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Tandale BV, Khude PM, Deshmukh PS, Narang R, Qazi MS, Padmaja GV, Jain M, Jain D, Guduru VK, Deshmukh PR, Raut AV, Narlawar UW, Jha PK, Rajderkar SS. Effectiveness of Japanese encephalitis vaccination among children in central India. J Med Virol 2023; 95:e28399. [PMID: 36512338 DOI: 10.1002/jmv.28399] [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: 09/23/2022] [Revised: 11/19/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Japanese encephalitis (JE) disease among children continues in central India despite vaccination implemented in the routine immunization program. Therefore, we planned to estimate the JE vaccination effectiveness among children by undertaking a 1:2 individually-matched population-based case-control study from August 2018 to October 2020. The laboratory-confirmed JE cases aged 1-15 years were enrolled along with neighborhood controls without fever and encephalitis matched on the residence area, age and sex. The JE vaccination history was enquired from parents and verified independently from the vaccination cards available at home and records at health facilities. We enrolled 35 JE cases and 70 matched controls. The vaccination effectiveness of 86.7% (95% confidence interval [CI]: 30.8-94.7) was estimated on the per-protocol analysis of 31 case-control sets. The screening method provided an effectiveness of 89.5% (CI: 78.9-94.7) on using the population vaccination coverage of 90% reported earlier in the same area. In conclusion, JE vaccination offered a moderate level of protection among children in JE medium-endemic central India, similar to reports from high-endemic areas in India. The operational aspects of vaccination program implementation need to be evaluated to assess the impact of vaccination on the disease burden of JE in medium-endemic regions of India.
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Affiliation(s)
- Babasaheb V Tandale
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Poornima M Khude
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Pravin S Deshmukh
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Rahul Narang
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Mohiuddin S Qazi
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Goteti V Padmaja
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Manish Jain
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Dipty Jain
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Vijay Kumar Guduru
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Pradeep R Deshmukh
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Abhishek V Raut
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Uday W Narlawar
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Punam Kumari Jha
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Shekhar S Rajderkar
- Community Medicine Deaprtment, Government Medical College, Miraj, Maharashtra, India
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Kling K, Harder T, Younger Z, Burchard G, Schmidt-Chanasit J, Wichmann O. Vaccination against Japanese encephalitis with IC51: systematic review on immunogenicity, duration of protection and safety. J Travel Med 2020; 27:5732465. [PMID: 32043122 DOI: 10.1093/jtm/taaa016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/28/2020] [Indexed: 01/04/2023]
Abstract
Japanese encephalitis is a disease caused by a flavivirus which is transmitted by mosquitos in endemic countries. Considering the potentially severe outcomes of the disease, vaccination is recommended for those at risk of exposure. During recent years, IC51 (IXIARO®, JESPECT®, JEVAL®) has increasingly been used to protect travellers from Europe and the USA. However, no systematic review exists that summarizes the currently available evidence on the immunogenicity and safety of this vaccine. We conducted a systematic review on the immunogenicity and safety of IC51, using the databases PubMed, MEDLINE, EMBASE and ClinicalTrials.gov (search date: 31 August 2019). Data extracted from included studies were grouped by outcomes and stratified by population and setting. Risk of bias (ROB) was assessed using the RoB 2 tool for randomized controlled trials (RCTs) and ROBINS-I for non-randomized studies. Due to high heterogeneity, meta-analysis was not performed. A total of 32 studies from 16 countries met the inclusion criteria (15 RCTs, 17 non-randomized studies). ROB was serious or high in the majority of studies. Seroprotection rates ranged from 93 to 100% in adults (seven studies) and from 91 to 100% in children (four studies). In the study involving adults aged 64 years and older, seroprotection was 65% with higher rates in persons who were previously vaccinated against tick-borne encephalitis virus. Safety was investigated in 27 studies. Rates of serious adverse events were below 5% in all age groups, with the majority not being causally related to the vaccine. IC51 is a safe vaccine with good seroprotective abilities in persons aged >2 months to <64 years. The body of evidence, however, is weakened by a large amount of heterogeneity in study and clinical trial methodology. Further well-designed RCTs with special risk groups are needed.
