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Nicoli F, Clave E, Wanke K, von Braun A, Bondet V, Alanio C, Douay C, Baque M, Lependu C, Marconi P, Stiasny K, Heinz FX, Muetsch M, Duffy D, Boddaert J, Sauce D, Toubert A, Karrer U, Appay V. Primary immune responses are negatively impacted by persistent herpesvirus infections in older people: results from an observational study on healthy subjects and a vaccination trial on subjects aged more than 70 years old. EBioMedicine 2022; 76:103852. [PMID: 35114631 PMCID: PMC8818547 DOI: 10.1016/j.ebiom.2022.103852] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background Advanced age is accompanied by a decline of immune functions, which may play a role in increased vulnerability to emerging pathogens and low efficacy of primary vaccinations in elderly people. The capacity to mount immune responses against new antigens is particularly affected in this population. However, its precise determinants are not fully understood. We aimed here at establishing the influence of persistent viral infections on the naive T-cell compartment and primary immune responsiveness in older adults. Methods We assessed immunological parameters, related to CD8+ and CD4+ T-cell responsiveness, according to the serological status for common latent herpesviruses in two independent cohorts: 1) healthy individuals aged 19y to 95y (n = 150) and 2) individuals above 70y old enrolled in a primo-vaccination clinical trial (n = 137). Findings We demonstrate a prevalent effect of age and CMV infection on CD8+ and CD4+ naive T cells, respectively. CMV seropositivity was associated with blunted CD4+ T-cell and antibody responses to primary vaccination. Interpretation These data provide insights on the changes in adaptive immunity over time and the associated decline in vaccine efficacy with ageing. This knowledge is important for the management of emerging infectious diseases in elderly populations.
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Affiliation(s)
- Francesco Nicoli
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France; Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara 44121, Italy
| | - Emmanuel Clave
- Université de Paris, Institut de Recherche Saint Louis, EMiLy, Inserm U1160, Paris F-75010, France
| | - Kerstin Wanke
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland
| | - Amrei von Braun
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Vincent Bondet
- Translational Immunology Lab, Institut Pasteur, Université de Paris, Paris, France
| | - Cécile Alanio
- INSERM U932, PSL University, Institut Curie, Paris 75005, France; Laboratoire D'immunologie Clinique, Institut Curie, Paris 75005, France
| | - Corinne Douay
- Université de Paris, Institut de Recherche Saint Louis, EMiLy, Inserm U1160, Paris F-75010, France
| | - Margaux Baque
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France
| | - Claire Lependu
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France
| | - Peggy Marconi
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara 44121, Italy
| | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Austria
| | - Franz X Heinz
- Center for Virology, Medical University of Vienna, Austria
| | - Margot Muetsch
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Darragh Duffy
- Translational Immunology Lab, Institut Pasteur, Université de Paris, Paris, France
| | - Jacques Boddaert
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France
| | - Delphine Sauce
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France
| | - Antoine Toubert
- Université de Paris, Institut de Recherche Saint Louis, EMiLy, Inserm U1160, Paris F-75010, France; Laboratoire d'Immunologie et d'Histocompatibilité, AP-HP, Hopital Saint-Louis, Paris F-75010, France
| | - Urs Karrer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland; Division of Infectious Diseases, Department of Medicine, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
| | - Victor Appay
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM U1135, 75013 Paris, France; Université de Bordeaux, CNRS UMR5164, INSERM ERL1303, ImmunoConcEpT, Bordeaux, France; International Research Center of Medical Sciences, Kumamoto University, Kumamoto, Japan.
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2
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Collins MH, Tu HA, Gimblet-Ochieng C, Liou GJA, Jadi RS, Metz SW, Thomas A, McElvany BD, Davidson E, Doranz BJ, Reyes Y, Bowman NM, Becker-Dreps S, Bucardo F, Lazear HM, Diehl SA, de Silva AM. Human antibody response to Zika targets type-specific quaternary structure epitopes. JCI Insight 2019; 4:124588. [PMID: 30996133 DOI: 10.1172/jci.insight.124588] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/07/2019] [Indexed: 12/22/2022] Open
Abstract
The recent Zika virus (ZIKV) epidemic in the Americas has revealed rare but serious manifestations of infection. ZIKV has emerged in regions endemic for dengue virus (DENV), a closely related mosquito-borne flavivirus. Cross-reactive antibodies confound studies of ZIKV epidemiology and pathogenesis. The immune responses to ZIKV may be different in people, depending on their DENV immune status. Here, we focus on the human B cell and antibody response to ZIKV as a primary flavivirus infection to define the properties of neutralizing and protective antibodies generated in the absence of preexisting immunity to DENV. The plasma antibody and memory B cell response is highly ZIKV type-specific, and ZIKV-neutralizing antibodies mainly target quaternary structure epitopes on the viral envelope. To map viral epitopes targeted by protective antibodies, we isolated 2 type-specific monoclonal antibodies (mAbs) from a ZIKV case. Both mAbs were strongly neutralizing in vitro and protective in vivo. The mAbs recognize distinct epitopes centered on domains I and II of the envelope protein. We also demonstrate that the epitopes of these mAbs define antigenic regions commonly targeted by plasma antibodies in individuals from endemic and nonendemic regions who have recovered from ZIKV infections.
