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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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Alabi A, Kokou K, Mahmoudou S, Kavishna R, Nakka SS, Rothenberger S, Musangomunei FP, Olubiyi BF, Bie-Ondo JC, Kabwende AL, Velavan TP, Medaglini D, Nakaya HI, Engler O, Harandi AM, Siegrist CA, Kremsner PG, Agnandji ST. Replication, safety and immunogenicity of the vectored Ebola vaccine rVSV-ΔG-ZEBOV-GP in a sub-Saharan African paediatric population: A randomised controlled, open-label trial in children aged 1-12 years living in Lambaréné, Gabon. J Infect 2024; 89:106237. [PMID: 39121969 DOI: 10.1016/j.jinf.2024.106237] [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: 04/21/2024] [Revised: 07/17/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Unlike adults, children experienced stronger and longer vector replication in plasma and shedding in saliva following rVSVΔG-ZEBOV-GP vaccination. The resulting risks of immunosuppression or immune hyperactivation leading to increased Adverse Events (AEs) and altered antibody responses are concerns that have been addressed in the present manuscript. METHODS Children aged 1-12 years living in Gabon received either rVSVΔG-ZEBOV-GP (ERVEBO®) vaccine or the varicella-zoster virus (VZV) vaccine (VZV). The concentration of rVSVΔG vector in blood and saliva, the occurrence of AEs up to day 28; the anti-rVSVΔG-ZEBOV-GP and anti-VZV IgG antibody titres, neutralising and avidity functions of anti-rVSVΔG-ZEBOV-GP by day 365; were assessed in serum. (PACTR202005733552021) FINDINGS: In the rVSVΔG-ZEBOV-GP group, 70% and 7% of children had >0 copies/ml of rVSVΔG respectively in plasma by day 3 and in saliva by day 14 after vaccination, with no detection on day 28. Significantly higher but transient AEs occurred in the rVSVΔG-ZEBOV-GP group. Both vaccines induced seroconversion on day 28 and sustainable IgG antibody titres by day 365. Avidity and neutralisation functions of the anti-rVSVΔG-ZEBOV-GP antibodies peaked at day 28 and were maintained by day 365. INTERPRETATION The replication and shedding do not affect the favourable risk-benefit balance of the rVSVΔG-ZEBOV-GP in children.
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Affiliation(s)
- Ayodele Alabi
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon; Institute of Tropical Medicine, Travel Medicine and Human Parasitology, Competence Centre for Tropical Medicine Baden-Württemberg, Universitätsklinikum Tübingen, Tübingen, Germany; German Center for Infectious Diseases Research (DZIF), Tübingen, Germany; Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Center, Leiden, the Netherlands
| | - Kossiwa Kokou
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon
| | - Saidou Mahmoudou
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon
| | - Ranmali Kavishna
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sravya S Nakka
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sylvia Rothenberger
- Institute of Microbiology, University Hospital Center and University of Lausanne, Rue du Bugnon 48, CH-1011 Lausanne, Switzerland; Spiez Laboratory, CH-3700 Spiez, Switzerland
| | | | - Bisola F Olubiyi
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon
| | - Juste C Bie-Ondo
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon
| | - Anita L Kabwende
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, Travel Medicine and Human Parasitology, Competence Centre for Tropical Medicine Baden-Württemberg, Universitätsklinikum Tübingen, Tübingen, Germany; German Center for Infectious Diseases Research (DZIF), Tübingen, Germany; Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Vietnam; Faculty of Medicine, Duy Tan University, DaNang, Vietnam
| | - Donata Medaglini
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | | | - Ali M Harandi
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | | | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon; Institute of Tropical Medicine, Travel Medicine and Human Parasitology, Competence Centre for Tropical Medicine Baden-Württemberg, Universitätsklinikum Tübingen, Tübingen, Germany; German Center for Infectious Diseases Research (DZIF), Tübingen, Germany
| | - Selidji T Agnandji
- Centre de Recherches Médicales de Lambaréné, CERMEL, Lambaréné, Gabon; Institute of Tropical Medicine, Travel Medicine and Human Parasitology, Competence Centre for Tropical Medicine Baden-Württemberg, Universitätsklinikum Tübingen, Tübingen, Germany; German Center for Infectious Diseases Research (DZIF), Tübingen, Germany; Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
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Waltenburg MA, Kainulainen MH, Whitesell A, Nyakarahuka L, Baluku J, Kyondo J, Twongyeirwe S, Harmon J, Mulei S, Tumusiime A, Bergeron E, Haberling DL, Klena JD, Spiropoulou C, Montgomery JM, Lutwama JJ, Makumbi I, Driwale A, Muruta A, Balinandi S, Shoemaker T, Cossaboom CM. Knowledge, attitudes, and practices and long-term immune response after rVSVΔG-ZEBOV-GP Ebola vaccination in healthcare workers in high-risk districts in Uganda. Vaccine 2024; 42:126031. [PMID: 38880693 DOI: 10.1016/j.vaccine.2024.05.079] [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: 03/11/2024] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND The rVSVΔG-ZEBOV-GP Ebola vaccine (rVSV-ZEBOV) has been used in response to Ebola disease outbreaks caused by Ebola virus (EBOV). Understanding Ebola knowledge, attitudes, and practices (KAP) and the long-term immune response following rVSV-ZEBOV are critical to inform recommendations on future use. METHODS We administered surveys and collected blood samples from healthcare workers (HCWs) from seven Ugandan healthcare facilities. Questionnaires collected information on demographic characteristics and KAP related to Ebola and vaccination. IgG ELISA, virus neutralization, and interferon gamma ELISpot measured immunological responses against EBOV glycoprotein (GP). RESULTS Overall, 37 % (210/565) of HCWs reported receiving any Ebola vaccination. Knowledge that rVSV-ZEBOV only protects against EBOV was low among vaccinated (32 %; 62/192) and unvaccinated (7 %; 14/200) HCWs. Most vaccinated (91 %; 192/210) and unvaccinated (92 %; 326/355) HCWs wanted to receive a booster or initial dose of rVSV-ZEBOV, respectively. Median time from rVSV-ZEBOV vaccination to sample collection was 37.7 months (IQR: 30.5, 38.3). IgG antibodies against EBOV GP were detected in 95 % (61/64) of HCWs with vaccination cards and in 84 % (162/194) of HCWs who reported receiving a vaccination. Geometric mean titer among seropositive vaccinees was 0.066 IU/mL (95 % CI: 0.058-0.076). CONCLUSION As Uganda has experienced outbreaks of Sudan virus and Bundibugyo virus, for which rVSV-ZEBOV does not protect against, our findings underscore the importance of continued education and risk communication to HCWs on Ebola and other viral hemorrhagic fevers. IgG antibodies against EBOV GP were detected in most vaccinated HCWs in Uganda 2─4 years after vaccination; however, the duration and correlates of protection warrant further investigation.
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Affiliation(s)
- Michelle A Waltenburg
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Markus H Kainulainen
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Amy Whitesell
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Luke Nyakarahuka
- Uganda Virus Research Institute, Entebbe, Uganda; Department of Biosecurity, Ecosystems, and Veterinary Public Health, Makerere University, Kampala, Uganda
| | - Jimmy Baluku
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | | | - Jessica Harmon
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sophia Mulei
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | - Eric Bergeron
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Dana L Haberling
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - John D Klena
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christina Spiropoulou
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Joel M Montgomery
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | | | | | - Trevor Shoemaker
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Caitlin M Cossaboom
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Choi EML, Kasonia K, Kavunga-Membo H, Mukadi-Bamuleka D, Soumah A, Mossoko Z, Edwards T, Tetsa-Tata D, Makarimi R, Toure O, Mambula G, Brindle H, Camacho A, Connor NE, Mukadi P, McLean C, Keshinro B, Gaddah A, Robinson C, Luhn K, Foster J, Roberts CH, Johnson JE, Imbault N, Bausch DG, Grais RF, Watson-Jones D, Muyembe-Tamfum JJ. Immunogenicity of an Extended Dose Interval for the Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children in the Democratic Republic of the Congo. Vaccines (Basel) 2024; 12:828. [PMID: 39203955 PMCID: PMC11359010 DOI: 10.3390/vaccines12080828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/21/2024] [Accepted: 07/18/2024] [Indexed: 09/03/2024] Open
Abstract
During the 2018-2020 Ebola virus disease outbreak in Democratic Republic of the Congo, a phase 3 trial of the Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine (DRC-EB-001) commenced in Goma, with participants being offered the two-dose regimen given 56 days apart. Suspension of trial activities in 2020 due to the COVID-19 pandemic led to some participants receiving a late dose 2 outside the planned interval. Blood samples were collected from adults, adolescents, and children prior to their delayed dose 2 vaccination and 21 days after, and tested for IgG binding antibodies against Ebola virus glycoprotein using the Filovirus Animal Nonclinical Group (FANG) ELISA. Results from 133 participants showed a median two-dose interval of 9.3 months. The pre-dose 2 antibody geometric mean concentration (GMC) was 217 ELISA Units (EU)/mL (95% CI 157; 301) in adults, 378 EU/mL (281; 510) in adolescents, and 558 EU/mL (471; 661) in children. At 21 days post-dose 2, the GMC increased to 22,194 EU/mL (16,726; 29,449) in adults, 37,896 EU/mL (29,985; 47,893) in adolescents, and 34,652 EU/mL (27,906; 43,028) in children. Participants receiving a delayed dose 2 had a higher GMC at 21 days post-dose 2 than those who received a standard 56-day regimen in other African trials, but similar to those who received the regimen with an extended interval.