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Affiliation(s)
- Kerstin Kling
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Thomas Harder
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Zane Younger
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
| | - Gerd Burchard
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg 20359, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg 20359, Germany
- Faculty of Mathematics, Informatics and Natural Sciences, Universität Hamburg, Hamburg 22609, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin 13353, Germany
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Vu TD, Nguyen QD, Tran HTA, Bosch-Castells V, Zocchetti C, Houillon G. Immunogenicity and safety of a single dose of a live attenuated Japanese encephalitis chimeric virus vaccine in Vietnam: A single-arm, single-center study. Int J Infect Dis 2017; 66:137-142. [PMID: 29081368 DOI: 10.1016/j.ijid.2017.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/05/2017] [Accepted: 10/14/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe the immunogenicity and safety of the Japanese encephalitis chimeric virus vaccine (JE-CV) in children and adults in Vietnam. METHODS In this prospective, open-label, single-center, single-arm study, 250 healthy participants aged 9 months to 60 years received a single dose of JE-CV (IMOJEV®). JE neutralizing antibody titers were assessed at baseline and 28days after vaccination using the 50% plaque reduction neutralization test (PRNT50). Safety and reactogenicity were assessed through solicited and unsolicited adverse events. FINDINGS Seroconversion (titer ≥10 [1/dil] in participants JE seronegative [titer <10] at baseline [per protocol analysis], or a 4-fold rise from a baseline titer ≥10) and seroprotection (titer ≥10 [1/dil]) rates 28days after vaccination were both 98.5% (132/134) in the per protocol analysis, and 82.4% (201/244) and 98.8% (242/245), respectively, in the full analysis set. Geometric mean titers (GMTs) increased in all age groups from Day 0 to Day 28; Day 28/Day 0 GMT ratios were 55.3 (95% confidence interval [CI] 38.4-79.8), 348 (95% CI 211-572), 296 (95% CI 152-576) and 194 (95% CI 13.1-2870) in those aged 9 months to 4 years, 5-11 years, 12-17 years and 18-60 years, respectively, in the per protocol analysis. There were no safety concerns during the study. CONCLUSION A single dose of JE-CV in children and adults aged 9 months to 60 years in Vietnam elicited a protective immune response and was well tolerated with no safety concerns. Registered at www.clinicaltrials.gov (NCT02492165).
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Affiliation(s)
- Thiem Dinh Vu
- National Institute of Hygiene and Epidemiology, 1 Yersin St., Hanoi 10000, Viet Nam.
| | - Quang Dang Nguyen
- National Institute of Hygiene and Epidemiology, 1 Yersin St., Hanoi 10000, Viet Nam
| | - Huong Thi Ai Tran
- Hoa Binh Provincial Preventive Medicine Centre, Hoa Binh Province, Viet Nam
| | | | | | - Guy Houillon
- Sanofi Pasteur, 2 Pont Pasteur, 69007 Lyon, France
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Hegde NR, Gore MM. Japanese encephalitis vaccines: Immunogenicity, protective efficacy, effectiveness, and impact on the burden of disease. Hum Vaccin Immunother 2017; 13:1-18. [PMID: 28301270 DOI: 10.1080/21645515.2017.1285472] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Japanese encephalitis (JE) is a serious public health concern in most of Asia. The disease is caused by JE virus (JEV), a flavivirus transmitted by Culex mosquitoes. Several vaccines have been developed to control JE in endemic areas as well as to protect travelers and military personnel who visit or are commissioned from non-endemic to endemic areas. The vaccines include inactivated vaccines produced in mouse brain or cell cultures, live attenuated vaccines, and a chimeric vaccine based on the live attenuated yellow fever virus 17D vaccine strain. All the marketed vaccines belong to the JEV genotype III, but have been shown to be efficacious against other genotypes and strains, with varying degrees of cross-neutralization, albeit at levels deemed to be protective. The protective responses have been shown to last three or more years, depending on the type of vaccine and the number of doses. This review presents a brief account of the different JE vaccines, their immunogenicity and protective ability, and the impact of JE vaccines in reducing the burden of disease in endemic countries.
