiveness. METHODS AND ANALYSIS This open-label, non-randomised, population-based trial enrolled eligible adults and children aged 1 year and above. Participants were offered the two-dose candidate EVD vaccine regimen VAC52150 (Ad26.ZEBOV, Modified Vaccinia Ankara (MVA)-BN-Filo), with the doses being given 56 days apart. After vaccination, serious adverse events (SAEs) were passively recorded until 1 month post dose 2. 1000 safety subset participants were telephoned at 1 month post dose 2 to collect SAEs. 500 pregnancy subset participants were contacted to collect SAEs at D7 and D21 post dose 1 and at D7, 1 month, 3 months and 6 months post dose 2, unless delivery was before these time points. The first 100 infants born to these women were given a clinical examination 3 months post delivery. Due to COVID-19 and temporary suspension of dose 2 vaccinations, at least 50 paediatric and 50 adult participants were enrolled into an immunogenicity subset to examine immune responses following a delayed second dose. Samples collected predose 2 and at 21 days post dose 2 will be tested using the Ebola viruses glycoprotein Filovirus Animal Non-Clinical Group ELISA. For qualitative research, in-depth interviews and focus group discussions were being conducted with participants or parents/care providers of paediatric participants. ETHICS AND DISSEMINATION Approved by Comité National d'Ethique et de la Santé du Ministère de la santé de RDC, Comité d'Ethique de l'Ecole de Santé Publique de l'Université de Kinshasa, the LSHTM Ethics Committee and the MSF Ethics Review Board. Findings will be presented to stakeholders and conferences. Study data will be made available for open access. TRIAL REGISTRATION NUMBER NCT04152486.
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Affiliation(s)
- Deborah Watson-Jones
- London School of Hygiene & Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, Mwanza, Tanzania, United Republic of
| | - Hugo Kavunga-Membo
- L'Institut National de Recherche Biomédicale, Goma, Democratic Republic of the Congo
| | | | - Steve Ahuka
- L'Institut National de Recherche Biomédicale, Goma, Democratic Republic of the Congo
| | | | - W John Edmunds
- London School of Hygiene & Tropical Medicine, London, UK
| | - Edward M Choi
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Tansy Edwards
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Shelley Lees
- London School of Hygiene & Tropical Medicine, London, UK
| | - Maarten Leyssen
- Janssen Vaccines and Prevention BV, Leiden, Zuid-Holland, The Netherlands
| | - Bart Spiessens
- Janssen Vaccines and Prevention BV, Leiden, Zuid-Holland, The Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention BV, Leiden, Zuid-Holland, The Netherlands
| | - Macaya Douoguih
- Janssen Vaccines and Prevention BV, Leiden, Zuid-Holland, The Netherlands
| | | | - Daniel G Bausch
- London School of Hygiene & Tropical Medicine, London, UK
- UK Public Health Rapid Support Team, Public Health England and LSHTM, London, UK
| | - Jean-Jacques Muyembe
- L'Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
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Chang A, Yu J. Fighting Fire with Fire: Immunogenicity of Viral Vectored Vaccines against COVID-19. Viruses 2022; 14:380. [PMID: 35215973 PMCID: PMC8874888 DOI: 10.3390/v14020380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
The persistent expansion of the coronavirus disease 2019 (COVID-19) global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires the rapid development of safe and effective countermeasures to reduce transmission, morbidity, and mortality. Several highly efficacious vaccines are actively being deployed around the globe to expedite mass vaccination and control of COVID-19. Notably, viral vectored vaccines (VVVs) are among the first to be approved for global distribution and use. In this review, we examine the humoral, cellular, and innate immune responses elicited by viral vectors, and the immune correlates of protection against COVID-19 in preclinical and clinical studies. We also discuss the durability and breadth of immune response induced by VVVs and boosters. Finally, we present challenges associated with VVVs and offer solutions for overcoming certain limitations of current vaccine regimens. Collectively, this review provides the rationale for expanding the portfolio of VVVs against SARS-CoV-2.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19 Vaccines/genetics
- COVID-19 Vaccines/immunology
- Clinical Trials as Topic
- Disease Models, Animal
- Genetic Vectors/immunology
- Immunity, Cellular
- Immunity, Humoral
- Immunity, Innate
- Immunization, Secondary
- Immunogenicity, Vaccine
- SARS-CoV-2/immunology
- Spike Glycoprotein, Coronavirus/genetics
- Vaccination
- Viral Vaccines/classification
- Viral Vaccines/genetics
- Viral Vaccines/immunology
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Affiliation(s)
- Aiquan Chang
- Beth Israel Deaconess Medical Center, Center for Virology and Vaccine Research, Harvard Medical School, Boston, MA 02115, USA
| | - Jingyou Yu
- Beth Israel Deaconess Medical Center, Center for Virology and Vaccine Research, Harvard Medical School, Boston, MA 02115, USA
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Ebola vaccines for mass immunisation in affected regions. THE LANCET. INFECTIOUS DISEASES 2022; 22:8-10. [PMID: 34529960 DOI: 10.1016/s1473-3099(21)00226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/20/2022]
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30
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Anywaine Z, Barry H, Anzala O, Mutua G, Sirima SB, Eholie S, Kibuuka H, Bétard C, Richert L, Lacabaratz C, McElrath MJ, De Rosa SC, Cohen KW, Shukarev G, Katwere M, Robinson C, Gaddah A, Heerwegh D, Bockstal V, Luhn K, Leyssen M, Thiébaut R, Douoguih M. Safety and immunogenicity of 2-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccination in children and adolescents in Africa: A randomised, placebo-controlled, multicentre Phase II clinical trial. PLoS Med 2022; 19:e1003865. [PMID: 35015777 PMCID: PMC8752100 DOI: 10.1371/journal.pmed.1003865] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/09/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Reoccurring Ebola outbreaks in West and Central Africa have led to serious illness and death in thousands of adults and children. The objective of this study was to assess safety, tolerability, and immunogenicity of the heterologous 2-dose Ad26.ZEBOV, MVA-BN-Filo vaccination regimen in adolescents and children in Africa. METHODS AND FINDINGS In this multicentre, randomised, observer-blind, placebo-controlled Phase II study, 131 adolescents (12 to 17 years old) and 132 children (4 to 11 years old) were enrolled from Eastern and Western Africa and randomised 5:1 to receive study vaccines or placebo. Vaccine groups received intramuscular injections of Ad26.ZEBOV (5 × 1010 viral particles) and MVA-BN-Filo (1 × 108 infectious units) 28 or 56 days apart; placebo recipients received saline. Primary outcomes were safety and tolerability. Solicited adverse events (AEs) were recorded until 7 days after each vaccination and serious AEs (SAEs) throughout the study. Secondary and exploratory outcomes were humoral immune responses (binding and neutralising Ebola virus [EBOV] glycoprotein [GP]-specific antibodies), up to 1 year after the first dose. Enrolment began on February 26, 2016, and the date of last participant last visit was November 28, 2018. Of the 263 participants enrolled, 217 (109 adolescents, 108 children) received the 2-dose regimen, and 43 (20 adolescents, 23 children) received 2 placebo doses. Median age was 14.0 (range 11 to 17) and 7.0 (range 4 to 11) years for adolescents and children, respectively. Fifty-four percent of the adolescents and 51% of the children were male. All participants were Africans, and, although there was a slight male preponderance overall, the groups were well balanced. No vaccine-related SAEs were reported; solicited AEs were mostly mild/moderate. Twenty-one days post-MVA-BN-Filo vaccination, binding antibody responses against EBOV GP were observed in 100% of vaccinees (106 adolescents, 104 children). Geometric mean concentrations tended to be higher after the 56-day interval (adolescents 13,532 ELISA units [EU]/mL, children 17,388 EU/mL) than the 28-day interval (adolescents 6,993 EU/mL, children 8,007 EU/mL). Humoral responses persisted at least up to Day 365. A limitation of the study is that the follow-up period was limited to 365 days for the majority of the participants, and so it was not possible to determine whether immune responses persisted beyond this time period. Additionally, formal statistical comparisons were not preplanned but were only performed post hoc. CONCLUSIONS The heterologous 2-dose vaccination was well tolerated in African adolescents and children with no vaccine-related SAEs. All vaccinees displayed anti-EBOV GP antibodies after the 2-dose regimen, with higher responses in the 56-day interval groups. The frequency of pyrexia after vaccine or placebo was higher in children than in adolescents. These data supported the prophylactic indication against EBOV disease in a paediatric population, as licenced in the EU. TRIAL REGISTRATION ClinicalTrials.gov NCT02564523.