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Affiliation(s)
- Matthew H Collins
- Department of Medicine, Emory University, Atlanta, Georgia, USA, and Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia, USA.,Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Huy A Tu
- Cellular, Molecular, and Biomedical Sciences Program, University of Vermont, Burlington, Vermont, USA.,Vaccine Testing Center, Department of Microbiology and Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Ciara Gimblet-Ochieng
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Guei-Jiun Alice Liou
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ramesh S Jadi
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Stefan W Metz
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ashlie Thomas
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Benjamin D McElvany
- Vaccine Testing Center, Department of Microbiology and Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Edgar Davidson
- Integral Molecular, Inc., Philadelphia, Pennsylvania, USA
| | | | - Yaoska Reyes
- Department of Microbiology, Faculty of Medical Sciences, National Autonomous University of León, Nicaragua
| | - Natalie M Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Sylvia Becker-Dreps
- Departments of Family Medicine and Epidemiology, University of North Carolina at Chapel Hill, Schools of Medicine and Public Health, Chapel Hill, North Carolina, USA
| | - Filemón Bucardo
- Department of Microbiology, Faculty of Medical Sciences, National Autonomous University of León, Nicaragua
| | - Helen M Lazear
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Sean A Diehl
- Cellular, Molecular, and Biomedical Sciences Program, University of Vermont, Burlington, Vermont, USA.,Vaccine Testing Center, Department of Microbiology and Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Aravinda M de Silva
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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3
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Dorko E, Bušová A, Rimárová K, Drabiščák E, Kizek P, Popaďák P, Popaďáková J, Jenčová J, Jenča A, Petrášová A. Effectiveness of primary vaccination against tick-borne encephalitis in employees of the armed forces. Cent Eur J Public Health 2019; 26 Suppl:S42-S46. [PMID: 30817872 DOI: 10.21101/cejph.a5271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 11/15/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of our study is to evaluate immune response after receiving the primary vaccination against tick-borne encephalitis (TBE), and to establish a link between seropositivity and selected factors in soldiers. METHODS Blood samples, questionnaires and vaccination records were obtained. TBE antibodies were detected using both ELISA and a neutralization test (NT). We used logistic regression for statistical analysis. RESULTS Overall, seropositivity (presence of IgG) was detected in 88% of participants. The proportion of seropositive subjects in relation to the number of doses of vaccine was 69% (2 doses) and 91% (3 doses). A statistically significant relationship was found between seropositivity and the number of vaccine doses. No statistical significance was identified in relation to age and sex. There was no statistical significance of seropositivity, depending on the time of the last dose of the vaccine. CONCLUSIONS TBE immunisation should be targeted at individuals in the most affected locations and those at highest risk of exposure according to lifestyle and occupation.