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Affiliation(s)
- Edward Man-Lik Choi
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Kambale Kasonia
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Hugo Kavunga-Membo
- Institut National de Recherche Biomédicale, Kinshasa P.O. Box 1192, Democratic Republic of the Congo; (H.K.-M.); (D.M.-B.); (Z.M.); (P.M.); (J.J.M.-T.)
| | - Daniel Mukadi-Bamuleka
- Institut National de Recherche Biomédicale, Kinshasa P.O. Box 1192, Democratic Republic of the Congo; (H.K.-M.); (D.M.-B.); (Z.M.); (P.M.); (J.J.M.-T.)
| | - Aboubacar Soumah
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Zephyrin Mossoko
- Institut National de Recherche Biomédicale, Kinshasa P.O. Box 1192, Democratic Republic of the Congo; (H.K.-M.); (D.M.-B.); (Z.M.); (P.M.); (J.J.M.-T.)
| | - Tansy Edwards
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
| | - Darius Tetsa-Tata
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Rockyath Makarimi
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Oumar Toure
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Grace Mambula
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Hannah Brindle
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Anton Camacho
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Nicholas E. Connor
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Pierre Mukadi
- Institut National de Recherche Biomédicale, Kinshasa P.O. Box 1192, Democratic Republic of the Congo; (H.K.-M.); (D.M.-B.); (Z.M.); (P.M.); (J.J.M.-T.)
| | - Chelsea McLean
- Janssen Vaccines and Prevention B.V., 2333 CN Leiden, The Netherlands; (C.M.); (B.K.); (C.R.); (K.L.)
| | - Babajide Keshinro
- Janssen Vaccines and Prevention B.V., 2333 CN Leiden, The Netherlands; (C.M.); (B.K.); (C.R.); (K.L.)
| | | | - Cynthia Robinson
- Janssen Vaccines and Prevention B.V., 2333 CN Leiden, The Netherlands; (C.M.); (B.K.); (C.R.); (K.L.)
| | - Kerstin Luhn
- Janssen Vaccines and Prevention B.V., 2333 CN Leiden, The Netherlands; (C.M.); (B.K.); (C.R.); (K.L.)
| | - Julie Foster
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | - Chrissy h. Roberts
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
| | | | - Nathalie Imbault
- Coalition for Epidemic Preparedness Innovations, 0191 Oslo, Norway;
| | - Daniel G. Bausch
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
- FIND, 1218 Geneva, Switzerland
| | - Rebecca F. Grais
- Epicentre, 75019 Paris, France; (A.S.); (R.M.); (O.T.); (G.M.); (A.C.); (R.F.G.)
| | - Deborah Watson-Jones
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (K.K.); (D.T.-T.); (H.B.); (N.E.C.); (C.h.R.); (D.G.B.); (D.W.-J.)
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza P.O. Box 11936, Tanzania
| | - Jean Jacques Muyembe-Tamfum
- Institut National de Recherche Biomédicale, Kinshasa P.O. Box 1192, Democratic Republic of the Congo; (H.K.-M.); (D.M.-B.); (Z.M.); (P.M.); (J.J.M.-T.)
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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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Lee AW, Liu K, Lhomme E, Blie J, McCullough J, Onorato MT, Connor L, Simon JK, Dubey S, VanRheenen S, Deutsch J, Owens A, Morgan A, Welebob C, Hyatt D, Nair S, Hamzé B, Guindo O, Sow SO, Beavogui AH, Leigh B, Samai M, Akoo P, Serry-Bangura A, Fleck S, Secka F, Lowe B, Watson-Jones D, Roy C, Hensley LE, Kieh M, Coller BAG. Immunogenicity and Vaccine Shedding After 1 or 2 Doses of rVSVΔG-ZEBOV-GP Ebola Vaccine (ERVEBO®): Results From a Phase 2, Randomized, Placebo-controlled Trial in Children and Adults. Clin Infect Dis 2024; 78:870-879. [PMID: 37967326 PMCID: PMC11006114 DOI: 10.1093/cid/ciad693] [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: 08/23/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The rVSVΔG-ZEBOV-GP vaccine (ERVEBO®) is a single-dose, live-attenuated, recombinant vesicular stomatitis virus vaccine indicated for the prevention of Ebola virus disease (EVD) caused by Zaire ebolavirus in individuals 12 months of age and older. METHODS The Partnership for Research on Ebola VACcination (PREVAC) is a multicenter, phase 2, randomized, double-blind, placebo-controlled trial of 3 vaccine strategies in healthy children (ages 1-17) and adults, with projected 5 years of follow-up (NCT02876328). Using validated assays (GP-ELISA and PRNT), we measured antibody responses after 1-dose rVSVΔG-ZEBOV-GP, 2-dose rVSVΔG-ZEBOV-GP (given on Day 0 and Day 56), or placebo. Furthermore, we quantified vaccine virus shedding in a subset of children's saliva using RT-PCR. RESULTS In total, 819 children and 783 adults were randomized to receive rVSVΔG-ZEBOV-GP (1 or 2 doses) or placebo. A single dose of rVSVΔG-ZEBOV-GP increased antibody responses by Day 28 that were sustained through Month 12. A second dose of rVSVΔG-ZEBOV-GP given on Day 56 transiently boosted antibody concentrations. In vaccinated children, GP-ELISA titers were superior to placebo and non-inferior to vaccinated adults. Vaccine virus shedding was observed in 31.7% of children, peaking by Day 7, with no shedding observed after Day 28 post-dose 1 or any time post-dose 2. CONCLUSIONS A single dose of rVSVΔG-ZEBOV-GP induced robust antibody responses in children that was non-inferior to the responses induced in vaccinated adults. Vaccine virus shedding in children was time-limited and only observed after the first dose. Overall, these data support the use of rVSVΔG-ZEBOV-GP for the prevention of EVD in at-risk children. Clinical Trials Registration. The study is registered at ClinicalTrials.gov (NCT02876328), the Pan African Clinical Trials Registry (PACTR201712002760250), and the European Clinical Trials Register (EudraCT number: 2017-001798-18).
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Affiliation(s)
| | - Ken Liu
- Merck & Co., Inc., Rahway, New Jersey, USA
| | - Edouard Lhomme
- Inserm, CHU Bordeaux, CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, University of Bordeaux, Bordeaux, France
| | - Julie Blie
- Partnership for Research on Ebola Vaccines in Liberia (PREVAIL), Monrovia, Liberia
| | - John McCullough
- Advanced BioMedical Laboratories (ABML), Cinnaminson, New Jersey, USA
| | | | | | | | | | | | | | | | - Amy Morgan
- Merck & Co., Inc., Rahway, New Jersey, USA
| | | | | | | | - Benjamin Hamzé
- Pôle Recherche Clinique, Institut National de la Santé et de la Recherche Médicale (Inserm), Paris, France
| | - Oumar Guindo
- University Clinical Research Center (UCRC), Bamako, Mali
| | | | - Abdoul H Beavogui
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR), Maferinyah, Guinea
| | - Bailah Leigh
- College of Medicine & Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- College of Medicine & Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Pauline Akoo
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Alimamy Serry-Bangura
- College of Medicine & Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Suzanne Fleck
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Fatou Secka
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Brett Lowe
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Deborah Watson-Jones
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Céline Roy
- Inserm, CHU Bordeaux, CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, University of Bordeaux, Bordeaux, France
- University of Bordeaux, INSERM, MART, UMS 54, F-33000 Bordeaux, France
| | - Lisa E Hensley
- National Bio and Agro-Defense Facility (NBAF), United States Department of Agriculture (USDA), Manhattan, Kansas, USA
| | - Mark Kieh
- Partnership for Research on Ebola Vaccines in Liberia (PREVAIL), Monrovia, Liberia
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Martinez-Murillo PA, Huttner A, Lemeille S, Medaglini D, Ottenhoff THM, Harandi AM, Didierlaurent AM, Siegrist CA. Refined innate plasma signature after rVSVΔG-ZEBOV-GP immunization is shared among adult cohorts in Europe and North America. Front Immunol 2024; 14:1279003. [PMID: 38235127 PMCID: PMC10791923 DOI: 10.3389/fimmu.2023.1279003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/07/2023] [Indexed: 01/19/2024] Open
Abstract
Background During the last decade Ebola virus has caused several outbreaks in Africa. The recombinant vesicular stomatitis virus-vectored Zaire Ebola (rVSVΔG-ZEBOV-GP) vaccine has proved safe and immunogenic but is reactogenic. We previously identified the first innate plasma signature response after vaccination in Geneva as composed of five monocyte-related biomarkers peaking at day 1 post-immunization that correlates with adverse events, biological outcomes (haematological changes and viremia) and antibody titers. In this follow-up study, we sought to identify additional biomarkers in the same Geneva cohort and validate those identified markers in a US cohort. Methods Additional biomarkers were identified using multiplexed protein biomarker platform O-link and confirmed by Luminex. Principal component analysis (PCA) evaluated if these markers could explain a higher variability of the vaccine response (and thereby refined the initial signature). Multivariable and linear regression models evaluated the correlations of the main components with adverse events, biological outcomes, and antibody titers. External validation of the refined signature was conducted in a second cohort of US vaccinees (n=142). Results Eleven additional biomarkers peaked at day 1 post-immunization: MCP2, MCP3, MCP4, CXCL10, OSM, CX3CL1, MCSF, CXCL11, TRAIL, RANKL and IL15. PCA analysis retained three principal components (PC) that accounted for 79% of the vaccine response variability. PC1 and PC2 were very robust and had different biomarkers that contributed to their variability. PC1 better discriminated different doses, better defined the risk of fever and myalgia, while PC2 better defined the risk of headache. We also found new biomarkers that correlated with reactogenicity, including transient arthritis (MCP-2, CXCL10, CXCL11, CX3CL1, MCSF, IL-15, OSM). Several innate biomarkers are associated with antibody levels one and six months after vaccination. Refined PC1 correlated strongly in both data sets (Geneva: r = 0.97, P < 0.001; US: r = 0.99, P< 0.001). Conclusion Eleven additional biomarkers refined the previously found 5-biomarker Geneva signature. The refined signature better discriminated between different doses, was strongly associated with the risk of adverse events and with antibody responses and was validated in a separate cohort.