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Affiliation(s)
- Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | | | - Omu Anzala
- KAVI - Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Gaudensia Mutua
- KAVI - Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Sodiomon B. Sirima
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Unité de Recherche Clinique de Banfora, Banfora, Burkina Faso
| | - Serge Eholie
- Unit of Infectious and Tropical Diseases, BPV3, Treichville University Teaching Hospital, Abidjan, Côte d’Ivoire
| | - Hannah Kibuuka
- Makerere University - Walter Reed Project, Kampala, Uganda
| | - Christine Bétard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, Bordeaux, France
| | - Laura Richert
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - M. Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Stephen C. De Rosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kristen W. Cohen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | | | | | | | | | | | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
- * E-mail:
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Ishola D, Manno D, Afolabi MO, Keshinro B, Bockstal V, Rogers B, Owusu-Kyei K, Serry-Bangura A, Swaray I, Lowe B, Kowuor D, Baiden F, Mooney T, Smout E, Köhn B, Otieno GT, Jusu M, Foster J, Samai M, Deen GF, Larson H, Lees S, Goldstein N, Gallagher KE, Gaddah A, Heerwegh D, Callendret B, Luhn K, Robinson C, Leyssen M, Greenwood B, Douoguih M, Leigh B, Watson-Jones D. Safety and long-term immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in adults in Sierra Leone: a combined open-label, non-randomised stage 1, and a randomised, double-blind, controlled stage 2 trial. THE LANCET. INFECTIOUS DISEASES 2022; 22:97-109. [PMID: 34529963 PMCID: PMC7613326 DOI: 10.1016/s1473-3099(21)00125-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/18/2020] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Ebola epidemics in west Africa and the Democratic Republic of the Congo highlight an urgent need for safe and effective vaccines to prevent Ebola virus disease. We aimed to assess the safety and long-term immunogenicity of a two-dose heterologous vaccine regimen, comprising the adenovirus type 26 vector-based vaccine encoding the Ebola virus glycoprotein (Ad26.ZEBOV) and the modified vaccinia Ankara vector-based vaccine, encoding glycoproteins from Ebola virus, Sudan virus, and Marburg virus, and the nucleoprotein from the Tai Forest virus (MVA-BN-Filo), in Sierra Leone, a country previously affected by Ebola. METHODS The trial comprised two stages: an open-label, non-randomised stage 1, and a randomised, double-blind, controlled stage 2. The study was done at three clinics in Kambia district, Sierra Leone. In stage 1, healthy adults (aged ≥18 years) residing in or near Kambia district, received an intramuscular injection of Ad26.ZEBOV (5 × 1010 viral particles) on day 1 (first dose) followed by an intramuscular injection of MVA-BN-Filo (1 × 108 infectious units) on day 57 (second dose). An Ad26.ZEBOV booster vaccination was offered at 2 years after the first dose to stage 1 participants. The eligibility criteria for adult participants in stage 2 were consistent with stage 1 eligibility criteria. Stage 2 participants were randomly assigned (3:1), by computer-generated block randomisation (block size of eight) via an interactive web-response system, to receive either the Ebola vaccine regimen (Ad26.ZEBOV followed by MVA-BN-Filo) or an intramuscular injection of a single dose of meningococcal quadrivalent (serogroups A, C, W135, and Y) conjugate vaccine (MenACWY; first dose) followed by placebo on day 57 (second dose; control group). Study team personnel, except those with primary responsibility for study vaccine preparation, and participants were masked to study vaccine allocation. The primary outcome was the safety of the Ad26.ZEBOV and MVA-BN-Filo vaccine regimen, which was assessed in all participants who had received at least one dose of study vaccine. Safety was assessed as solicited local and systemic adverse events occurring in the first 7 days after each vaccination, unsolicited adverse events occurring in the first 28 days after each vaccination, and serious adverse events or immediate reportable events occurring up to each participant's last study visit. Secondary outcomes were to assess Ebola virus glycoprotein-specific binding antibody responses at 21 days after the second vaccine in a per-protocol set of participants (ie, those who had received both vaccinations within the protocol-defined time window, had at least one evaluable post-vaccination sample, and had no major protocol deviations that could have influenced the immune response) and to assess the safety and tolerability of the Ad26.ZEBOV booster vaccination in stage 1 participants who had received the booster dose. This study is registered at ClinicalTrials.gov, NCT02509494. FINDINGS Between Sept 30, 2015, and Oct 19, 2016, 443 participants (43 in stage 1 and 400 in stage 2) were enrolled; 341 participants assigned to receive the Ad26.ZEBOV and MVA-BN-Filo regimen and 102 participants assigned to receive the MenACWY and placebo regimen received at least one dose of study vaccine. Both regimens were well tolerated with no safety concerns. In stage 1, solicited local adverse events (mostly mild or moderate injection-site pain) were reported in 12 (28%) of 43 participants after Ad26.ZEBOV vaccination and in six (14%) participants after MVA-BN-Filo vaccination. In stage 2, solicited local adverse events were reported in 51 (17%) of 298 participants after Ad26.ZEBOV vaccination, in 58 (24%) of 246 after MVA-BN-Filo vaccination, in 17 (17%) of 102 after MenACWY vaccination, and in eight (9%) of 86 after placebo injection. In stage 1, solicited systemic adverse events were reported in 18 (42%) of 43 participants after Ad26.ZEBOV vaccination and in 17 (40%) after MVA-BN-Filo vaccination. In stage 2, solicited systemic adverse events were reported in 161 (54%) of 298 participants after Ad26.ZEBOV vaccination, in 107 (43%) of 246 after MVA-BN-Filo vaccination, in 51 (50%) of 102 after MenACWY vaccination, and in 39 (45%) of 86 after placebo injection. Solicited systemic adverse events in both stage 1 and 2 participants included mostly mild or moderate headache, myalgia, fatigue, and arthralgia. The most frequent unsolicited adverse event after the first dose was headache in stage 1 and malaria in stage 2. Malaria was the most frequent unsolicited adverse event after the second dose in both stage 1 and 2. No serious adverse event was considered related to the study vaccine, and no immediate reportable events were observed. In stage 1, the safety profile after the booster vaccination was not notably different to that observed after the first dose. Vaccine-induced humoral immune responses were observed in 41 (98%) of 42 stage 1 participants (geometric mean binding antibody concentration 4784 ELISA units [EU]/mL [95% CI 3736-6125]) and in 176 (98%) of 179 stage 2 participants (3810 EU/mL [3312-4383]) at 21 days after the second vaccination. INTERPRETATION The Ad26.ZEBOV and MVA-BN-Filo vaccine regimen was well tolerated and immunogenic, with persistent humoral immune responses. These data support the use of this vaccine regimen for Ebola virus disease prophylaxis in adults. FUNDING Innovative Medicines Initiative 2 Joint Undertaking and Janssen Vaccines & Prevention BV.