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Affiliation(s)
- Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Andrea Bušová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Erik Drabiščák
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Peter Kizek
- 1st Department of Stomatology, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic
| | - Peter Popaďák
- Department of Forensic Medicine and Pathological Anatomy, Health Care Surveillance Authority, Kosice, Slovak Republic
| | - Jana Popaďáková
- Department of Neurology, Hospital Vranov nad Toplou, Vranov nad Toplou, Slovak Republic
| | - Janka Jenčová
- Department of Stomatology and Maxilofacial Surgery, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic
| | - Andrej Jenča
- Department of Stomatology and Maxilofacial Surgery, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic
| | - Adriána Petrášová
- Department of Stomatology and Maxilofacial Surgery, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic
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Tick-borne encephalitis (TBE) in children in Europe: Epidemiology, clinical outcome and comparison of vaccination recommendations. Ticks Tick Borne Dis 2019; 10:100-110. [DOI: 10.1016/j.ttbdis.2018.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/02/2018] [Accepted: 08/04/2018] [Indexed: 12/21/2022]
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5
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Beran J, Lattanzi M, Xie F, Moraschini L, Galgani I. Second five-year follow-up after a booster vaccination against tick-borne encephalitis following different primary vaccination schedules demonstrates at least 10 years antibody persistence. Vaccine 2018; 37:4623-4629. [PMID: 29397225 DOI: 10.1016/j.vaccine.2017.12.081] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Tick borne encephalitis (TBE) endemic zones are expanding. We previously evaluated long term persistence of antibody 5 years after the first booster immunization following different primary immunization schedules with the polygeline-free inactivated TBE vaccine (TBEvac) in adults and adolescents. Here, we report anti-TBE virus (TBEV) antibody persistence from 6 to 10 years post-booster administration. METHODS This was a phase IV, open-label, single-center, second extension study (NCT01562444), conducted in Czechia. Healthy adults and adolescents ≥12 years who had received 3 different primary vaccination schedules (rapid, conventional and accelerated conventional) in the parent study and a booster dose before (12-18 months post-primary series completion) or at the beginning (3 years post-primary series completion) of the first extension study were screened and enrolled in this study. Blood samples were collected yearly and anti-TBEV antibody response was evaluated by neutralizing test (NT) antibody assays. Analysis was performed overall and per age strata: 15-49 years, ≥50 years, and ≥60 years. RESULTS Of 206 screened individuals, 191 completed the study. Overall, 90-100% of participants in the all-screened set and ≥97% in the per-protocol set had the clinically meaningful threshold of protection (NT titers ≥10) across all timepoints, regardless of the primary vaccination schedule. Overall, antibody geometric mean titers (GMTs) varied from 134 to 343 in the all-screened set. Older age groups showed overall lower GMTs, although GMTs remained higher than NT titers ≥10 up to year 10 in all groups. CONCLUSION This study showed long-term persistence of anti-TBEV NT antibodies for up to 10 years after the first booster dose of TBEvac in all age groups, regardless of the primary vaccination schedule.
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Affiliation(s)
- Jiri Beran
- Vaccination and Travel Medicine Centre, Tylovo nábřeží 418/6, 500 02 Hradec Králové, Czech Republic; Department for Tropical, Travel Medicine and Immunization, Institute for Postgraduate Medical Education in Prague, Ruská 2412/85, 100 00 Prague 10, Czech Republic.
| | | | - Fang Xie
- GSK Vaccines, 14200 Shady Grove Rd, Rockville, MD 20850, USA.
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6
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Galgani I, Bunge EM, Hendriks L, Schludermann C, Marano C, De Moerlooze L. Systematic literature review comparing rapid 3-dose administration of the GSK tick-borne encephalitis vaccine with other primary immunization schedules. Expert Rev Vaccines 2017; 16:919-932. [DOI: 10.1080/14760584.2017.1358620] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Eveline M. Bunge
- Pallas Health research and consultancy, Rotterdam, The Netherlands
| | - Lisa Hendriks
- Pallas Health research and consultancy, Rotterdam, The Netherlands
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7
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Collins MH, Metz SW. Progress and Works in Progress: Update on Flavivirus Vaccine Development. Clin Ther 2017; 39:1519-1536. [PMID: 28754189 DOI: 10.1016/j.clinthera.2017.07.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 12/30/2022]
Abstract
Most areas of the globe are endemic for at least one flavivirus, putting billions at risk for infection. This diverse group of viral pathogens causes a range of manifestations in humans from asymptomatic infection to hemorrhagic fever to encephalitis to birth defects and even death. Many flaviviruses are transmitted by mosquitos and have expanded in geographic distribution in recent years, with dengue virus being the most prevalent, infecting approximately 400 million people each year. The explosive emergence of Zika virus in Latin America in 2014 refocused international attention on this medically important group of viruses. Meanwhile, yellow fever has caused major outbreaks in Africa and South America since 2015 despite a reliable vaccine. There is no vaccine for Zika yet, and the only licensed dengue vaccine performs suboptimally in certain contexts. Further lessons are found when considering the experience with Japanese encephalitis virus, West Nile virus, and tickborne encephalitis virus, all of which now have protective vaccination in human or veterinary populations. Thus, vaccination is a mainstay of public health strategy for combating flavivirus infections; however, numerous challenges exist along the path from development to delivery of a tolerable and effective vaccine. Nevertheless, intensification of investment and effort in this area holds great promise for significantly reducing the global burden of disease attributable to flavivirus infection.