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Affiliation(s)
- Paola Andrea Martinez-Murillo
- Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Angela Huttner
- Center for Vaccinology, Geneva University Hospitals, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Clinical Research, Geneva University Hospitals, Geneva, Switzerland
| | - Sylvain Lemeille
- Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Donata Medaglini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Tom H. M. Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Ali M. Harandi
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Vaccine Evaluation Centre, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Arnaud M. Didierlaurent
- Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Center of Vaccinology, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Vaccinology, Geneva University Hospitals, Geneva, Switzerland
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Vianello E, Persson J, Andersson B, van Veen S, Dias TL, Santoro F, Östensson M, Obudulu O, Agbajogu C, Torkzadeh S, Nakaya HI, Medaglini D, Siegrist CA, Ottenhoff TH, Harandi AM. Global blood miRNA profiling unravels early signatures of immunogenicity of Ebola vaccine rVSVΔG-ZEBOV-GP. iScience 2023; 26:108574. [PMID: 38162033 PMCID: PMC10755791 DOI: 10.1016/j.isci.2023.108574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/27/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
The vectored Ebola vaccine rVSVΔG-ZEBOV-GP elicits protection against Ebola Virus Disease (EVD). In a study of forty-eight healthy adult volunteers who received either the rVSVΔG-ZEBOV-GP vaccine or placebo, we profiled intracellular microRNAs (miRNAs) from whole blood cells (WB) and circulating miRNAs from serum-derived extracellular vesicles (EV) at baseline and longitudinally following vaccination. Further, we identified early miRNA signatures associated with ZEBOV-specific IgG antibody responses at baseline and up to one year post-vaccination, and pinpointed target mRNA transcripts and pathways correlated to miRNAs whose expression was altered after vaccination by using systems biology approaches. Several miRNAs were differentially expressed (DE) and miRNA signatures predicted high or low IgG ZEBOV-specific antibody levels with high classification performance. The top miRNA discriminators were WB-miR-6810, EV-miR-7151-3p, and EV-miR-4426. An eight-miRNA antibody predictive signature was associated with immune-related target mRNAs and pathways. These findings provide valuable insights into early blood biomarkers associated with rVSVΔG-ZEBOV-GP vaccine-induced IgG antibody responses.
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Affiliation(s)
- Eleonora Vianello
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Josefine Persson
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Andersson
- Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Suzanne van Veen
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Malin Östensson
- Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ogonna Obudulu
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Agbajogu
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Torkzadeh
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Donata Medaglini
- Department of Medical Biotechnologies, University of Siena, Italy
| | - Claire-Anne Siegrist
- Centre for Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Tom H.M. Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Ali M. Harandi
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, Canada
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9
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Huttner A, Agnandji ST, Engler O, Hooper JW, Kwilas S, Ricks K, Clements TL, Jonsdottir HR, Nakka SS, Rothenberger S, Kremsner P, Züst R, Medaglini D, Ottenhoff T, Harandi AM, Siegrist CA. Antibody responses to recombinant vesicular stomatitis virus-Zaire Ebolavirus vaccination for Ebola virus disease across doses and continents: 5-year durability. Clin Microbiol Infect 2023; 29:1587-1594. [PMID: 37661067 DOI: 10.1016/j.cmi.2023.08.026] [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: 06/11/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES To report 5-year persistence and avidity of antibodies produced by the live-attenuated recombinant vesicular stomatitis virus (rVSV) expressing the Zaire Ebolavirus (ZEBOV) glycoprotein (GP), known as rVSV-ZEBOV (Ervebo®). METHODS Healthy adults vaccinated with 300,000 or 10-50 million plaque-forming units of rVSV-ZEBOV in the WHO-coordinated trials of 2014-2015 were followed for up to 4 (Lambaréné, Gabon) and 5 (Geneva, Switzerland) years. We report seropositivity rates, geometric mean titres (GMTs), and population distribution of ZEBOV-GP ELISA IgG antibodies, neutralizing antibodies (pseudovirus and live-virus neutralization) and antibody avidity; the primary outcome was ZEBOV-GP ELISA IgG GMTs at 4 or 5 years compared with 1 year (Y1) after immunization. RESULTS Among the 168 eligible vaccinees (Geneva: 97 and Lambaréné: 71) enrolled 1 year post-immunization, 146 (87%) remained enrolled at 4 years (Geneva: n = 88, Lambaréné: n = 58), and 84 (87%, Geneva) at 5 years post-vaccination. ZEBOV-GP ELISA IgG GMTs plateaued, with no declining trend from 1 year through the last time point assessed (1147.8 [95% CI 874.3-1507.0] at Y1 versus 1548.1 [95% CI 1136.6-2108.5] at Y5 in Geneva volunteers receiving ≥10 million plaque-forming units of rVSV-ZEBOV), their avidity matching that of ZEBOV convalescents. Live-virus neutralizing antibodies were detected for shorter periods and in fewer vaccinees (53/95 [56%] at Y1 versus 35/84 [42%] at Y5 in Geneva volunteers, all dose levels). DISCUSSION Titres at Y1 emerged as a correlate of antibody persistence at Y5. The findings of persistent ZEBOV-GP ELISA IgG titres yet shorter-lasting, lower titres of live-virus neutralizing antibodies suggest the contribution of antibody-mediated protective mechanisms other than neutralization. Long-term clinical efficacy of rVSV-ZEBOV, however, requires further study.
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Affiliation(s)
- Angela Huttner
- Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland; Clinical Trials Unit, Centre for Clinical Research, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; Centre for Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Campus CERMEL, Lambaréné, Gabon; Institut für Tropenmedizin, Reisemedizin und Humanparasitologie Universitätsklinikum Tübingen, Tübingen, Germany; GermanCenter for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Olivier Engler
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Jay W Hooper
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Steve Kwilas
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Keersten Ricks
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Tamara L Clements
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Hulda R Jonsdottir
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Sravya Sowdamini Nakka
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sylvia Rothenberger
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland; Institute of Microbiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Peter Kremsner
- Centre de Recherches Médicales de Lambaréné, Campus CERMEL, Lambaréné, Gabon; Institut für Tropenmedizin, Reisemedizin und Humanparasitologie Universitätsklinikum Tübingen, Tübingen, Germany; GermanCenter for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Roland Züst
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Donata Medaglini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Tom Ottenhoff
- Department of Infectious Diseases, Leiden Hospital Centre and University Hospital, Leiden, The Netherlands
| | - Ali M Harandi
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Vaccine Evaluation Centre, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Claire-Anne Siegrist
- Centre for Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
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Niemuth NA, Triplett CA, Anderson MS, Sankovich KA, Rudge TL. A Case Study for Critical Reagent Qualification for Ligand Binding Assays Using Equivalence Test Methodology. AAPS J 2023; 25:89. [PMID: 37715073 DOI: 10.1208/s12248-023-00857-8] [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: 06/21/2023] [Accepted: 08/26/2023] [Indexed: 09/17/2023] Open
Abstract
Qualifying critical reagents in ligand binding assays by parallel testing of current and candidate reagent lots is recommended by regulatory agencies and industry groups, but specific guidance on the format of reagent qualification experiments is limited. Equivalence testing is a statistically sound approach that is consistent with the objective of critical reagent qualification. We present power analysis for equivalence regions ranging from 1.25- to 1.5-fold multiples of the GM ratio (centered on 1) of current and candidate lots, over a range of assay variability from 5 to 30% coefficient of variation (CV). A 1.25-fold equivalence region can be tested using 6 to 12 plates per lot for assays with up to 15% CV but is not practical for more variable assays. For these assays, wider equivalence regions are justified so long as care is taken to avoid assay drift and the assay remains suitable for the intended use. The equivalence test method is illustrated using historical data from passing and failing reagent qualification experiments. Simulation analysis was performed to support the design of qualification experiments using 6, 12, or 18 plates per lot over a broad range of assay variability. A challenge in implementing the equivalence test approach is selecting an appropriate equivalence region. Equivalence regions providing 90% power using 12 plates/lot were consistent with 1.5σ bounds, which are recommended for equivalence testing of critical quality attributes of biosimilars.
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Affiliation(s)
| | | | | | | | - Thomas L Rudge
- Battelle Biomedical Research Center, West Jefferson, OH, USA
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11
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Zola Matuvanga T, Mariën J, Larivière Y, Osang’ir BI, Milolo S, Meta R, Esanga E, Maketa V, Matangila J, Mitashi P, Ahuka Mundeke S, Muhindo-Mavoko H, Muyembe Tamfum JJ, Van Damme P, Van Geertruyden JP. Low seroprevalence of Ebola virus in health care providers in an endemic region (Tshuapa province) of the Democratic Republic of the Congo. PLoS One 2023; 18:e0286479. [PMID: 37656725 PMCID: PMC10473486 DOI: 10.1371/journal.pone.0286479] [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: 02/03/2023] [Accepted: 05/16/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION A serosurvey among health care providers (HCPs) and frontliners of an area previously affected by Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) was conducted to assess the seroreactivity to Ebola virus antigens. METHODS Serum samples were collected in a cohort of HCPs and frontliners (n = 698) participants in the EBL2007 vaccine trial (December 2019 to October 2022). Specimens seroreactive for EBOV were confirmed using either the Filovirus Animal Nonclinical Group (FANG) ELISA or a Luminex multiplex assay. RESULTS The seroreactivity to at least two EBOV-Mayinga (m) antigens was found in 10 (1.4%: 95% CI, 0.7-2.6) samples for GP-EBOV-m + VP40-EBOV-m, and 2 (0.3%: 95% CI, 0.0-1.0) samples for VP40-EBOV-m + NP-EBOV-m using the Luminex assay. Seroreactivity to GP-EBOV-Kikwit (k) was observed in 59 (8.5%: 95%CI, 6.5-10.9) samples using FANG ELISA. CONCLUSION In contrast to previous serosurveys, a low seroprevalence was found in the HCP and frontline population participating in the EBL2007 Ebola vaccine trial in Boende, DRC. This underscores the high need for standardized antibody assays and cutoffs in EBOV serosurveys to avoid the broad range of reported EBOV seroprevalence rates in EBOV endemic areas.