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Affiliation(s)
- David Ishola
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Daniela Manno
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Muhammed O Afolabi
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | | | - Viki Bockstal
- Janssen Vaccines and Prevention BV, Leiden, Netherlands
| | - Baimba Rogers
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Kwabena Owusu-Kyei
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Alimamy Serry-Bangura
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ibrahim Swaray
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Brett Lowe
- London School of Hygiene & Tropical Medicine, London, UK; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Dickens Kowuor
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Frank Baiden
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Thomas Mooney
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Elizabeth Smout
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Brian Köhn
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Godfrey T Otieno
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Morrison Jusu
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Julie Foster
- London School of Hygiene & Tropical Medicine, London, UK
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Gibrilla Fadlu Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Shelley Lees
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | | | - Kerstin Luhn
- Janssen Vaccines and Prevention BV, Leiden, Netherlands
| | | | | | | | | | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Deborah Watson-Jones
- London School of Hygiene & Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Assessments of different batches and dose levels of a two-dose Ad26.ZEBOV and MVA-BN-Filo vaccine regimen. NPJ Vaccines 2021; 6:157. [PMID: 34930928 PMCID: PMC8688528 DOI: 10.1038/s41541-021-00402-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022] Open
Abstract
Two phase 3 clinical studies were conducted in the USA to bridge across different Ad26.ZEBOV manufacturing processes and sites, and to evaluate the immunogenicity of different dose levels of Ad26.ZEBOV and MVA-BN-Filo. Study 1 evaluated the immunological equivalence of three batches of Ad26.ZEBOV administered as dose 1, followed by one batch of MVA-BN-Filo as dose 2. In Study 2, immunogenic non-inferiority of intermediate (Ad26.ZEBOV: 2 × 1010 viral particles [vp], MVA-BN-Filo: 5 × 107 infectious units [Inf.U]) and low (8 × 109 vp, 5 × 107 Inf.U) doses of Ad26.ZEBOV and MVA-BN-Filo were evaluated against the full clinical dose (5 × 1010 vp, 1 × 108 Inf.U). In Study 1, equivalence was demonstrated for two of three batch comparisons post-dose 1 and all three batches after the full regimen. Study 2 demonstrated a dose-dependent response; however, non-inferiority against the full clinical dose was not met. All regimens were well tolerated and immune responses were observed in all participants, regardless of manufacturing process or dose. Consistency of immunogenicity of different Ad26.ZEBOV batches was demonstrated and a dose-dependent response was observed after Ad26.ZEBOV, MVA-BN-Filo vaccination. ClinicalTrials.gov identifiers: NCT02543268; NCT02543567.
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Othman M, Baker AT, Gupalo E, Elsebaie A, Bliss CM, Rondina MT, Lillicrap D, Parker AL. To clot or not to clot? Ad is the question-Insights on mechanisms related to vaccine-induced thrombotic thrombocytopenia. J Thromb Haemost 2021; 19:2845-2856. [PMID: 34351057 PMCID: PMC8420166 DOI: 10.1111/jth.15485] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023]
Abstract
Vaccine-induced immune thrombotic thrombocytopenia (VITT) has caused global concern. VITT is characterized by thrombosis and thrombocytopenia following COVID-19 vaccinations with the AstraZeneca ChAdOx1 nCov-19 and the Janssen Ad26.COV2.S vaccines. Patients present with thrombosis, severe thrombocytopenia developing 5-24 days following first dose of vaccine, with elevated D-dimer, and PF4 antibodies, signifying platelet activation. As of June 1, 2021, more than 1.93 billion COVID-19 vaccine doses had been administered worldwide. Currently, 467 VITT cases (0.000024%) have been reported across the UK, Europe, Canada, and Australia. Guidance on diagnosis and management of VITT has been reported but the pathogenic mechanism is yet to be fully elucidated. Here, we propose and discuss potential mechanisms in relation to adenovirus induction of VITT. We provide insights and clues into areas warranting investigation into the mechanistic basis of VITT, highlighting the unanswered questions. Further research is required to help solidify a pathogenic model for this condition.
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Affiliation(s)
- Maha Othman
- Department of Biomedical and Molecular SciencesSchool of MedicineQueen's UniversityKingstonOntarioCanada
- School of Baccalaureate NursingSt. Lawrence CollegeKingstonOntarioCanada
| | - Alexander T. Baker
- Center for Individualized MedicineMayo ClinicScottsdaleArizonaUSA
- Division of Cancer and GeneticsCardiff University School of MedicineCardiffUK
| | - Elena Gupalo
- National Medical Research Center for CardiologyMoscowRussia
| | - Abdelrahman Elsebaie
- Department of Biomedical and Molecular SciencesSchool of MedicineQueen's UniversityKingstonOntarioCanada
| | - Carly M. Bliss
- Division of Cancer and GeneticsCardiff University School of MedicineCardiffUK
| | - Matthew T. Rondina
- Departments of Internal Medicine and Pathology, and the Molecular Medicine ProgramUniversity of Utah HealthSalt Lake CityUtahUSA
- Department of Internal Medicine and GRECCGeorge E. Wahlen VAMCSalt Lake CityUtahUSA
| | - David Lillicrap
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Alan L. Parker
- Division of Cancer and GeneticsCardiff University School of MedicineCardiffUK
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Sheerin D, Dold C, O'Connor D, Pollard AJ, Rollier CS. Distinct patterns of whole blood transcriptional responses are induced in mice following immunisation with adenoviral and poxviral vector vaccines encoding the same antigen. BMC Genomics 2021; 22:777. [PMID: 34717548 PMCID: PMC8556829 DOI: 10.1186/s12864-021-08061-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/21/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Viral vectors, including adenovirus (Ad) and modified vaccinia Ankara (MVA), have gained increasing attention as vaccine platforms in recent years due to their capacity to express antigens from a wide array of pathogens, their rapid induction of humoral and cellular protective immune responses, and their relatively low production costs. In particular, the chimpanzee Ad vector, ChAdOx1, has taken centre stage as a leading COVID-19 vaccine candidate. However, despite mounting data, both clinical and pre-clinical, demonstrating effective induction of adaptive immune responses, the innate immune signals that precede the protective responses that make these vectors attractive vaccine platforms remain poorly understood. RESULTS In this study, a mouse immunisation model was used to evaluate whole blood gene expression changes 24 h after either a single dose or heterologous prime-boost regimen of an Ad and/or MVA vaccine. We demonstrate through comparative analysis of Ad vectors encoding different antigens that a transgene product-specific gene signature can be discerned from the vector-induced transcriptional response. Expression of genes involved in TLR2 stimulation and γδ T cell and natural killer cell activation were induced after a single dose of Ad, while MVA led to greater expression of type I interferon genes. The order of prime-boost combinations was found to influence the magnitude of the gene expression changes, with MVA/Ad eliciting greater transcriptional perturbation than Ad/MVA. Contrasting the two regimens revealed significant enrichment of epigenetic regulation pathways and augmented expression of MHC class I and II molecules associated with MVA/Ad. CONCLUSION These data demonstrate that the order in which vaccines from heterologous prime-boost regimens are administered leads to distinct transcriptional responses and may shape the immune response induced by such combinations. The characterisation of early vaccine-induce responses strengthens our understanding of viral vector vaccine mechanisms of action ahead of their characterisation in human clinical trials and are a valuable resource to inform the pre-clinical design of appropriate vaccine constructs for emerging infectious diseases.
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Affiliation(s)
- Dylan Sheerin
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK.
- Infectious Diseases and Immune Defence Division, The Walter & Eliza Hall Institute of Medical Research (WEHI), Melbourne, Victoria, 3052, Australia.
| | - Christina Dold
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK
| | - Daniel O'Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK
| | - Christine S Rollier
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK
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Yoshikawa T. Third-generation smallpox vaccine strain-based recombinant vaccines for viral hemorrhagic fevers. Vaccine 2021; 39:6174-6181. [PMID: 34521550 DOI: 10.1016/j.vaccine.2021.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/27/2022]
Abstract
Vaccinia virus has been used as a smallpox vaccine. Now that smallpox has been eradicated, the vaccinia virus is expected to be used as a bioterrorism countermeasure and a recombinant vaccine vector for other infectious diseases, such as viral hemorrhagic fevers. Many vaccinia virus strains were used as smallpox vaccines in the smallpox eradication campaign coordinated by the World Health Organization. These strains can be classified into generations, according to the history of improving production methods and efforts to reduce the adverse reactions. Significantly, the third-generation of smallpox vaccine strains, which include modified vaccinia Ankara (MVA) and LC16m8, are currently popular as recombinant vaccine vectors due to their well-balanced safety and immunogenicity profiles. The present review firstly focuses on the characteristics of the smallpox vaccine generations. The historical background of the development of the third-generation smallpox vaccine strains is detailed, along with the history of the transition of the vaccinia virus generation used as vectors for hemorrhagic fever vaccines to the third generation. Among the vaccinia viruses, MVA is currently the most commonly used vector for developing hemorrhagic fever vaccines, including dengue fever, yellow fever, Ebola viral disease, Lassa fever, Rift Valley fever, and Crimean-Congo hemorrhagic fever. LC16m8 is a vaccine candidate for severe fever with thrombocytopenia syndrome. The current status and recent advances in the development of these hemorrhagic fever vaccines using third-generation vaccinia strains are discussed.