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Affiliation(s)
- Nagendra R Hegde
- a Ella Foundation, Genome Valley , Turkapally, Shameerpet Mandal , Hyderabad , India
| | - Milind M Gore
- b National Institute of Virology, Indian Council of Medical Research , Pune , India
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de Wispelaere M, Ricklin M, Souque P, Frenkiel MP, Paulous S, Garcìa-Nicolàs O, Summerfield A, Charneau P, Desprès P. A Lentiviral Vector Expressing Japanese Encephalitis Virus-like Particles Elicits Broad Neutralizing Antibody Response in Pigs. PLoS Negl Trop Dis 2015; 9:e0004081. [PMID: 26437302 PMCID: PMC4593544 DOI: 10.1371/journal.pntd.0004081] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 08/21/2015] [Indexed: 01/08/2023] Open
Abstract
Background Japanese encephalitis virus (JEV) is the major cause of viral encephalitis in Southeast Asia. Vaccination of domestic pigs has been suggested as a “one health” strategy to reduce viral disease transmission to humans. The efficiency of two lentiviral TRIP/JEV vectors expressing the JEV envelope prM and E glycoproteins at eliciting protective humoral response was assessed in a mouse model and piglets. Methodology/Principal Findings A gene encoding the envelope proteins prM and E from a genotype 3 JEV strain was inserted into a lentiviral TRIP vector. Two lentiviral vectors TRIP/JEV were generated, each expressing the prM signal peptide followed by the prM protein and the E glycoprotein, the latter being expressed either in its native form or lacking its two C-terminal transmembrane domains. In vitro transduction of cells with the TRIP/JEV vector expressing the native prM and E resulted in the efficient secretion of virus-like particles of Japanese encephalitis virus. Immunization of BALB/c mice with TRIP/JEV vectors resulted in the production of IgGs against Japanese encephalitis virus, and the injection of a second dose one month after the prime injection greatly boosted antibody titers. The TRIP/JEV vectors elicited neutralizing antibodies against JEV strains belonging to genotypes 1, 3, and 5. Immunization of piglets with two doses of the lentiviral vector expressing JEV virus-like particles led to high titers of anti-JEV antibodies, that had efficient neutralizing activity regardless of the JEV genotype tested. Conclusions/Significance Immunization of pigs with the lentiviral vector expressing JEV virus-like particles is particularly efficient to prime antigen-specific humoral immunity and trigger neutralizing antibody responses against JEV genotypes 1, 3, and 5. The titers of neutralizing antibodies elicited by the TRIP/JEV vector are sufficient to confer protection in domestic pigs against different genotypes of JEV and this could be of a great utility in endemic regions where more than one genotype is circulating. Japanese encephalitis virus is the etiologic agent of the most medically important viral encephalitis in South Asia with thousands of deaths per year. The virus is maintained in an enzootic cycle between Culex mosquitoes and amplifying vertebrate hosts, such as wild boars and pigs. Vaccination of domestic pigs has been suggested as a strategy to reduce viral disease transmission to humans, in line with the now-called “One Health” concept. Lentiviral gene transfer vectors represent a novel vaccination platform with an unprecedented ability to induce robust humoral immunity in various animal species. In our study, we demonstrated that immunization of pigs with a recombinant lentiviral vector expressing virus-like particles of Japanese encephalitis virus is particularly efficient at eliciting specific humoral immunity. The titers of neutralizing antibodies elicited by the lentiviral vector are sufficient to confer protection in domestic pigs against the different genotypes of Japanese encephalitis virus observed in Asia.
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Affiliation(s)
| | - Meret Ricklin
- Institute of Virology and Immunology, Mittelhäusern, Switzerland
| | - Philippe Souque
- Virologie Moléculaire et Vaccinologie, Institut Pasteur, Paris, France
| | | | - Sylvie Paulous
- Interactions Moléculaires Flavivirus-Hôtes, Institut Pasteur, Paris, France
| | | | - Artur Summerfield
- Institute of Virology and Immunology, Mittelhäusern, Switzerland
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Pierre Charneau
- Virologie Moléculaire et Vaccinologie, Institut Pasteur, Paris, France
- * E-mail: (PC); (PD)
| | - Philippe Desprès
- Interactions Moléculaires Flavivirus-Hôtes, Institut Pasteur, Paris, France
- * E-mail: (PC); (PD)
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Yen NT, Liu W, Hanh HD, Chang NY, Duong TN, Gibbons RV, Marks F, Thu NA, Hong NM, Park JK, Tuan PA, Nisalak A, Clemens JD, Xu ZY. A model immunization programme to control Japanese encephalitis in Viet Nam. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2015; 33:207-213. [PMID: 25995736 PMCID: PMC4438663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In Viet Nam, an inactivated, mouse brain-derived vaccine for Japanese encephalitis (JE) has been given exclusively to ≤ 5 years old children in 3 paediatric doses since 1997. However, JE incidence remained high, especially among children aged 5-9 years. We conducted a model JE immunization programme to assess the feasibility and impact of JE vaccine administered to 1-9 year(s) children in 3 standard-dose regimen: paediatric doses for children aged <3 years and adult doses for those aged ≥ 3 years. Of the targeted children, 96.2% were immunized with ≥ 2 doses of the vaccine. Compared to the national immunization programme, JE incidence rate declined sharply in districts with the model programme (11.32 to 0.87 per 100,000 in pre-versus post-vaccination period). The rate of reduction was most significant in the 5-9 years age-group. We recommend a policy change to include 5-9 years old children in the catch-up immunization campaign and administer a 4th dose to those aged 5-9 years, who had received 3 doses of the vaccine during the first 2-3 years of life.