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Affiliation(s)
- Trésor Zola Matuvanga
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Joachim Mariën
- Department of Biology, Evolutionary Ecology Group, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Ynke Larivière
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Bernard Isekah Osang’ir
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Rachel Meta
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Emmanuel Esanga
- Division Provinciale de la Santé de la Tshuapa, Ministry of Health Hygiene and Prevention, Boende, Tshuapa, Democratic Republic of the Congo
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka Mundeke
- Department of Virology, Institut National de Recherches Biomedicales, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe Tamfum
- Department of Virology, Institut National de Recherches Biomedicales, Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pierre Van Damme
- Vaccine and Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Jean-Pierre Van Geertruyden
- Department of Family Medicine and Population Health, Global Health Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
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12
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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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McLean C, Barry H, Kieh M, Anywaine Z, Tapima Rogers B, Doumbia S, Sirima SB, Serry-Bangura A, Habib Beavogui A, Gaddah A, Katwere M, Hendriks J, Keshinro B, Eholie S, Kibuuka H, Kennedy SB, Anzala O, Samai M, D'Ortenzio E, Leigh B, Sow S, Thiébaut R, Greenwood B, Watson-Jones D, Douoguih M, Luhn K, Robinson C. Immune response of a two-dose heterologous Ebola vaccine regimen: summary of three African clinical trials using a single validated Filovirus Animal Nonclinical Group enzyme-linked immunosorbent assay in a single accredited laboratory. EBioMedicine 2023; 91:104562. [PMID: 37099841 PMCID: PMC10149382 DOI: 10.1016/j.ebiom.2023.104562] [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: 09/01/2022] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND This analysis evaluated the immune response to the two-dose, heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola virus vaccine regimen, administered 56-days apart, from multiple African sites based on results from one analytic laboratory. METHODS Immunogenicity across three trials (EBL2002, EBL2004/PREVAC, EBL3001) conducted in East and West Africa is summarised. Vaccine-induced Ebola glycoprotein-binding antibody concentrations were analysed by Q2 Solutions laboratory at baseline, 21 days (EBL2002 and EBL3001) or 28 days (EBL2004) post-dose 2 (regimen completion), and 12 months post-dose 1 using the validated Filovirus Animal Nonclinical Group Ebola glycoprotein enzyme-linked immunosorbent assay (ELISA). Responders were defined as those with a >2.5-fold increase from baseline or the lower limit of quantification (LLOQ) if FINDINGS At 21 or 28 (21/28) days post-dose 2, the geometric mean concentration (GMC) range was 3810-7518 ELISA units (EU)/mL (percent responders: ≥98%) in adults, 9929-13532 EU/mL (≥98%) in adolescents aged 12-17 years, 10,212-17388 EU/mL (≥99%) in older children, and 22,568-25111 EU/mL (≥98%) in younger children. When stratified by country, GMCs at 21/28 days post-dose 2 were generally similar among adults and within paediatric cohorts (percent responders: 95%-100%). At month 12, GMC range was 259-437 EU/mL (percent responders: 49%-88%) in adults and 386-1139 EU/mL (70%-100%) in paediatric participants. INTERPRETATION Based on data from a single laboratory using a single validated assay, Ad26.ZEBOV, MVA-BN-Filo induced a strong humoral immune response, with ≥95% of participants across countries classified as responders at 21/28 days post-dose 2 (regimen completion), regardless of age. FUNDING Janssen Vaccines & Prevention BV; Innovative Medicines Initiative.
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Affiliation(s)
- Chelsea McLean
- Janssen Vaccines and Prevention BV, Leiden, the Netherlands.
| | | | - Mark Kieh
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | | | - Seydou Doumbia
- University Clinical Research Center, University of Sciences, Technique and Technology of Bamako, Bamako, Mali
| | - Sodiomon B Sirima
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | | | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Mafèrinyah, Guinea
| | | | | | - Jenny Hendriks
- Janssen Vaccines and Prevention BV, Leiden, the Netherlands
| | | | - Serge Eholie
- Medical School, University Felix Houphouet Boigny, Abidjan, Cote d'Ivoire
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Stephen B Kennedy
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Omu Anzala
- Kenya AIDS Vaccine Initiative (KAVI), University of Nairobi, Nairobi, Kenya
| | | | - Eric D'Ortenzio
- ANRS Emerging Infectious Diseases, Institut national de la santé et de la recherche médicale (Inserm), Paris, France
| | - Bailah Leigh
- University of Sierra Leone, Freetown, Sierra Leone
| | - Samba Sow
- Centre pour le Développement des Vaccins, Bamako, Mali
| | - Rodolphe Thiébaut
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | | | - Deborah Watson-Jones
- London School of Hygiene and Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | | | - Kerstin Luhn
- Janssen Vaccines and Prevention BV, Leiden, the Netherlands
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14
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Gunn BM, McNamara RP, Wood L, Taylor S, Devadhasan A, Guo W, Das J, Nilsson A, Shurtleff A, Dubey S, Eichberg M, Suscovich TJ, Saphire EO, Lauffenburger D, Coller BA, Simon JK, Alter G. Antibodies against the Ebola virus soluble glycoprotein are associated with long-term vaccine-mediated protection of non-human primates. Cell Rep 2023; 42:112402. [PMID: 37061918 PMCID: PMC10576837 DOI: 10.1016/j.celrep.2023.112402] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/30/2023] [Accepted: 03/31/2023] [Indexed: 04/17/2023] Open
Abstract
The 2013 Ebola epidemic in Central and West Africa heralded the emergence of wide-spread, highly pathogenic viruses. The successful recombinant vector vaccine against Ebola (rVSVΔG-ZEBOV-GP) will limit future outbreaks, but identifying mechanisms of protection is essential to protect the most vulnerable. Vaccine-induced antibodies are key determinants of vaccine efficacy, yet the mechanism by which vaccine-induced antibodies prevent Ebola infection remains elusive. Here, we exploit a break in long-term vaccine efficacy in non-human primates to identify predictors of protection. Using unbiased humoral profiling that captures neutralization and Fc-mediated functions, we find that antibodies specific for soluble glycoprotein (sGP) drive neutrophil-mediated phagocytosis and predict vaccine-mediated protection. Similarly, we show that protective sGP-specific monoclonal antibodies have elevated neutrophil-mediated phagocytic activity compared with non-protective antibodies, highlighting the importance of sGP in vaccine protection and monoclonal antibody therapeutics against Ebola virus.
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Affiliation(s)
- Bronwyn M Gunn
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ryan P McNamara
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA.
| | - Lianna Wood
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA; Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Sabian Taylor
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | | | - Wenyu Guo
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Jishnu Das
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Avlant Nilsson
- Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Amy Shurtleff
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | | | | | | | | | - Douglas Lauffenburger
- Division of Gastroenterology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | | | | | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
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15
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Finch CL, King TH, Alfson KJ, Albanese KA, Smith JNP, Smock P, Jakubik J, Goez-Gazi Y, Gazi M, Dutton JW, Clemmons EA, Mattix ME, Carrion R, Rudge T, Ridenour A, Woodin SF, Hunegnaw R, Sullivan NJ, Xu R. Single-Shot ChAd3-MARV Vaccine in Modified Formulation Buffer Shows 100% Protection of NHPs. Vaccines (Basel) 2022; 10:1935. [PMID: 36423030 PMCID: PMC9694189 DOI: 10.3390/vaccines10111935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022] Open
Abstract
Marburg virus (MARV) is a virus of high human consequence with a case fatality rate of 24-88%. The global health and national security risks posed by Marburg virus disease (MVD) underscore the compelling need for a prophylactic vaccine, but no candidate has yet reached regulatory approval. Here, we evaluate a replication-defective chimpanzee adenovirus type 3 (ChAd3)-vectored MARV Angola glycoprotein (GP)-expressing vaccine against lethal MARV challenge in macaques. The ChAd3 platform has previously been reported to protect against the MARV-related viruses, Ebola virus (EBOV) and Sudan virus (SUDV), and MARV itself in macaques, with immunogenicity demonstrated in macaques and humans. In this study, we present data showing 100% protection against MARV Angola challenge (versus 0% control survival) and associated production of GP-specific IgGs generated by the ChAd3-MARV vaccine following a single dose of 1 × 1011 virus particles prepared in a new clinical formulation buffer designed to enhance product stability. These results are consistent with previously described data using the same vaccine in a different formulation and laboratory, demonstrating the reproducible and robust protective efficacy elicited by this promising vaccine for the prevention of MVD. Additionally, a qualified anti-GP MARV IgG ELISA was developed as a critical pre-requisite for clinical advancement and regulatory approval.
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Affiliation(s)
| | | | | | | | | | - Paul Smock
- Sabin Vaccine Institute, Washington, DC 20037, USA
| | | | - Yenny Goez-Gazi
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Michal Gazi
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - John W. Dutton
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | | | - Marc E. Mattix
- Nonclinical Pathology Services, LLC, Medina, OH 44256, USA
| | - Ricardo Carrion
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Thomas Rudge
- Battelle Biomedical Research Center, Madison County, OH 43162, USA
| | - Alex Ridenour
- Battelle Biomedical Research Center, Madison County, OH 43162, USA
| | | | - Ruth Hunegnaw
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nancy J. Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rong Xu
- Clover Biopharmaceuticals, Boston, MA 02109, USA
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16
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Worwa G, Cooper TK, Yeh S, Shantha JG, Hischak AMW, Klim SE, Byrum R, Kurtz JR, Anthony SM, Aiosa NM, Ragland D, Lee JH, Claire MS, Davis C, Ahmed R, Holbrook MR, Kuhn JH, Saphire EO, Crozier I. Persistent intraocular Ebola virus RNA is associated with severe uveitis in a convalescent rhesus monkey. Commun Biol 2022; 5:1204. [PMID: 36352100 PMCID: PMC9644391 DOI: 10.1038/s42003-022-04158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Despite increasing evidence that uveitis is common and consequential in survivors of Ebola virus disease (EVD), the host-pathogen determinants of the clinical phenotype are undefined, including the pathogenetic role of persistent viral antigen, ocular tissue-specific immune responses, and histopathologic characterization. Absent sampling of human intraocular fluids and tissues, these questions might be investigated in animal models of disease; however, challenges intrinsic to the nonhuman primate model and the animal biosafety level 4 setting have historically limited inquiry. In a rhesus monkey survivor of experimental Ebola virus (EBOV) infection, we observed and documented the clinical, virologic, immunologic, and histopathologic features of severe uveitis. Here we show the clinical natural history, resultant ocular pathology, intraocular antigen-specific antibody detection, and persistent intraocular EBOV RNA detected long after clinical resolution. The association of persistent EBOV RNA as a potential driver of severe immunopathology has pathophysiologic implications for understanding, preventing, and mitigating vision-threatening uveitis in EVD survivors.