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Affiliation(s)
- Tomoki Yoshikawa
- Department of Virology 1, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama-shi, Tokyo 208-0011, Japan.
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Barry H, Mutua G, Kibuuka H, Anywaine Z, Sirima SB, Meda N, Anzala O, Eholie S, Bétard C, Richert L, Lacabaratz C, McElrath MJ, De Rosa S, Cohen KW, Shukarev G, Robinson C, Gaddah A, Heerwegh D, Bockstal V, Luhn K, Leyssen M, Douoguih M, Thiébaut R. Safety and immunogenicity of 2-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccination in healthy and HIV-infected adults: A randomised, placebo-controlled Phase II clinical trial in Africa. PLoS Med 2021; 18:e1003813. [PMID: 34714820 PMCID: PMC8555783 DOI: 10.1371/journal.pmed.1003813] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/13/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We investigated safety, tolerability, and immunogenicity of the heterologous 2-dose Ebola vaccination regimen in healthy and HIV-infected adults with different intervals between Ebola vaccinations. METHODS AND FINDINGS In this randomised, observer-blind, placebo-controlled Phase II trial, 668 healthy 18- to 70-year-olds and 142 HIV-infected 18- to 50-year-olds were enrolled from 1 site in Kenya and 2 sites each in Burkina Faso, Cote d'Ivoire, and Uganda. Participants received intramuscular Ad26.ZEBOV followed by MVA-BN-Filo at 28-, 56-, or 84-day intervals, or saline. Females represented 31.4% of the healthy adult cohort in contrast to 69.7% of the HIV-infected cohort. A subset of healthy adults received booster vaccination with Ad26.ZEBOV or saline at Day 365. Following vaccinations, adverse events (AEs) were collected until 42 days post last vaccination and serious AEs (SAEs) were recorded from signing of the ICF until the end of the study. The primary endpoint was safety, and the secondary endpoint was immunogenicity. Anti-Ebola virus glycoprotein (EBOV GP) binding and neutralising antibodies were measured at baseline and at predefined time points throughout the study. The first participant was enrolled on 9 November 2015, and the date of last participant's last visit was 12 February 2019. No vaccine-related SAEs and mainly mild-to-moderate AEs were observed among the participants. The most frequent solicited AEs were injection-site pain (local), and fatigue, headache, and myalgia (systemic), respectively. Twenty-one days post-MVA-BN-Filo vaccination, geometric mean concentrations (GMCs) with 95% confidence intervals (CIs) of EBOV GP binding antibodies in healthy adults in 28-, 56-, and 84-day interval groups were 3,085 EU/mL (2,648 to 3,594), 7,518 EU/mL (6,468 to 8,740), and 7,300 EU/mL (5,116 to 10,417), respectively. In HIV-infected adults in 28- and 56-day interval groups, GMCs were 4,207 EU/mL (3,233 to 5,474) and 5,283 EU/mL (4,094 to 6,817), respectively. Antibody responses were observed until Day 365. Ad26.ZEBOV booster vaccination after 1 year induced an anamnestic response. Study limitations include that some healthy adult participants either did not receive dose 2 or received dose 2 outside of their protocol-defined interval and that the follow-up period was limited to 365 days for most participants. CONCLUSIONS Ad26.ZEBOV, MVA-BN-Filo vaccination was well tolerated and immunogenic in healthy and HIV-infected African adults. Increasing the interval between vaccinations from 28 to 56 days improved the magnitude of humoral immune responses. Antibody levels persisted to at least 1 year, and Ad26.ZEBOV booster vaccination demonstrated the presence of vaccination-induced immune memory. These data supported the approval by the European Union for prophylaxis against EBOV disease in adults and children ≥1 year of age. TRIAL REGISTRATION ClinicalTrials.gov NCT02564523.
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Affiliation(s)
| | - Gaudensia Mutua
- KAVI—Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Hannah Kibuuka
- Makerere University—Walter Reed Project, Kampala, Uganda
| | - Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Sodiomon B. Sirima
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Unité de Recherche Clinique de Banfora, Ouagadougou, Burkina Faso
| | | | - Omu Anzala
- KAVI—Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Serge Eholie
- Unit of Infectious and Tropical Diseases, BPV3, Treichville University Teaching Hospital, Abidjan, Côte d’Ivoire
| | - Christine Bétard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
| | - Laura Richert
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - M. Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Stephen De Rosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kristen W. Cohen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | | | | | | | | | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | | | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
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Larivière Y, Zola T, Stoppie E, Maketa V, Matangila J, Mitashi P, De Bie J, Muhindo-Mavoko H, Van Geertruyden JP, Van Damme P. Open-label, randomised, clinical trial to evaluate the immunogenicity and safety of a prophylactic vaccination of healthcare providers by administration of a heterologous vaccine regimen against Ebola in the Democratic Republic of the Congo: the study protocol. BMJ Open 2021; 11:e046835. [PMID: 34588237 PMCID: PMC8479954 DOI: 10.1136/bmjopen-2020-046835] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/04/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This article describes the protocol of an Ebola vaccine clinical trial which investigates the safety and immunogenicity of a two-dose prophylactic Ebola vaccine regimen comprised of two Ebola vaccines (Ad26.ZEBOV and MVA-BN-Filo) administered 56 days apart, followed by a booster vaccination with Ad26.ZEBOV offered at either 1 year or 2 years (randomisation 1:1) after the first dose. This clinical trial is part of the EBOVAC3 project (an Innovative Medicines Initiative 2 Joint Undertaking), and is the first to evaluate the safety and immunogenicity of two different booster vaccination arms in a large cohort of adults. METHODS AND ANALYSIS This study is an open-label, monocentric, phase 2, randomised vaccine trial. A total of 700 healthcare providers and frontliners are planned to be recruited from the Tshuapa province in the Democratic Republic of the Congo (DRC). The primary and secondary objectives of the study assess the immunogenicity of the first (Ad26.ZEBOV), second (MVA-BN-Filo) and booster (Ad26.ZEBOV) dose. Immunogenicity is assessed through the evaluation of EBOV glycoprotein binding antibody responses after vaccination. Safety is assessed through the collection of serious adverse events from the first dose until 6 months post booster vaccination and the collection of solicited and unsolicited adverse events for 1 week after the booster dose. ETHICS AND DISSEMINATION The protocol was approved by the National Ethics Committee of the Ministry of Health of the DRC (n°121/CNES/BN/PMMF/2019). The clinical trial was registered on 4 December 2019 on ClinicalTrials.gov. Trial activities are planned to finish in October 2022. All participants are required to provide written informed consent and no study-related procedures will be performed until consent is obtained. The results of the trial will be added on ClinicalTrials.gov, published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT04186000; Pre-results.
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Affiliation(s)
- Ynke Larivière
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Trésor Zola
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Elke Stoppie
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Jessie De Bie
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
- Global Health Institute, University of Antwerp, Wilrijk, Belgium
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Pierre Van Damme
- Centre for Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
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Hargreaves A, Brady C, Mellors J, Tipton T, Carroll MW, Longet S. Filovirus Neutralising Antibodies: Mechanisms of Action and Therapeutic Application. Pathogens 2021; 10:pathogens10091201. [PMID: 34578233 PMCID: PMC8468515 DOI: 10.3390/pathogens10091201] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 12/02/2022] Open
Abstract
Filoviruses, especially Ebola virus, cause sporadic outbreaks of viral haemorrhagic fever with very high case fatality rates in Africa. The 2013–2016 Ebola epidemic in West Africa provided large survivor cohorts spurring a large number of human studies which showed that specific neutralising antibodies played a key role in protection following a natural Ebola virus infection, as part of the overall humoral response and in conjunction with the cellular adaptive response. This review will discuss the studies in survivors and animal models which described protective neutralising antibody response. Their mechanisms of action will be detailed. Furthermore, the importance of neutralising antibodies in antibody-based therapeutics and in vaccine-induced responses will be explained, as well as the strategies to avoid immune escape from neutralising antibodies. Understanding the neutralising antibody response in the context of filoviruses is crucial to furthering our understanding of virus structure and function, in addition to improving current vaccines & antibody-based therapeutics.