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Affiliation(s)
- Matthew H Collins
- Department of Medicine, Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina.
| | - Stefan W Metz
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina
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8
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Pereira RC, Silva ANMR, Souza MCO, Silva MV, Neves PPCC, Silva AAMV, Matos DDCS, Herrera MAO, Yamamura AMY, Freire MS, Gaspar LP, Caride E. An inactivated yellow fever 17DD vaccine cultivated in Vero cell cultures. Vaccine 2015; 33:4261-8. [PMID: 25862300 DOI: 10.1016/j.vaccine.2015.03.077] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 03/10/2015] [Accepted: 03/24/2015] [Indexed: 02/03/2023]
Abstract
Yellow fever is an acute infectious disease caused by prototype virus of the genus Flavivirus. It is endemic in Africa and South America where it represents a serious public health problem causing epidemics of hemorrhagic fever with mortality rates ranging from 20% to 50%. There is no available antiviral therapy and vaccination is the primary method of disease control. Although the attenuated vaccines for yellow fever show safety and efficacy it became necessary to develop a new yellow fever vaccine due to the occurrence of rare serious adverse events, which include visceral and neurotropic diseases. The new inactivated vaccine should be safer and effective as the existing attenuated one. In the present study, the immunogenicity of an inactivated 17DD vaccine in C57BL/6 mice was evaluated. The yellow fever virus was produced by cultivation of Vero cells in bioreactors, inactivated with β-propiolactone, and adsorbed to aluminum hydroxide (alum). Mice were inoculated with inactivated 17DD vaccine containing alum adjuvant and followed by intracerebral challenge with 17DD virus. The results showed that animals receiving 3 doses of the inactivated vaccine (2 μg/dose) with alum adjuvant had neutralizing antibody titers above the cut-off of PRNT50 (Plaque Reduction Neutralization Test). In addition, animals immunized with inactivated vaccine showed survival rate of 100% after the challenge as well as animals immunized with commercial attenuated 17DD vaccine.
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Affiliation(s)
- Renata C Pereira
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Andrea N M R Silva
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Marta Cristina O Souza
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Marlon V Silva
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Patrícia P C C Neves
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Andrea A M V Silva
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Denise D C S Matos
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Miguel A O Herrera
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Anna M Y Yamamura
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Marcos S Freire
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Luciane P Gaspar
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil.
| | - Elena Caride
- Oswaldo Cruz Foundation (FIOCRUZ), Bio-Manguinhos, Avenida Brasil 4365, 21045-900, Rio de Janeiro, RJ, Brazil
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Šmit R, Postma MJ. Review of tick-borne encephalitis and vaccines: clinical and economical aspects. Expert Rev Vaccines 2014; 14:737-47. [DOI: 10.1586/14760584.2015.985661] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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10
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Abstract
Two tick-borne encephalitis vaccines produced by two vaccine manufacturers are available in most European countries. A question that is frequently asked regarding these two vaccines concerns their exchangeability, however, to date, no detailed assessment has been published. This review analyzes clinical studies investigating these two vaccines and describes possible approaches to boost or continue uncompleted primary immunization schedules, with either of the two tick-borne encephalitis vaccines.
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Affiliation(s)
- Michael Bröker
- Novartis Vaccines, Clinical Research and Medical Affairs, Post Box 1630, 35006 Marburg, Germany.
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11
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12
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Abstract
Vaccines to protect against tick-borne encephalitis (TBE) are produced by two manufacturers and are widely used in European and Asian countries, where TBE virus is endemic. General trends in vaccine development during recent decades and extensive postmarketing experience resulted in several modifications to their formulations and practical implications for use. Modifications were made to the production process, such as the change of the virus master bank from mouse brain to primary cells; to the excipients, especially the stabilizers and preservative; and to include formulations for children. Additionally, a rapid vaccination schedule has been developed for persons who require a fast onset of protection. Recent data from clinical studies and postmarketing surveillance indicate that both vaccines are safe, efficacious and interchangeable. Further (major) changes to formulation or alternative targets for vaccine development are not anticipated in the next 5 years. Recent serologic studies indicate that the persistence of protective immunity was longer than expected. Thus, recommendations for prolongation of TBE booster intervals have been made in several European countries, and a harmonization for booster recommendations is predicted within the European Union. Based on epidemiologic trends, the use of TBE vaccines will continue to increase in all age groups, including children.
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Affiliation(s)
- Olaf Zent
- Chiron Vaccines, Clinical Research and Medical Affairs, Chiron Behring GmbH & Co KG, Emil-von-Behring Str. 76, 35041 Marburg, Germany.