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Affiliation(s)
- Gabriella Worwa
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA.
| | - Timothy K Cooper
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Steven Yeh
- Emory Eye Center, Emory University, Atlanta, GA, 30322, USA
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, 68105, USA
| | | | - Amanda M W Hischak
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Sarah E Klim
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Russell Byrum
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Jonathan R Kurtz
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Scott M Anthony
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Nina M Aiosa
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Danny Ragland
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Ji Hyun Lee
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Marisa St Claire
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Carl Davis
- Emory Vaccine Center, Emory University, Atlanta, GA, 30322, USA
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University, Atlanta, GA, 30322, USA
| | - Michael R Holbrook
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA
| | - Erica Ollmann Saphire
- Center for Infectious Disease and Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA, 92065, USA
| | - Ian Crozier
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Fort Detrick, Frederick, MD, 21702, USA.
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702, USA.
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17
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Simon JK, Kennedy SB, Mahon BE, Dubey SA, Grant-Klein RJ, Liu K, Hartzel J, Coller BAG, Welebob C, Hanson ME, Grais RF. Immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccine (ERVEBO®) in African clinical trial participants by age, sex, and baseline GP-ELISA titer: A post hoc analysis of three Phase 2/3 trials. Vaccine 2022; 40:6599-6606. [PMID: 36208978 DOI: 10.1016/j.vaccine.2022.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND ERVEBO®, a live recombinant vesicular stomatitis virus (VSV) vaccine containing the Zaire ebolavirus glycoprotein (GP) in place of the VSV GP (rVSVΔG-ZEBOV-GP), was advanced through clinical development by Merck & Co., Inc., Rahway, NJ, USA in collaboration with multiple partners to prevent Ebola virus disease (EVD) and has been approved for human use in several countries. METHODS We evaluated data from three Phase 2/3 clinical trials conducted in Liberia (PREVAIL), Guinea (FLW), and Sierra Leone (STRIVE) during the 2013-2016 West African EVD outbreak to assess immune responses using validated assays. We performed a post hoc analysis of the association of vaccine response with sex, age (18-50 yrs & >50 yrs), and baseline (BL) GP-enzyme-linked immunosorbent assay (ELISA) titer (<200 & ≥200 EU/mL), including individual study (PREVAIL, FLW, or STRIVE) data and pooled data from all 3 studies. The endpoints were total IgG antibody response (EU/mL) measured by the GP-ELISA and neutralizing antibody response measured by the plaque reduction neutralization test (PRNT) to rVSVΔG-ZEBOV-GP at Days 28, 180, and 365 postvaccination. RESULTS In the overall pooled population, in all subgroups, and in each trial independently, GP-ELISA and PRNT geometric mean titers increased from BL, generally peaking at Day 28 and persisting through Day 365. Immune responses were greater in women and participants with BL GP-ELISA ≥ 200 EU/mL, but did not differ across age groups. CONCLUSION These data demonstrate that rVSVΔG-ZEBOV-GP elicits a robust and durable immune response through 12 months postvaccination in participants regardless of age, sex, or BL GP-ELISA titer. The higher immune responses observed in women and participants with pre-existing immunity are consistent with those described previously and for other vaccines. Trials were registered as follows: PREVAIL: ClinicalTrials.gov NCT02344407; FLW: Pan African Clinical Trials Registry PACTR201503001057193; STRIVE: ClinicalTrials.gov NCT02378753. Protocols V920-009, 011, and 018.
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Affiliation(s)
| | - Stephen B Kennedy
- Partnership for Research on Ebola Vaccines in Liberia (PREVAIL), Monrovia, Liberia
| | - Barbara E Mahon
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Ken Liu
- Merck & Co., Inc., Rahway, NJ, USA
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18
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Lessons Learned from the Development and Roll-Out of the rVSVΔG-ZEBOV-GP Zaire ebolavirus Vaccine to Inform Marburg Virus and Sudan ebolavirus Vaccines. Vaccines (Basel) 2022; 10:vaccines10091446. [PMID: 36146524 PMCID: PMC9505064 DOI: 10.3390/vaccines10091446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
This review describes key aspects of the development of the rVSVΔG-ZEBOV-GP Ebola vaccine and key activities which are continuing to further expand our knowledge of the product. Extensive partnerships and innovative approaches were used to address the various challenges encountered during this process. The rVSVΔG-ZEBOV-GP Ebola vaccine was initially approved by the European Medicines Agency and prequalified by the World Health Organization in November 2019. It was approved by the United States Food and Drug Administration in December 2019 and approved in five African countries within 90 days of prequalification. The development resulted in the first stockpile of a registered Ebola vaccine that is available to support outbreak response. This also provides insights into how the example of rVSVΔG-ZEBOV-GP can inform the development of vaccines for Sudan ebolavirus, Marburg virus, and other emerging epidemic diseases in terms of the types of approaches and data needed to support product registration, availability, and the use of a filovirus vaccine.
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19
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Triplett CA, Niemuth NA, Cirimotich C, Meister G, Guebre-Xabier M, Patel N, Massare M, Glenn G, Smith G, Alfson KJ, Goez-Gazi Y, Carrion R. Immune Correlates of Protection from Filovirus Efficacy Studies in Non-Human Primates. Vaccines (Basel) 2022; 10:1338. [PMID: 36016226 PMCID: PMC9416512 DOI: 10.3390/vaccines10081338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Non-human primate (NHP) efficacy data for several Ebola virus (EBOV) vaccine candidates exist, but definitive correlates of protection (CoP) have not been demonstrated, although antibodies to the filovirus glycoprotein (GP) antigen and other immunological endpoints have been proposed as potential CoPs. Accordingly, studies that could elucidate biomarker(s) that statistically correlate, whether mechanistically or not, with protection are warranted. The primary objective of this study was to evaluate potential CoP for Novavax EBOV GP vaccine candidate administered at different doses to cynomolgus macaques using the combined data from two separate, related studies containing a total of 44 cynomolgus macaques. Neutralizing antibodies measured by pseudovirion neutralization assay (PsVNA) and anti-GP IgG binding antibodies were evaluated as potential CoP using logistic regression models. The predictive ability of these models was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). Fitted models indicated a statistically significant relationship between survival and log base 10 (log10) transformed anti-GP IgG antibodies, with good predictive ability of the model. Neither (log10 transformed) PsVNT50 nor PsVNT80 titers were statistically significant predictors of survival, though predictive ability of both models was good. Predictive ability was not statistically different between any pair of models. Models that included immunization dose in addition to anti-GP IgG antibodies failed to detect statistically significant effects of immunization dose. These results support anti-GP IgG antibodies as a correlate of protection. Total assay variabilities and geometric coefficients of variation (GCVs) based on the study data appeared to be greater for both PsVNA readouts, suggesting the increased assay variability may account for non-significant model results for PsVNA despite the good predictive ability of the models. The statistical approach to evaluating CoP for this EBOV vaccine may prove useful for advancing research for Sudan virus (SUDV) and Marburg virus (MARV) candidate vaccines.
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Affiliation(s)
| | | | | | | | | | - Nita Patel
- Novavax Inc., Gaithersburg, MD 20878, USA
| | | | - Greg Glenn
- Novavax Inc., Gaithersburg, MD 20878, USA
| | - Gale Smith
- Novavax Inc., Gaithersburg, MD 20878, USA
| | | | - Yenny Goez-Gazi
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Ricardo Carrion
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
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20
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Tiemessen MM, Solforosi L, Dekking L, Czapska-Casey D, Serroyen J, Sullivan NJ, Volkmann A, Pau MG, Callendret B, Schuitemaker H, Luhn K, Zahn R, Roozendaal R. Protection against Marburg Virus and Sudan Virus in NHP by an Adenovector-Based Trivalent Vaccine Regimen Is Correlated to Humoral Immune Response Levels. Vaccines (Basel) 2022; 10:1263. [PMID: 36016151 PMCID: PMC9412258 DOI: 10.3390/vaccines10081263] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
The Marburg virus (MARV) and Sudan virus (SUDV) belong to the filovirus family. The sporadic human outbreaks occur mostly in Africa and are characterized by an aggressive disease course with high mortality. The first case of Marburg virus disease in Guinea in 2021, together with the increased frequency of outbreaks of Ebola virus (EBOV), which is also a filovirus, accelerated the interest in potential prophylactic vaccine solutions against multiple filoviruses. We previously tested a two-dose heterologous vaccine regimen (Ad26.Filo, MVA-BN-Filo) in non-human primates (NHP) and showed a fully protective immune response against both SUDV and MARV in addition to the already-reported protective effect against EBOV. The vaccine-induced glycoprotein (GP)-binding antibody levels appear to be good predictors of the NHP challenge outcome as indicated by the correlation between antibody levels and survival outcome as well as the high discriminatory capacity of the logistic model. Moreover, the elicited GP-specific binding antibody response against EBOV, SUDV, and MARV remains stable for more than 1 year. Overall, the NHP data indicate that the Ad26.Filo, MVA-BN-Filo regimen may be a good candidate for a prophylactic vaccination strategy in regions at high risk of filovirus outbreaks.