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Affiliation(s)
- Alexander Hargreaves
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Caolann Brady
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
| | - Jack Mellors
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
- National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JG, UK
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool L69 7ZX, UK
| | - Tom Tipton
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
| | - Miles W. Carroll
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
- National Infection Service, Public Health England, Porton Down, Salisbury SP4 0JG, UK
| | - Stephanie Longet
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; (A.H.); (C.B.); (J.M.); (T.T.); (M.W.C.)
- Correspondence: ; Tel.: +44-18-6561-7892
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Safety and immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in children in Sierra Leone: a randomised, double-blind, controlled trial. THE LANCET. INFECTIOUS DISEASES 2021; 22:110-122. [PMID: 34529962 PMCID: PMC7613317 DOI: 10.1016/s1473-3099(21)00128-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/18/2020] [Accepted: 02/15/2021] [Indexed: 11/24/2022]
Abstract
Background Children account for a substantial proportion of cases and deaths from Ebola virus disease. We aimed to assess the safety and immunogenicity of a two-dose heterologous vaccine regimen, comprising the adenovirus type 26 vector-based vaccine encoding the Ebola virus glycoprotein (Ad26.ZEBOV) and the modified vaccinia Ankara vectorbased vaccine, encoding glycoproteins from the Ebola virus, Sudan virus, and Marburg virus, and the nucleoprotein from the Tai Forest virus (MVA-BN-Filo), in a paediatric population in Sierra Leone. Methods This randomised, double-blind, controlled trial was done at three clinics in Kambia district, Sierra Leone. Healthy children and adolescents aged 1–17 years were enrolled in three age cohorts (12–17 years, 4–11 years, and 1–3 years) and randomly assigned (3:1), via computer-generated block randomisation (block size of eight), to receive an intramuscular injection of either Ad26.ZEBOV (5 × 1010 viral particles; first dose) followed by MVA-BN-Filo (1 × 108 infectious units; second dose) on day 57 (Ebola vaccine group), or a single dose of meningococcal quadrivalent (serogroups A, C, W135, and Y) conjugate vaccine (MenACWY; first dose) followed by placebo (second dose) on day 57 (control group). Study team personnel (except for those with primary responsibility for study vaccine preparation), participants, and their parents or guardians were masked to study vaccine allocation. The primary outcome was safety, measured as the occurrence of solicited local and systemic adverse symptoms during 7 days after each vaccination, unsolicited systemic adverse events during 28 days after each vaccination, abnormal laboratory results during the study period, and serious adverse events or immediate reportable events throughout the study period. The secondary outcome was immunogenicity (humoral immune response), measured as the concentration of Ebola virus glycoprotein-specific binding antibodies at 21 days after the second dose. The primary outcome was assessed in all participants who had received at least one dose of study vaccine and had available reactogenicity data, and immunogenicity was assessed in all participants who had received both vaccinations within the protocol-defined time window, had at least one evaluable post-vaccination sample, and had no major protocol deviations that could have influenced the immune response. This study is registered at ClinicalTrials.gov, NCT02509494. Findings From April 4, 2017, to July 5, 2018, 576 eligible children or adolescents (192 in each of the three age cohorts) were enrolled and randomly assigned. The most common solicited local adverse event during the 7 days after the first and second dose was injection-site pain in all age groups, with frequencies ranging from 0% (none of 48) of children aged 1–3 years after placebo injection to 21% (30 of 144) of children aged 4–11 years after Ad26.ZEBOV vaccination. The most frequently observed solicited systemic adverse event during the 7 days was headache in the 12–17 years and 4–11 years age cohorts after the first and second dose, and pyrexia in the 1–3 years age cohort after the first and second dose. The most frequent unsolicited adverse event after the first and second dose vaccinations was malaria in all age cohorts, irrespective of the vaccine types. Following vaccination with MenACWY, severe thrombocytopaenia was observed in one participant aged 3 years. No other clinically significant laboratory abnormalities were observed in other study participants, and no serious adverse events related to the Ebola vaccine regimen were reported. There were no treatment-related deaths. Ebola virus glycoprotein-specific binding antibody responses at 21 days after the second dose of the Ebola virus vaccine regimen were observed in 131 (98%) of 134 children aged 12–17 years (9929 ELISA units [EU]/mL [95% CI 8172–12 064]), in 119 (99%) of 120 aged 4–11 years (10 212 EU/mL [8419–12 388]), and in 118 (98%) of 121 aged 1–3 years (22 568 EU/mL [18 426–27 642]). Interpretation The Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen was well tolerated with no safety concerns in children aged 1–17 years, and induced robust humoral immune responses, suggesting suitability of this regimen for Ebola virus disease prophylaxis in children. Funding Innovative Medicines Initiative 2 Joint Undertaking and Janssen Vaccines & Prevention BV.
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Diallo A, Carlos-Bolumbu M, Cervantes-Gonzalez M, Wozniak V, Diallo MH, Diallo BD, Delamou A, Galtier F. Immunogenicity and safety of Ebola virus vaccines in healthy adults: a systematic review and network meta-analysis. Hum Vaccin Immunother 2021; 17:3771-3783. [PMID: 34270366 DOI: 10.1080/21645515.2021.1932214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Clinical development of Ebola virus vaccines (EVV) was accelerated by the West African Ebola virus epidemic which remains the deadliest in history. To compare and rank the EVV according to their immunogenicity and safety. A total of 21 randomized controlled trial, evaluating seven different vaccines with different doses, and 5,275 participants were analyzed. The rVSVΔG-ZEBOV-GP (2 × 10 7) vaccine was more immunogenic (P-score 0.80). For pain, rVSVΔG-ZEBOV-GP (≤10 5) had few events (P-score 0.90). For fatigue and headache, the DNA-EBOV (≤ 4 mg) was the best one with P-scores of 0.94 and 0.87, respectively. For myalgia, the ChAd3 (10 10) had a lower risk (P-score 0.94). For fever, the Ad5.ZEBOV (≤ 8 × 10 10) was the best one (P-score 0.80). The best vaccine to be used to stop future outbreak of Ebola is the rVSVDG-ZEBOV-GP vaccine at dose of 2 × 107 PFU.
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Affiliation(s)
- Alhassane Diallo
- CIC-EC 1425, Department of Epidemiology, Biostatistics, Clinical Research, AP-HP Hospital Bichat, University of Paris Diderot, Paris, France
| | - Miguel Carlos-Bolumbu
- Département d'Urgence-Réanimation, Centre Hospitalier Sud-Essones CHSE, Paris, France
| | - Minerva Cervantes-Gonzalez
- CIC-EC 1425, Department of Epidemiology, Biostatistics, Clinical Research, AP-HP Hospital Bichat, Paris, France
| | | | - Mamadou Hassimiou Diallo
- Centre population et développement, Institut de recherche pour le développement, Université Paris Descartes, Paris, France
| | - Boubacar Djelo Diallo
- Faculté des Sciences et Techniques de la Santé, Université Gamal Abdel Nasser de Conakry, Service de Pneumo-Phtisiologie, CHU Conakry, Hôpital National Ignace Deen de Conakry, Conakry, Guinea
| | | | - Florence Galtier
- INSERM, CIC 1411, CHU of Montpellier, Saint Eloi Hospital, Montpellier, France
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Mc Kenna P, Masyn S, Willems A, De Paepe A, Rutten R, Mazarati JB, Sayinzoga F, Karita E, Nduwamungu JN, Mazzei A, Nyombayire J, Ingabire R, Amponsah M, Egoeh SG, Ezeanochie N. Leapfrogging with technology: introduction of a monitoring platform to support a large-scale Ebola vaccination program in Rwanda. Hum Vaccin Immunother 2021; 17:3192-3202. [PMID: 34077301 PMCID: PMC8381799 DOI: 10.1080/21645515.2021.1920872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Continued outbreaks of Ebola virus disease, including recent outbreaks in the Democratic Republic of the Congo (DRC), highlight the need for effective vaccine programs to combat future outbreaks. Given the population flow between DRC and Rwanda, the Rwanda Ministry of Health initiated a preventive vaccination campaign supported by a vaccination monitoring platform (VMP). The campaign aimed to vaccinate approximately 200,000 people from Rwanda’s Rubavu and Rusizi districts with the two-dose vaccine regimen Ad26.ZEBOV, MVA-BN-Filo. The VMP encompassed: biometric identification (iris scanning), mobile messaging, and an interactive reporting dashboard. The VMP collected data used to register and identify participants at subsequent visits. Mobile message reminders supported compliance. To 13 November 2020, the campaign was half complete with Ad26.ZEBOV administered to 116,974 participants and MVA-BN-Filo to 76,464. MVA-BN-Filo should be given to participants approximately 8 weeks after the Ad26.ZEBOV with a compliance window of −14 and +28 days. Of the 83,850 participants who were eligible per this dosing window for the subsequent MVA-BN-Filo vaccine, 91.2% (76,453/83,850) received it and 82.9% (69,505/83,850) received it within the compliance window defined for this campaign. Utilization of the VMP was instrumental to the success of the campaign, using biometric technology, dashboard reporting of near real-time data analysis and mobile phone communication technology to support vaccine administration and monitoring. A comprehensive VMP is feasible in large-scale health-care campaigns, beneficial for public health surveillance, and can allow effective response to an infectious disease outbreak.