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Affiliation(s)
- Nguyen Thu Yen
- National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Viet Nam
| | - Wei Liu
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
| | | | - Na Yoon Chang
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Viet Nam
| | - Robert V. Gibbons
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Florian Marks
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
| | - Nghiem Anh Thu
- National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Viet Nam
| | - Nguyen Minh Hong
- National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Viet Nam
| | - Jin Kyung Park
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
| | - Pham Anh Tuan
- National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Viet Nam
| | - Ananda Nisalak
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - John D. Clemens
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
| | - Zhi-yi Xu
- International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China
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Li X, Ma SJ, Liu X, Jiang LN, Zhou JH, Xiong YQ, Ding H, Chen Q. Immunogenicity and safety of currently available Japanese encephalitis vaccines: a systematic review. Hum Vaccin Immunother 2014; 10:3579-93. [PMID: 25668666 PMCID: PMC4514081 DOI: 10.4161/21645515.2014.980197] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/26/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
A number of Japanese encephalitis (JE) vaccines have been used for preventing Japanese encephalitis around the world. We here reviewed the immunogenicity and safety of the currently available Japanese encephalitis vaccines. We searched Pubmed, Embase, Web of Science, the Cochrane Library and other online databases up to March 25, 2014 for studies focusing on currently used JE vaccines in any language. The primary outcomes were the seroconversion rate against JEV and adverse events. Meta-analysis was performed for the primary outcome when available. A total of 51 articles were included. Studies were grouped on the basic types of vaccines. This systematic review led to 2 aspects of the conclusions. On one hand, all the currently available JE vaccines are safe and effective. On the other hand, the overall of JE vaccine evaluation is disorganized, the large variation in study designs, vaccine types, schedules, doses, population and few hand-to-hand trails, make direct comparisons difficult. In order to make a more evidence-based decision on optimizing the JE vaccine, it is warranted to standardize the JE vaccine evaluation research.
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Key Words
- ACIP, The Advisory Committee on Immunization Practices
- AEs, Adverse events
- CENTRAL, Cochrane Central Register of Controlled Trials
- CIs, Confidence intervals
- DARE, Database of Abstracts of Reviews of Effects
- GMTs, Geometric mean titers
- HAART, Highly active antiretroviral therapy
- JE, Japanese encephalitis
- JE-CV, Chimeric live-attenuated JE vaccine
- JEV, Japanese encephalitis virus
- Japanese encephalitis vaccine
- LILACS, Latin American and Caribbean Health Sciences Literature
- MBJEV, Mouse brain–derived inactivated vaccines
- MMR, Measles mumps rubella vaccine
- NIP, National Immunization Program
- NOS, Newcastle–Ottawa scale
- ORs, Odd ratios
- PHK, Primary hamster kidney cells
- PRNT50, Plaque-reduction neutralization tests
- RCTs, Randomized controlled trials
- TBE, Tick-borne encephalitis vaccine
- TGPO, Thai Governmental Pharmaceutical Organization
- WHO, World Health Organization
- YF-VAX, Yellow fever vaccine
- YFV, Yellow fever virus
- YFV17D, Yellow fever virus 17D vaccine strain
- immunogenicity
- meta-analysis
- safety
- systematic review
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Affiliation(s)
- Xing Li
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Shu-Juan Ma
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Xie Liu
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Li-Na Jiang
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Jun-Hua Zhou
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Yi-Quan Xiong
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Hong Ding
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Qing Chen
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
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