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Affiliation(s)
- Machteld M. Tiemessen
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Laura Solforosi
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Liesbeth Dekking
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | | | - Jan Serroyen
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Nancy J. Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ariane Volkmann
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, D-82152 Martinsried, Germany
| | - Maria Grazia Pau
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Benoit Callendret
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Hanneke Schuitemaker
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Kerstin Luhn
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Ramon Roozendaal
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
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21
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Rudge TL, Machesky NJ, Sankovich KA, Lemmon EE, Badorrek CS, Overman R, Niemuth NA, Anderson MS. Assays for the Evaluation of the Immune Response to Marburg and Ebola Sudan Vaccination-Filovirus Animal Nonclinical Group Anti-Marburg Virus Glycoprotein Immunoglobulin G Enzyme-Linked Immunosorbent Assay and a Pseudovirion Neutralization Assay. Vaccines (Basel) 2022; 10:1211. [PMID: 36016099 PMCID: PMC9413256 DOI: 10.3390/vaccines10081211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Since the discovery of the Marburg virus (MARV) in 1967 and Ebola virus (EBOV) in 1976, there have been over 40 reported outbreaks of filovirus disease with case fatality rates greater than 50%. This underscores the need for efficacious vaccines against these highly pathogenic filoviruses. Due to the sporadic and unpredictable nature of filovirus outbreaks, such a vaccine would likely need to be vetted through the U.S. Food and Drug Administration (FDA), following the Animal Rule or similar European Medicines Agency (EMA) regulatory pathway. Under the FDA Animal Rule, vaccine-induced immune responses correlating with survival of non-human primates (NHPs), or another well-characterized animal model, following lethal challenge, will need to be bridged for human immune response distributions in clinical trials. A correlate of protection has not yet been identified for the filovirus disease, but antibodies, specifically anti-glycoprotein (GP) antibodies, are believed to be critical in providing protection against the filovirus disease following vaccination and are thus a strong candidate for a correlate of protection. Thus, species-neutral methods capable of the detection and bridging of these antibody immune responses, such as methods to quantify anti-GP immunoglobulin G (IgG)-binding antibodies and neutralizing antibodies, are needed. Reported here is the development and qualification of two Filovirus Animal Nonclinical Group (FANG) anti-GP IgG Enzyme-Linked Immunosorbent Assays (ELISAs) to quantify anti-MARV and anti-Sudan virus (SUDV) IgG antibodies in human and NHP serum samples, as well as the development of pseudovirion neutralization assays (PsVNAs) to quantify MARV- and SUDV-neutralizing antibodies in human and NHP serum samples.
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Affiliation(s)
- Thomas L. Rudge
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
| | - Nicholas J. Machesky
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
| | - Karen A. Sankovich
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
| | - Erin E. Lemmon
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
| | - Christopher S. Badorrek
- Contract Support for the 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;
| | - Rachel Overman
- 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;
| | - Nancy A. Niemuth
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
| | - Michael S. Anderson
- Battelle, West Jefferson, OH 43162, USA; (N.J.M.); (K.A.S.); (E.E.L.); (N.A.N.); (M.S.A.)
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Crozier I, Britson KA, Wolfe DN, Klena JD, Hensley LE, Lee JS, Wolfraim LA, Taylor KL, Higgs ES, Montgomery JM, Martins KA. The Evolution of Medical Countermeasures for Ebola Virus Disease: Lessons Learned and Next Steps. Vaccines (Basel) 2022; 10:1213. [PMID: 36016101 PMCID: PMC9415766 DOI: 10.3390/vaccines10081213] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
The Ebola virus disease outbreak that occurred in Western Africa from 2013-2016, and subsequent smaller but increasingly frequent outbreaks of Ebola virus disease in recent years, spurred an unprecedented effort to develop and deploy effective vaccines, therapeutics, and diagnostics. This effort led to the U.S. regulatory approval of a diagnostic test, two vaccines, and two therapeutics for Ebola virus disease indications. Moreover, the establishment of fieldable diagnostic tests improved the speed with which patients can be diagnosed and public health resources mobilized. The United States government has played and continues to play a key role in funding and coordinating these medical countermeasure efforts. Here, we describe the coordinated U.S. government response to develop medical countermeasures for Ebola virus disease and we identify lessons learned that may improve future efforts to develop and deploy effective countermeasures against other filoviruses, such as Sudan virus and Marburg virus.
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Affiliation(s)
- Ian Crozier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA;
| | - Kyla A. Britson
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow, Oak Ridge, TN 37831, USA
| | - Daniel N. Wolfe
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
| | - John D. Klena
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.D.K.); (J.M.M.)
| | - Lisa E. Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, Fort Detrick, MD 12116, USA;
| | - John S. Lee
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
| | - Larry A. Wolfraim
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Kimberly L. Taylor
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Elizabeth S. Higgs
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Joel M. Montgomery
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.D.K.); (J.M.M.)
| | - Karen A. Martins
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
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23
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Ishola D. Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children. Clin Infect Dis 2022; 75:1585-1593. [PMID: 35640636 PMCID: PMC9617582 DOI: 10.1093/cid/ciac209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 11/14/2022] Open
Abstract
Background Malaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. Methods In this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs). Results A total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02). Conclusions The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.
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Affiliation(s)
- D Ishola
- Correspondence: D. Ishola, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK ()
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24
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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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25
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Hoff NA, Bratcher A, Kelly JD, Musene K, Kompany JP, Kabamba M, Mbala-Kingebeni P, Dighero-Kemp B, Kocher G, Elliott E, Reilly C, Halbrook M, Ilunga Kebela B, Gadoth A, Ngoie Mwamba G, Tambu M, McIlwain DR, Mukadi P, Hensley LE, Ahuka-Mundeke S, Rutherford GW, Muyembe-Tamfum JJ, Rimoin AW. Immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccination in exposed and potentially exposed persons in the Democratic Republic of the Congo. Proc Natl Acad Sci U S A 2022; 119:e2118895119. [PMID: 35110410 PMCID: PMC8833182 DOI: 10.1073/pnas.2118895119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022] Open
Abstract
Despite more than 300,000 rVSVΔG-ZEBOV-glycoprotein (GP) vaccine doses having been administered during Ebola virus disease (EVD) outbreaks in the Democratic Republic of the Congo (DRC) between 2018 and 2020, seroepidemiologic studies of vaccinated Congolese populations are lacking. This study examines the antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among EVD-exposed and potentially exposed populations in the DRC. We conducted a longitudinal cohort study of 608 rVSVΔG-ZEBOV-GP-vaccinated individuals during an EVD outbreak in North Kivu Province, DRC. Participants provided questionnaires and blood samples at three study visits (day 0, visit 1; day 21, visit 2; and month 6, visit 3). Anti-GP immunoglobulin G (IgG) antibody titers were measured in serum by the Filovirus Animal Nonclinical Group anti-Ebola virus GP IgG enzyme-linked immunosorbent assay. Antibody response was defined as an antibody titer that had increased fourfold from visit 1 to visit 2 and was above four times the lower limit of quantification at visit 2; antibody persistence was defined as a similar increase from visit 1 to visit 3. We then examined demographics for associations with follow-up antibody titers using generalized linear mixed models. A majority of the sample, 87.2%, had an antibody response at visit 2, and 95.6% demonstrated antibody persistence at visit 3. Being female and of young age was predictive of a higher antibody titer postvaccination. Antibody response and persistence after Ebola vaccination was robust in this cohort, confirming findings from outside of the DRC.
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Affiliation(s)
- Nicole A Hoff
- Department of Epidemiology, University of California, Los Angeles, CA 90095
| | - Anna Bratcher
- Department of Epidemiology, University of California, Los Angeles, CA 90095
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158
- Institute for Global Health Sciences, University of California, San Francisco, CA 94158
- F.I. Proctor Foundation, University of California, San Francisco, CA 94143
| | - Kamy Musene
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Jean Paul Kompany
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Michel Kabamba
- Expanded Programme for Immunization, Kinshasa, Democratic Republic of the Congo
| | - Placide Mbala-Kingebeni
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Bonnie Dighero-Kemp
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21701
| | - Gregory Kocher
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21701
| | - Elizabeth Elliott
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21701
| | - Cavan Reilly
- Division of Biostatistics, University of Minnesota, Minneapolis, MN 55455
| | - Megan Halbrook
- Department of Epidemiology, University of California, Los Angeles, CA 90095
| | - Benoit Ilunga Kebela
- Division of Disease Control, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | - Adva Gadoth
- Department of Epidemiology, University of California, Los Angeles, CA 90095
| | | | - Merly Tambu
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - David R McIlwain
- Department of Pathology, Stanford University, Stanford, CA 94304
| | - Patrick Mukadi
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Lisa E Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21701
| | - Steve Ahuka-Mundeke
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - George W Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158
- Institute for Global Health Sciences, University of California, San Francisco, CA 94158
| | - Jean Jacques Muyembe-Tamfum
- Department of Epidemiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Anne W Rimoin
- Department of Epidemiology, University of California, Los Angeles, CA 90095;
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26
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Mahon BE, Simon J, Widdowson MA, Samai M, Rogier E, Legardy-Williams J, Liu K, Schiffer J, Lange J, DeByle C, Pinner R, Schuchat A, Slutsker L, Goldstein S. Baseline Asymptomatic Malaria Infection and Immunogenicity of Recombinant Vesicular Stomatitis Virus-Zaire Ebola Virus Envelope Glycoprotein. J Infect Dis 2021; 224:1907-1915. [PMID: 34013349 PMCID: PMC8643414 DOI: 10.1093/infdis/jiab243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of malaria infection on the immunogenicity of the recombinant vesicular stomatitis virus-Zaire Ebola virus envelope glycoprotein (GP) vaccine (rVSVΔG-ZEBOV-GP) (ERVEBO) is unknown. METHODS The Sierra Leone Trial to Introduce a Vaccine Against Ebola (STRIVE) vaccinated 7998 asymptomatic adults with rVSVΔG-ZEBOV-GP during the 2014-2016 Ebola epidemic. In STRIVE's immunogenicity substudy, participants provided blood samples at baseline and at 1, 6, and 9-12 months. Anti-GP binding and neutralizing antibodies were measured using validated assays. Baseline samples were tested for malaria parasites by polymerase chain reaction. RESULTS Overall, 506 participants enrolled in the immunogenicity substudy and had ≥1 postvaccination antibody titer. Of 499 participants with a result, baseline malaria parasitemia was detected in 73 (14.6%). All GP enzyme-linked immunosorbent assay (ELISA) and plaque reduction neutralization test (PRNT) geometric mean titers (GMTs) at 1, 6, and 9-12 months were above baseline, and 94.1% of participants showed seroresponse by GP-ELISA (≥2-fold rise and ≥200 ELISA units/mL), while 81.5% showed seroresponse by PRNT (≥4-fold rise) at ≥1 postvaccination assessment. In participants with baseline malaria parasitemia, the PRNT seroresponse proportion was lower, while PRNT GMTs and GP-ELISA seroresponse and GMTs showed a trend toward lower responses at 6 and 9-12 months. CONCLUSION Asymptomatic adults with or without malaria parasitemia had robust immune responses to rVSVΔG-ZEBOV-GP, persisting for 9-12 months. Responses in those with malaria parasitemia were somewhat lower.