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Affiliation(s)
- Paula Mc Kenna
- Johnson & Johnson Global Public Health, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Serge Masyn
- Johnson & Johnson Global Public Health, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Annik Willems
- Johnson & Johnson Global Public Health, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Anne De Paepe
- Johnson & Johnson Global Public Health, Janssen Pharmaceutica N.V., Beerse, Belgium
| | - Romain Rutten
- Johnson & Johnson Global Public Health, Janssen Pharmaceutica N.V., Beerse, Belgium
| | | | - Felix Sayinzoga
- Maternal, Child and Community Health Division, Rwanda Biomedical Center, Kigali, Rwanda
| | - Etienne Karita
- Project San Francisco/Center for Family Health Research, Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Kigali, Rwanda
| | - Jean Nepo Nduwamungu
- Project San Francisco/Center for Family Health Research, Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Kigali, Rwanda
| | - Amelia Mazzei
- Project San Francisco/Center for Family Health Research, Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Kigali, Rwanda
| | - Julien Nyombayire
- Project San Francisco/Center for Family Health Research, Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Kigali, Rwanda
| | - Rosine Ingabire
- Project San Francisco/Center for Family Health Research, Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine, Emory University, Kigali, Rwanda
| | | | | | - Nnamdi Ezeanochie
- Johnson and Johnson Health and Wellness Solutions, Inc., New Brunswick, NJ, USA
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Custers J, Kim D, Leyssen M, Gurwith M, Tomaka F, Robertson J, Heijnen E, Condit R, Shukarev G, Heerwegh D, van Heesbeen R, Schuitemaker H, Douoguih M, Evans E, Smith ER, Chen RT. Vaccines based on replication incompetent Ad26 viral vectors: Standardized template with key considerations for a risk/benefit assessment. Vaccine 2021; 39:3081-3101. [PMID: 33676782 PMCID: PMC7532807 DOI: 10.1016/j.vaccine.2020.09.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Abstract
Replication-incompetent adenoviral vectors have been under investigation as a platform to carry a variety of transgenes, and express them as a basis for vaccine development. A replication-incompetent adenoviral vector based on human adenovirus type 26 (Ad26) has been evaluated in several clinical trials. The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety and features of recombinant viral vector vaccines. This paper reviews features of the Ad26 vectors, including tabulation of safety and risk assessment characteristics of Ad26-based vaccines. In the Ad26 vector, deletion of E1 gene rendering the vector replication incompetent is combined with additional genetic engineering for vaccine manufacturability and transgene expression optimization. These vaccines can be manufactured in mammalian cell lines at scale providing an effective, flexible system for high-yield manufacturing. Ad26 vector vaccines have favorable thermostability profiles, compatible with vaccine supply chains. Safety data are compiled in the Ad26 vaccine safety database version 4.0, with unblinded data from 23 ongoing and completed clinical studies for 3912 participants in five different Ad26-based vaccine programs. Overall, Ad26-based vaccines have been well tolerated, with no significant safety issues identified. Evaluation of Ad26-based vaccines is continuing, with >114,000 participants vaccinated as of 4th September 2020. Extensive evaluation of immunogenicity in humans shows strong, durable humoral and cellular immune responses. Clinical trials have not revealed impact of pre-existing immunity to Ad26 on vaccine immunogenicity, even in the presence of Ad26 neutralizing antibody titers or Ad26-targeting T cell responses at baseline. The first Ad26-based vaccine, against Ebola virus, received marketing authorization from EC on 1st July 2020, as part of the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen. New developments based on Ad26 vectors are underway, including a COVID-19 vaccine, which is currently in phase 3 of clinical evaluation.
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Affiliation(s)
| | - Denny Kim
- Janssen Research & Development, Titusville, NJ, USA
| | | | - Marc Gurwith
- Brighton Collaboration, A Program of the Task Force for Global Health, Decatur, GA, USA
| | - Frank Tomaka
- Janssen Research & Development, Titusville, NJ, USA
| | | | | | - Richard Condit
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL, USA
| | | | | | | | | | | | - Eric Evans
- Brighton Collaboration, A Program of the Task Force for Global Health, Decatur, GA, USA
| | - Emily R Smith
- Brighton Collaboration, A Program of the Task Force for Global Health, Decatur, GA, USA
| | - Robert T Chen
- Brighton Collaboration, A Program of the Task Force for Global Health, Decatur, GA, USA
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Volkmann A, Williamson AL, Weidenthaler H, Meyer TPH, Robertson JS, Excler JL, Condit RC, Evans E, Smith ER, Kim D, Chen RT. The Brighton Collaboration standardized template for collection of key information for risk/benefit assessment of a Modified Vaccinia Ankara (MVA) vaccine platform. Vaccine 2021; 39:3067-3080. [PMID: 33077299 PMCID: PMC7568176 DOI: 10.1016/j.vaccine.2020.08.050] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 12/25/2022]
Abstract
The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety and characteristics of live, recombinant viral vector vaccines. The Modified Vaccinia Ankara (MVA) vector system is being explored as a platform for development of multiple vaccines. This paper reviews the molecular and biological features specifically of the MVA-BN vector system, followed by a template with details on the safety and characteristics of an MVA-BN based vaccine against Zaire ebolavirus and other filovirus strains. The MVA-BN-Filo vaccine is based on a live, highly attenuated poxviral vector incapable of replicating in human cells and encodes glycoproteins of Ebola virus Zaire, Sudan virus and Marburg virus and the nucleoprotein of the Thai Forest virus. This vaccine has been approved in the European Union in July 2020 as part of a heterologous Ebola vaccination regimen. The MVA-BN vector is attenuated following over 500 serial passages in eggs, showing restricted host tropism and incompetence to replicate in human cells. MVA has six major deletions and other mutations of genes outside these deletions, which all contribute to the replication deficiency in human and other mammalian cells. Attenuation of MVA-BN was demonstrated by safe administration in immunocompromised mice and non-human primates. In multiple clinical trials with the MVA-BN backbone, more than 7800 participants have been vaccinated, demonstrating a safety profile consistent with other licensed, modern vaccines. MVA-BN has been approved as smallpox vaccine in Europe and Canada in 2013, and as smallpox and monkeypox vaccine in the US in 2019. No signal for inflammatory cardiac disorders was identified throughout the MVA-BN development program. This is in sharp contrast to the older, replicating vaccinia smallpox vaccines, which have a known risk for myocarditis and/or pericarditis in up to 1 in 200 vaccinees. MVA-BN-Filo as part of a heterologous Ebola vaccination regimen (Ad26.ZEBOV/MVA-BN-Filo) has undergone clinical testing including Phase III in West Africa and is currently in use in large scale vaccination studies in Central African countries. This paper provides a comprehensive picture of the MVA-BN vector, which has reached regulatory approvals, both as MVA-BN backbone for smallpox/monkeypox, as well as for the MVA-BN-Filo construct as part of an Ebola vaccination regimen, and therefore aims to provide solutions to prevent disease from high-consequence human pathogens.