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Affiliation(s)
- Barbara E Mahon
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jakub Simon
- Global Clinical Development–Vaccines, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | | | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kenneth Liu
- Biostatistics, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | - Jarad Schiffer
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Lange
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolynn DeByle
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert Pinner
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne Schuchat
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Susan Goldstein
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Wolf J, Jannat R, Dubey S, Troth S, Onorato MT, Coller BA, Hanson ME, Simon JK. Development of Pandemic Vaccines: ERVEBO Case Study. Vaccines (Basel) 2021; 9:190. [PMID: 33668698 PMCID: PMC7996233 DOI: 10.3390/vaccines9030190] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 12/21/2022] Open
Abstract
Preventative vaccines are considered one of the most cost-effective and efficient means to contain outbreaks and prevent pandemics. However, the requirements to gain licensure and manufacture a vaccine for human use are complex, costly, and time-consuming. The 2013-2016 Ebola virus disease (EVD) outbreak was the largest EVD outbreak to date and the third Public Health Emergency of International Concern in history, so to prevent a pandemic, numerous partners from the public and private sectors combined efforts and resources to develop an investigational Zaire ebolavirus (EBOV) vaccine candidate (rVSVΔG-ZEBOV-GP) as quickly as possible. The rVSVΔG-ZEBOV-GP vaccine was approved as ERVEBOTM by the European Medicines Authority (EMA) and the United States Food and Drug Administration (FDA) in December 2019 after five years of development. This review describes the development program of this EBOV vaccine, summarizes what is known about safety, immunogenicity, and efficacy, describes ongoing work in the program, and highlights learnings applicable to the development of pandemic vaccines.
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Affiliation(s)
- Jayanthi Wolf
- Regulatory Affairs, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Risat Jannat
- Global Vaccines & Biologics Commercialization, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Sheri Dubey
- Pharmacokinetics, Pharmacodynamics & Drug Metabolism, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Sean Troth
- Department of Safety Assessment and Laboratory Animal Resources, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Matthew T. Onorato
- Global Clinical Trial Operations, Vaccines, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Beth-Ann Coller
- Global Clinical Development, Vaccines, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Mary E. Hanson
- Global Scientific & Medical Publications, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
| | - Jakub K. Simon
- Global Clinical Development, Vaccines, Merck & Co. Inc., Kenilworth, NJ 07033, USA;
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28
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Grais RF, Kennedy SB, Mahon BE, Dubey SA, Grant-Klein RJ, Liu K, Hartzel J, Coller BA, Welebob C, Hanson ME, Simon JK. Estimation of the correlates of protection of the rVSVΔG-ZEBOV-GP Zaire ebolavirus vaccine: a post-hoc analysis of data from phase 2/3 clinical trials. LANCET MICROBE 2021; 2:e70-e78. [DOI: 10.1016/s2666-5247(20)30198-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022]
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Nonhuman primate to human immunobridging to infer the protective effect of an Ebola virus vaccine candidate. NPJ Vaccines 2020; 5:112. [PMID: 33335092 PMCID: PMC7747701 DOI: 10.1038/s41541-020-00261-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/13/2020] [Indexed: 01/07/2023] Open
Abstract
It has been proven challenging to conduct traditional efficacy trials for Ebola virus (EBOV) vaccines. In the absence of efficacy data, immunobridging is an approach to infer the likelihood of a vaccine protective effect, by translating vaccine immunogenicity in humans to a protective effect, using the relationship between vaccine immunogenicity and the desired outcome in a suitable animal model. We here propose to infer the protective effect of the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen with an 8-week interval in humans by immunobridging. Immunogenicity and protective efficacy data were obtained for Ad26.ZEBOV and MVA-BN-Filo vaccine regimens using a fully lethal EBOV Kikwit challenge model in cynomolgus monkeys (nonhuman primates [NHP]). The association between EBOV neutralizing antibodies, glycoprotein (GP)-binding antibodies, and GP-reactive T cells and survival in NHP was assessed by logistic regression analysis. Binding antibodies against the EBOV surface GP were identified as the immune parameter with the strongest correlation to survival post EBOV challenge, and used to infer the predicted protective effect of the vaccine in humans using published data from phase I studies. The human vaccine-elicited EBOV GP-binding antibody levels are in a range associated with significant protection against mortality in NHP. Based on this immunobridging analysis, the EBOV GP-specific-binding antibody levels elicited by the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen in humans will likely provide protection against EBOV disease.
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Wolfe DN, Taylor MJ, Zarrabian AG. Lessons learned from Zaire ebolavirus to help address urgent needs for vaccines against Sudan ebolavirus and Marburg virus. Hum Vaccin Immunother 2020; 16:2855-2860. [PMID: 32275465 PMCID: PMC7734060 DOI: 10.1080/21645515.2020.1741313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/07/2020] [Indexed: 02/08/2023] Open
Abstract
The 2014-2016 Ebola virus epidemic in West Africa triggered extensive investments from public and private partners in an attempt to slow the spread of disease and bring the outbreak under control. This significantly accelerated the pace of development of countermeasures against Zaire ebolavirus that enabled vaccines to be a part of an effective response to the most recent 2018-2019 outbreak in the Democratic Republic of the Congo. However, there remain urgent and unmet needs for medical countermeasures against other members of the Filoviridae family that cause viral hemorrhagic fevers. To improve the national and global preparedness posture for viral hemorrhagic fevers, a renewed emphasis is being placed on developing vaccines for filoviruses other than Zaire ebolavirus. Here we discuss lessons learned from the West Africa epidemic and how those lessons apply to the development of vaccine candidates for other filoviruses, specifically Sudan ebolavirus and Marburg virus. This commentary will highlight some of the key product development gaps to address in preparation for future disease outbreaks caused by these viruses.
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Affiliation(s)
- Daniel N. Wolfe
- Division of CBRN Countermeasures, Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | - Marva J. Taylor
- Division of CBRN Countermeasures, Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | - Amanda G. Zarrabian
- Division of CBRN Countermeasures, Biomedical Advanced Research and Development Authority, Washington, DC, USA
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Niemuth NA, Rudge TL, Sankovich KA, Anderson MS, Skomrock ND, Badorrek CS, Sabourin CL. Method feasibility for cross-species testing, qualification, and validation of the Filovirus Animal Nonclinical Group anti-Ebola virus glycoprotein immunoglobulin G enzyme-linked immunosorbent assay for non-human primate serum samples. PLoS One 2020; 15:e0241016. [PMID: 33119638 PMCID: PMC7595334 DOI: 10.1371/journal.pone.0241016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
An anti-Zaire Ebola virus (EBOV) glycoprotein (GP) immunoglobulin G (IgG) enzyme linked immunosorbent assay (ELISA) was developed to quantify the serum levels of anti-EBOV IgG in human and non-human primate (NHP) serum following vaccination and/or exposure to EBOV. This method was validated for testing human serum samples as previously reported. However, for direct immunobridging comparability between humans and NHPs, additional testing was warranted. First, method feasibility experiments were performed to assess cross-species reactivity and parallelism between human and NHP serum samples. During these preliminary assessments, the goat anti-human IgG secondary antibody conjugate used in the previous human validation was found to be favorably cross-reactive with NHP samples when tested at the same concentrations previously used in the validated assay for human sample testing. Further, NHP serum samples diluted in parallel with human serum when tested side-by-side in the ELISA. A subsequent NHP matrix qualification and partial validation in the anti-GP IgG ELISA were performed based on ICH and FDA guidance, to characterize assay performance for NHP test samples and supplement the previous validation for human sample testing. Based on our assessments, the anti-EBOV GP IgG ELISA method is considered suitable for the intended use of testing with both human and NHP serum samples in the same assay for immunobridging purposes.
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Affiliation(s)
- Nancy A. Niemuth
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
- * E-mail:
| | - Thomas L. Rudge
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
| | - Karen A. Sankovich
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
| | - Michael S. Anderson
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
| | - Nicholas D. Skomrock
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
| | - Christopher S. Badorrek
- Contract Support for the 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, Maryland, United States of America
| | - Carol L. Sabourin
- Battelle Biomedical Research Center, West Jefferson, Ohio, United States of America
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Anderson MS, Niemuth NA, Sabourin CL, Badorrek CS, Bounds CE, Rudge TL. Interlaboratory comparison for the Filovirus Animal Nonclinical Group (FANG) anti-Ebola virus glycoprotein immunoglobulin G enzyme-linked immunosorbent assay. PLoS One 2020; 15:e0238196. [PMID: 32841291 PMCID: PMC7447032 DOI: 10.1371/journal.pone.0238196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/11/2020] [Indexed: 01/11/2023] Open
Abstract
The need for an efficacious vaccine against highly pathogenic filoviruses was reinforced by the devastating 2014–2016 outbreak of Ebola virus (EBOV) disease (EVD) in Guinea, Sierra Leone, and Liberia that resulted in over 28,000 cases and over 11,300 deaths. In addition, the 2018–2020 outbreak in the Democratic Republic of the Congo currently has over 3,400 cases and over 2,200 deaths. A fully licensed vaccine and at least one other investigational vaccine are being deployed to combat this EVD outbreak. To support vaccine development and pre-clinical/clinical testing a Filovirus Animal Nonclinical Group (FANG) human anti-EBOV GP IgG ELISA was developed to measure anti-EBOV GP IgG antibodies. This ELISA is currently being used in multiple laboratories. Reported here is a characterization of an interlaboratory statistical analysis of the human anti-EBOV GP IgG ELISA as part of a collaborative study between five participating laboratories. Each laboratory used similar method protocols and reagents to measure anti-EBOV GP IgG levels in human serum samples from a proficiency panel consisting of ten serum samples created by the differential dilution of a serum sample positive for anti-GP IgG antibodies (BMIZAIRE105) with negative serum (BMI529). The total assay variability (inter- and intra-assay variability) %CVs observed at each laboratory ranged from 12.2 to 30.6. Intermediate precision (inter-assay variability) for the laboratory runs ranged from 8.9 to 21.7%CV and repeatability (intra-assay variability) %CVs ranged from 7.2 to 23.7. The estimated slope for the relationship between log10(Target Concentration) and the log10(Observed Concentration) across all five laboratories was 0.95 with a 90% confidence interval of (0.93, 0.97). Equivalence test results showed that the 90% confidence interval for the ratios for the sample-specific mean concentrations at the five individual labs to the overall laboratory consensus value were within the equivalence bounds of 0.80 to 1.25 for each laboratory and test sample, except for six test samples from Lab D, two samples from Lab B1, and one sample from Lab B2. The mean laboratory concentrations for Lab D were less than those from the other laboratories by 20% on average across the serum samples. The evaluation of the proficiency panel at these laboratories provides a limited assessment of assay precision (intermediate precision, repeatability, and total assay variability), dilutional linearity, and accuracy. This evaluation suggests that the within-laboratory performance of the anti-EBOV GP IgG ELISA as implemented at the five laboratories is consistent with the intended use of the assay based on the acceptance criteria used by laboratories that have validated the assay. However, the assessment of between-laboratory performance revealed lower observed concentrations at Lab D and greater variability in assay results at Lab B1 relative to other laboratories.