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Affiliation(s)
| | - Anna-Lise Williamson
- Institute of Infectious Disease and Molecular Medicine at the University of Cape Town, South Africa
| | | | | | | | | | - Richard C Condit
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610, USA
| | - Eric Evans
- Brighton Collaboration, a Program of the Task Force for Global Health, Decatur, GA, USA
| | - Emily R Smith
- Brighton Collaboration, a Program of the Task Force for Global Health, Decatur, GA, USA.
| | - Denny Kim
- Janssen Pharmaceuticals, Titusville, NJ, USA
| | - Robert T Chen
- Brighton Collaboration, a Program of the Task Force for Global Health, Decatur, GA, USA
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Salisch NC, Stephenson KE, Williams K, Cox F, van der Fits L, Heerwegh D, Truyers C, Habets MN, Kanjilal DG, Larocca RA, Abbink P, Liu J, Peter L, Fierro C, De La Barrera RA, Modjarrad K, Zahn RC, Hendriks J, Cahill CP, Leyssen M, Douoguih M, van Hoof J, Schuitemaker H, Barouch DH. A Double-Blind, Randomized, Placebo-Controlled Phase 1 Study of Ad26.ZIKV.001, an Ad26-Vectored Anti-Zika Virus Vaccine. Ann Intern Med 2021; 174:585-594. [PMID: 33587687 DOI: 10.7326/m20-5306] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) may cause severe congenital disease after maternal-fetal transmission. No vaccine is currently available. OBJECTIVE To assess the safety and immunogenicity of Ad26.ZIKV.001, a prophylactic ZIKV vaccine candidate. DESIGN Phase 1 randomized, double-blind, placebo-controlled clinical study. (ClinicalTrials.gov: NCT03356561). SETTING United States. PARTICIPANTS 100 healthy adult volunteers. INTERVENTION Ad26.ZIKV.001, an adenovirus serotype 26 vector encoding ZIKV M-Env, administered in 1- or 2-dose regimens of 5 × 1010 or 1 × 1011 viral particles (vp), or placebo. MEASUREMENTS Local and systemic adverse events; neutralization titers by microneutralization assay (MN50) and T-cell responses by interferon-γ enzyme-linked immunospot and intracellular cytokine staining; and protectivity of vaccine-induced antibodies in a subset of participants through transfer in an exploratory mouse ZIKV challenge model. RESULTS All regimens were well tolerated, with no safety concerns identified. In both 2-dose regimens, ZIKV neutralizing titers peaked 14 days after the second vaccination, with geometric mean MN50 titers (GMTs) of 1065.6 (95% CI, 494.9 to 2294.5) for 5 × 1010 vp and 956.6 (595.8 to 1535.8) for 1 × 1011 vp. Titers persisted for at least 1 year at a GMT of 68.7 (CI, 26.4-178.9) for 5 × 1010 vp and 87.0 (CI, 29.3 to 258.6) for 1 × 1011 vp. A 1-dose regimen of 1 × 1011 vp Ad26.ZIKV.001 induced seroconversion in all participants 56 days after the first vaccination (GMT, 103.4 [CI, 52.7 to 202.9]), with titers persisting for at least 1 year (GMT, 90.2 [CI, 38.4 to 212.2]). Env-specific cellular responses were induced. Protection against ZIKV challenge was observed after antibody transfer from participants into mice, and MN50 titers correlated with protection in this model. LIMITATION The study was conducted in a nonendemic area, so it did not assess safety and immunogenicity in a flavivirus-exposed population. CONCLUSION The safety and immunogenicity profile makes Ad26.ZIKV.001 a promising candidate for further development if the need reemerges. PRIMARY FUNDING SOURCE Janssen Vaccines and Infectious Diseases.
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Affiliation(s)
- Nadine C Salisch
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Kathryn E Stephenson
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Kristi Williams
- Janssen Research and Development, Spring House, Pennsylvania (K.W.)
| | - Freek Cox
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Leslie van der Fits
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Dirk Heerwegh
- Janssen Research and Development, Beerse, Belgium (D.H., C.T.)
| | - Carla Truyers
- Janssen Research and Development, Beerse, Belgium (D.H., C.T.)
| | - Marrit N Habets
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Diane G Kanjilal
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Rafael A Larocca
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Peter Abbink
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Jinyan Liu
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Lauren Peter
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | | | | | - Kayvon Modjarrad
- Walter Reed Army Institute of Research, Silver Spring, Maryland (R.A.D., K.M.)
| | - Roland C Zahn
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Jenny Hendriks
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Conor P Cahill
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Maarten Leyssen
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Macaya Douoguih
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Johan van Hoof
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Hanneke Schuitemaker
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Dan H Barouch
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
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Pettini E, Pastore G, Fiorino F, Medaglini D, Ciabattini A. Short or Long Interval between Priming and Boosting: Does It Impact on the Vaccine Immunogenicity? Vaccines (Basel) 2021; 9:vaccines9030289. [PMID: 33804604 PMCID: PMC8003773 DOI: 10.3390/vaccines9030289] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 01/04/2023] Open
Abstract
Characterizing the impact of the vaccination schedule on the induction of B and T cell immune responses is critical for improving vaccine immunogenicity. Here we compare the effect of a short (4 weeks) or a long (18 weeks) interval between priming and boosting in mice, using a model vaccine formulation based on the chimeric tuberculosis vaccine antigen H56 combined with alum. While no significant difference was observed in serum antigen-specific IgG response and the induction of antigen-specific T follicular helper cells into draining lymph nodes after the two immunization schedules, a longer interval between priming and boosting elicited a higher number of germinal center-B cells and H56-specific antibody-secreting cells and modulated the effector function of reactivated CD4+ T cells. These data show that the scheduling of the booster immunization could affect the immune response elicited by vaccination modulating and improving the immunogenicity of the vaccine.
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Kitonsa J, Ggayi AB, Anywaine Z, Kisaakye E, Nsangi L, Basajja V, Nyantaro M, Watson-Jones D, Shukarev G, Ilsbroux I, Robinson C, Kaleebu P. Implementation of accelerated research: strategies for implementation as applied in a phase 1 Ad26.ZEBOV, MVA-BN-Filo two-dose Ebola vaccine clinical trial in Uganda. Glob Health Action 2021; 13:1829829. [PMID: 33073737 PMCID: PMC7594841 DOI: 10.1080/16549716.2020.1829829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The 2013–2016 Ebola epidemic in West Africa is the worst ever caused by Ebolaviruses with over 28,000 human cases and 11,325 deaths. The World Health Organisation (WHO) declared the epidemic a public health crisis that required accelerated development of novel interventions including vaccines. The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM Uganda Research Unit) was among the African research sites that implemented the VAC52150EBL1004 Ebola vaccine trial. Objective We report on the strategies utilised by the Unit and sponsor in ensuring expedited clinical trial approval and accelerated conduct. Methods Janssen Vaccines and Prevention B.V. conducted a phase 1 trial to evaluate the safety, tolerability, and immunogenicity of heterologous two-dose vaccination regimens using Ad26.ZEBOV and MVA-BN-Filo, in healthy adults in Africa. Accelerated implementation strategies are hereby presented. Results Strategies included: holding the African Vaccine Regulatory Forum (AVAREF) joint review meeting; expedited review by institutional ethics and country-specific regulatory bodies; competitive recruitment between sites; electronic data capture (EDC); frequent study monitoring schedule; involvement of a community advisory board (CAB); and utilization of a ‘phased’ study information-sharing approach in community engagement and participant recruitment. These strategies enabled the site to acquire approvals within 2 months and enrol 47 participants within a spurn of five. The same milestone is usually acquired in at least 1 year without accelerated implementation. Conclusion The use of well-thought strategies by sponsors and research sites can enable the implementation of accelerated research. We recommend the use of similar strategies in other settings.
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Affiliation(s)
- Jonathan Kitonsa
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Abu-Baker Ggayi
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Zacchaeus Anywaine
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Eva Kisaakye
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Laura Nsangi
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Vincent Basajja
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Mary Nyantaro
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | | | - Georgi Shukarev
- Janssen Vaccines and Prevention B.V., Clinical Development , Leiden, The Netherlands
| | - Ine Ilsbroux
- Janssen Research & Development, Portfolio Delivery Operations, Global Development , Beerse, Belgium
| | - Cynthia Robinson
- Janssen Vaccines and Prevention B.V., Clinical Development , Leiden, The Netherlands
| | - Pontiano Kaleebu
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
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47
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Longet S, Mellors J, Carroll MW, Tipton T. Ebolavirus: Comparison of Survivor Immunology and Animal Models in the Search for a Correlate of Protection. Front Immunol 2021; 11:599568. [PMID: 33679690 PMCID: PMC7935512 DOI: 10.3389/fimmu.2020.599568] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/29/2020] [Indexed: 01/21/2023] Open
Abstract
Ebola viruses are enveloped, single-stranded RNA viruses belonging to the Filoviridae family and can cause Ebola virus disease (EVD), a serious haemorrhagic illness with up to 90% mortality. The disease was first detected in Zaire (currently the Democratic Republic of Congo) in 1976. Since its discovery, Ebola virus has caused sporadic outbreaks in Africa and was responsible for the largest 2013-2016 EVD epidemic in West Africa, which resulted in more than 28,600 cases and over 11,300 deaths. This epidemic strengthened international scientific efforts to contain the virus and develop therapeutics and vaccines. Immunology studies in animal models and survivors, as well as clinical trials have been crucial to understand Ebola virus pathogenesis and host immune responses, which has supported vaccine development. This review discusses the major findings that have emerged from animal models, studies in survivors and vaccine clinical trials and explains how these investigations have helped in the search for a correlate of protection.
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Affiliation(s)
- Stephanie Longet
- Public Health England, National Infection Service, Salisbury, United Kingdom
| | - Jack Mellors
- Public Health England, National Infection Service, Salisbury, United Kingdom
| | - Miles W. Carroll
- Public Health England, National Infection Service, Salisbury, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Tom Tipton
- Public Health England, National Infection Service, Salisbury, United Kingdom
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48
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Wagstaffe HR, Clutterbuck EA, Bockstal V, Stoop JN, Luhn K, Douoguih M, Shukarev G, Snape MD, Pollard AJ, Riley EM, Goodier MR. Ebola virus glycoprotein stimulates IL-18-dependent natural killer cell responses. J Clin Invest 2021; 130:3936-3946. [PMID: 32315287 PMCID: PMC7324188 DOI: 10.1172/jci132438] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/16/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND NK cells are activated by innate cytokines and viral ligands to kill virus-infected cells. These functions are enhanced during secondary immune responses and after vaccination by synergy with effector T cells and virus-specific antibodies. In human Ebola virus infection, clinical outcome is strongly associated with the initial innate cytokine response, but the role of NK cells has not been thoroughly examined. METHODS The novel 2-dose heterologous Adenovirus type 26.ZEBOV (Ad26.ZEBOV) and modified vaccinia Ankara-BN-Filo (MVA-BN-Filo) vaccine regimen is safe and provides specific immunity against Ebola glycoprotein, and is currently in phase 2 and 3 studies. Here, we analyzed NK cell phenotype and function in response to Ad26.ZEBOV, MVA-BN-Filo vaccination regimen and in response to in vitro Ebola glycoprotein stimulation of PBMCs isolated before and after vaccination. RESULTS We show enhanced NK cell proliferation and activation after vaccination compared with baseline. Ebola glycoprotein–induced activation of NK cells was dependent on accessory cells and TLR-4–dependent innate cytokine secretion (predominantly from CD14+ monocytes) and enriched within less differentiated NK cell subsets. Optimal NK cell responses were dependent on IL-18 and IL-12, whereas IFN-γ secretion was restricted by high concentrations of IL-10. CONCLUSION This study demonstrates the induction of NK cell effector functions early after Ad26.ZEBOV, MVA-BN-Filo vaccination and provides a mechanism for the activation and regulation of NK cells by Ebola glycoprotein. TRIAL REGISTRATION ClinicalTrials.gov NCT02313077. FUNDING United Kingdom Medical Research Council Studentship in Vaccine Research, Innovative Medicines Initiative 2 Joint Undertaking, EBOVAC (grant 115861) and Crucell Holland (now Janssen Vaccines and Prevention B.V.), European Union’s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations (EFPIA).
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Affiliation(s)
- Helen R Wagstaffe
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth A Clutterbuck
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals and National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | | | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals and National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals and National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Martin R Goodier
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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49
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Dixit D, Masumbuko Claude K, Kjaldgaard L, Hawkes MT. Review of Ebola virus disease in children - how far have we come? Paediatr Int Child Health 2021; 41:12-27. [PMID: 32894024 DOI: 10.1080/20469047.2020.1805260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Ebola virus (EBOV) causes an extremely contagious viral haemorrhagic fever associated with high mortality. While, historically, children have represented a small number of total cases of Ebolavirus disease (EVD), in recent outbreaks up to a quarter of cases have been in children. They pose unique challenges in clinical management and infection prevention and control. In this review of paediatric EVD, the epidemiology of past EVD outbreaks with specific focus on children is discussed, the clinical manifestations and laboratory findings are described and key developments in clinical management including specific topics such as viral persistence and breastfeeding while considering unique psychosocial and anthropological considerations for paediatric care including of survivors and orphans and the stigma they face are discussed. In addition to summarising the literature, perspectives based on the authors' experience of EVD outbreaks in the Democratic Republic of the Congo (DRC) are described.Abbreviations: ARDS: acute respiratory distress syndrome; aOR: adjusted odds ratio; ALT: alanine transferase; ALIMA: Alliance for International Medical Action; AST: aspartate transaminase; BUN: blood urea nitrogen; CNS: central nervous system; CUBE: chambre d'urgence biosécurisée pour épidémie; COVID-19: coronavirus disease 2019; Ct: cycle threshold; DRC: Democratic Republic of Congo; ETC: ebola treatment centre; ETU: ebola treatment unit; EBOV: ebola virus; EVD: ebolavirus disease; FEAST: fluid expansion as supportive therapy; GP: glycoprotein; IV: intravenous; MEURI: monitored emergency use of unregistered interventions; NETEC: National Ebola Training and Education Centre; NP: nucleoprotein; ORS: oral rehydration solution; PALM: Pamoja Tulinde Maisha; PREVAIL: Partnership for Research on Ebola Virus in Liberia; PPE: personal protective equipment; PCR: polymerase chain reaction; PEP: post-exposure prophylaxis; RDTs: rapid diagnostic tests; RT: reverse transcriptase; RNA: ribonucleic acid; UNICEF: United Nations International Children's Emergency Fund; USA: United States of America; WHO: World Health Organization.
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Affiliation(s)
- Devika Dixit
- Department of Medicine and Pediatrics. Division of Infectious Diseases, University of Saskatchewan, Saskatoon, SK, Canada
| | | | | | - Michael T Hawkes
- Department of Pediatrics. Division of Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada.,Stollery Science Laboratory, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, Edmonton, Alberta, Canada
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50
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Durable natural killer cell responses after heterologous two-dose Ebola vaccination. NPJ Vaccines 2021; 6:19. [PMID: 33514756 PMCID: PMC7846750 DOI: 10.1038/s41541-021-00280-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/04/2021] [Indexed: 12/24/2022] Open
Abstract
Natural killer (NK) cells are implicated among immune effectors after vaccination against viral pathogens, including Ebola virus. The two-dose heterologous Ebola virus vaccine regimen, adenovirus type 26.ZEBOV followed by modified vaccinia Ankara-BN-Filo (EBOVAC2 consortium, EU Innovative Medicines Initiative), induces NK cell activation and anti-Ebola glycoprotein (GP) antibody-dependent NK cell activation post-dose 1, which is further elevated post-dose 2. Here, in a multicentre, phase 2 clinical trial (EBL2001), we demonstrate durable ex vivo NK cell activation 180 days after dose 2, with responses enriched in CD56bright NK cells. In vitro antibody-dependent responses to immobilised Ebola GP increased after dose 1, and remained elevated compared to pre-vaccination levels in serum collected 180 days later. Peak NK cell responses were observed post-dose 2 and NK cell IFN-γ responses remained significantly elevated at 180 days post-dose 2. Individual variation in NK cell responses were influenced by both anti-Ebola GP antibody concentrations and intrinsic interindividual differences in NK cell functional capacity. In summary, this study demonstrates durable NK cell responses after Ad26.ZEBOV, MVA-BN-Filo Ebola virus vaccination and could inform the immunological evaluation of future iterations of the vaccine regimen and vaccination schedules.
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