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Affiliation(s)
| | | | | | - Christopher S. Badorrek
- U.S. Department of Defense (DOD) Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND), Joint Program Manager for Chemical Biological Radiological and Nuclear Medical (JPM-CBRN Medical), Fort Detrick, Maryland, United States of America
| | - Callie E. Bounds
- U.S. Department of Defense (DOD) Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND), Joint Program Manager for Chemical Biological Radiological and Nuclear Medical (JPM-CBRN Medical), Fort Detrick, Maryland, United States of America
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Piszczatoski CR, Gums JG. Ervebo (Ebola Zaire Vaccine, Live/rVSVΔG-ZEBOV-GP): The First Licensed Vaccine for the Prevention of Ebola Virus Disease. J Pharm Technol 2020. [DOI: 10.1177/8755122520950692] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To review the clinical data regarding the safety and efficacy of the Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) vaccine for the prevention of the Ebola virus disease. Data Sources: A literature search through PubMed, MEDLINE, and Cochrane Library was conducted for clinical trials published between January 2014 and June 2020 in the English language using the keywords Ervebo, rVSVΔG-ZEBOV, rVSVΔG-ZEBOV-GP, Ebola Zaire, and vaccine. Study Selection and Data Extraction: Articles were selected if they were related to the Food and Drug Administration (FDA) approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) or provided novel data regarding this entity. Twelve articles noted in the FDA approval were chosen, along with 2 additional articles identified as providing novel information. Data Synthesis: The findings of the review show that Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) is a safe, immunogenic, and likely effective vaccine for the prevention of Ebola virus disease. Relevance to Patient Care and Clinical Practice: Ebola virus disease is highly infectious and often fatal. There have been multiple large outbreaks in the past 5 years, with no licensed treatments or vaccines. An effective vaccine could largely curtail current outbreaks and prevent further ones. Conclusion: The recent FDA approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) offers the first approved vaccine for the prevention of Ebola virus disease. It has been shown to be safe, immunogenic, and likely effective for use in real-world applications for those at risk of contracting the disease.
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Boum Y, Juan-Giner A, Hitchings M, Soumah A, Strecker T, Sadjo M, Cuthbertson H, Hayes P, Tchaton M, Jemmy JP, Clarck C, King D, Faga EM, Becker S, Halis B, Gunnstein N, Carroll M, Røttingen JA, Kondé MK, Doumbia M, Henao-Restrepo AM, Kieny MP, Cisse M, Draguez B, Grais RF. Humoral and cellular immune response induced by rVSVΔG-ZEBOV-GP vaccine among frontline workers during the 2013-2016 West Africa Ebola outbreak in Guinea. Vaccine 2020; 38:4877-4884. [PMID: 32499066 PMCID: PMC7306162 DOI: 10.1016/j.vaccine.2020.04.066] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/26/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND As part of a Phase III trial with the Ebola vaccine rVSVΔG-ZEBOV-GP in Guinea, we invited frontline workers (FLWs) to participate in a sub-study to provide additional information on the immunogenicity of the vaccine. METHODS We conducted an open-label, non-randomized, single-arm immunogenicity evaluation of one dose of rVSVΔG-ZEBOV-GP among healthy FLWs in Guinea. FLWs who refused vaccination were offered to participate as a control group. We followed participants for 84 days with a subset followed-up for 180 days. The primary endpoint was immune response, as measured by ELISA for ZEBOV-glycoprotein-specific antibodies (ELISA-GP) at 28 days. We also conducted neutralization, whole virion ELISA and enzyme-linked immunospot (ELISPOT) assay for cellular response. RESULTS A total of 1172 participants received one dose of vaccine and were followed-up for 84 days, among them 114 participants were followed-up for 180 days. Additionally, 99 participants were included in the control group and followed up for 180 days. Overall, 86.4% (95% CI 84.1-88.4) of vaccinated participants seroresponded at 28 days post-vaccination (ELISA- GP) with 65% of these seroresponding at 14 days post-vaccination. Among those who seroresponded at 28 days, 90.7% (95% CI 82.0-95.4) were still seropositive at 180 days. The proportion of seropositivity in the unvaccinated group was 0.0% (95% CI 0.0-3.8) at 28 days and 5.4% (95% CI 2.1-13.1) at 180 days post-vaccination. We found weak correlation between ELISA-GP and neutralization at baseline but significant pairwise correlation at 28 days post-vaccination. Among samples analysed for cellular response, only 1 (2.2%) exhibited responses towards the Zaire Ebola glycoprotein (Ebola GP ≥ 10) at baseline, 10 (13.5%) at day 28 post-vaccination and 27 (48.2%) at Day 180. CONCLUSIONS We found one dose of rVSVΔG-ZEBOV-GP to be highly immunogenic at 28- and 180-days post vaccination among frontline workers in Guinea. We also found a cellular response that increased with time.
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Affiliation(s)
| | | | - Matt Hitchings
- Center for Communicable Disease Dynamics and Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Thomas Strecker
- Institute of Virology, Philipps University, Marburg, Germany
| | - Mariama Sadjo
- Centre Hospital-Universitaire de Donka, Conakry, Guinea
| | | | - Peter Hayes
- Division of Medicine, Department of Infectious Diseases, Imperial College London, UK
| | | | - Jean-Paul Jemmy
- Médecins Sans Frontières-Operational Center Belgium, Brussels, Belgium
| | - Carolyn Clarck
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Deborah King
- Division of Medicine, Department of Infectious Diseases, Imperial College London, UK
| | | | - Stephan Becker
- Institute of Virology, Philipps University, Marburg, Germany
| | - Bassam Halis
- Public Health England, National Infection Service, Porton Down, UK
| | - Norheim Gunnstein
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Miles Carroll
- Public Health England, National Infection Service, Porton Down, UK
| | - John-Arne Røttingen
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway; Department of Health and Society, University of Oslo, Norway; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA; Coalition for Epidemic Preparedness Innovations, Care of Norwegian Institute of Public Health, Oslo, Norway; Research Council of Norway, Oslo, Norway
| | - Mandy Kader Kondé
- Center of Excellence for Training, Research On Malaria & Priority Diseases In Guinea, Conakry, Guinea
| | | | | | | | - Mohamed Cisse
- Centre Hospital-Universitaire de Donka, Conakry, Guinea
| | - Bertrand Draguez
- Médecins Sans Frontières-Operational Center Belgium, Brussels, Belgium
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Paweska JT, Moolla N, Storm N, Msimang V, Conteh O, Weyer J, Vuren PJV. Evaluation of Diagnostic Performance of Three Indirect Enzyme-Linked Immunosorbent Assays for the Detection of IgG Antibodies to Ebola Virus in Human Sera. Viruses 2019; 11:E678. [PMID: 31344850 PMCID: PMC6722596 DOI: 10.3390/v11080678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 01/02/2023] Open
Abstract
Filovirus serological diagnosis and epidemiological investigations are hampered due to the unavailability of validated immunoassays. Diagnostic performance of three indirect enzyme-linked immunosorbent assays (I-ELISA) was evaluated for the detection of IgG antibody to Ebola virus (EBOV) in human sera. One I-ELISA was based on a whole EBOV antigen (WAg) and two utilized recombinant nucleocapsid (NP) and glycoproteins (GP), respectively. Validation data sets derived from individual sera collected in South Africa (SA), representing an EBOV non-endemic country, and from sera collected during an Ebola disease (EBOD) outbreak in Sierra Leone (SL), were categorized according to the compounded results of the three I-ELISAs and real time reverse-transcription polymerase chain reaction (RT-PCR). At the cut-off values selected at 95% accuracy level by the two-graph receiver operating characteristic analysis, specificity in the SA EBOV negative serum panel (n = 273) ranged from 98.17% (GP ELISA) to 99.27% (WAg ELISA). Diagnostic specificity in the SL EBOV negative panel (n = 676) was 100% by the three ELISAs. The diagnostic sensitivity in 423 RT-PCR confirmed EBOD patients was dependent on the time when the serum was collected after onset of disease. It significantly increased 2 weeks post-onset, reaching 100% sensitivity by WAg and NP and 98.1% by GP I-ELISA.
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Affiliation(s)
- Janusz T Paweska
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa.
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa.
| | - Naazneen Moolla
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa
| | - Nadia Storm
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa
| | - Veerle Msimang
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa
| | - Ousman Conteh
- Ministry of Health and Sanitation, Freetown 47235, Sierra Leone
| | - Jacqueline Weyer
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa
| | - Petrus Jansen van Vuren
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg 2131, South Africa
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