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14
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Kollaritsch H, Paulke-Korinek M, Holzmann H, Hombach J, Bjorvatn B, Barrett A. Vaccines and vaccination against tick-borne encephalitis. Expert Rev Vaccines 2013; 11:1103-19. [PMID: 23151167 DOI: 10.1586/erv.12.86] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Tick-borne encephalitis (TBE) is an emerging viral zoonosis and is endemic from Japan, China, Mongolia and Russia, to Central Europe and France. There is no specific treatment and TBE can be fatal. The four licensed prophylactic vaccines are produced according to WHO manufacturing requirements. Large clinical trials and postmarketing surveillance demonstrated safety and efficacy of the two European vaccines. The two Russian vaccines showed their effectiveness in daily use, but limited published data are available on controlled clinical trials. Vaccination recommendations in endemic areas vary significantly. In some countries, public vaccination programs are implemented. The WHO has recently issued recommendations on evidence-based use of TBE vaccines. However, more data are needed regarding safety, efficacy and long-term protection after vaccination.
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Affiliation(s)
- Herwig Kollaritsch
- Department of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria
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15
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Petri E, Gniel D, Zent O. Tick-borne encephalitis (TBE) trends in epidemiology and current and future management. Travel Med Infect Dis 2010; 8:233-45. [DOI: 10.1016/j.tmaid.2010.08.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 08/09/2010] [Indexed: 12/30/2022]
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Monath TP, Lee CK, Julander JG, Brown A, Beasley DW, Watts DM, Hayman E, Guertin P, Makowiecki J, Crowell J, Levesque P, Bowick GC, Morin M, Fowler E, Trent DW. Inactivated yellow fever 17D vaccine: development and nonclinical safety, immunogenicity and protective activity. Vaccine 2010; 28:3827-40. [PMID: 20347059 DOI: 10.1016/j.vaccine.2010.03.023] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 03/08/2010] [Accepted: 03/10/2010] [Indexed: 11/19/2022]
Abstract
In the last 10 years new concerns have arisen about safety of the live, attenuated yellow fever (YF) 17D vaccine, in particular viscerotropic adverse events, which have a case-fatality rate of 64%. A non-replicating cell culture-based vaccine would not cause these adverse events, and potentially could be used in persons with precautions or contraindications to use of the live vaccine, including age <9 months and >60 years, egg allergy, immune suppression, and pregnancy. We developed a whole virion vaccine from the 17D strain inactivated with beta-propiolactone, and adsorbed to aluminum hydroxide. The inactivated vaccine was highly immunogenic in mice, hamsters, and cynomolgus macaques. After a single dose in hamsters and macaques, neutralizing antibody titers were similar to those elicited by the live 17D vaccine (YF-VAX, Sanofi Pasteur). After two doses of inactivated vaccine, neutralizing antibody titers in hamsters were significantly higher than after a single dose of YF-VAX [geometric mean titer (GMT) 20,480 vs. 1940, respectively (P<0.001, ANOVA)]. Hamsters given a single dose or two doses of inactivated vaccine or a single dose of YF-VAX were fully protected against hepatitis, viremia, weight loss and death after challenge with YF virus (Jimenez strain). A clinical trial of the inactivated vaccine (XRX-001) has been initiated.
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Affiliation(s)
- Thomas P Monath
- Kleiner Perkins Caufield & Byers, 2750 Sand Hill Road, Menlo Park, CA 94025, USA.
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Long-term persistence of tick-borne encephalitis antibodies in adults 5 years after booster vaccination with Encepur® Adults. Vaccine 2009; 27:853-6. [DOI: 10.1016/j.vaccine.2008.11.082] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 11/18/2008] [Accepted: 11/22/2008] [Indexed: 12/30/2022]
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19
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Protection against tick-borne encephalitis (TBE) for people living in and travelling to TBE-endemic areas. Travel Med Infect Dis 2008; 6:331-41. [PMID: 18984477 DOI: 10.1016/j.tmaid.2008.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 06/04/2008] [Indexed: 12/30/2022]
Abstract
Once considered a local health issue confined to certain regions in Russia and Central and Eastern Europe, tick-borne encephalitis (TBE) is now considered an international health concern, and the most important and widespread viral disease transmitted by ticks in Europe. The number of reported TBE cases continues to increase in many endemic regions, and new foci have been identified. Increases in travel, access to high-risk areas, and the pursuit of leisure activities within TBE-endemic areas are placing more people at risk of TBE. Travellers from non-endemic regions are often unaware of the risk of acquiring TBE and therefore many travellers are not protected against TBE. Active immunization is the most effective way to avoid TBE and its potentially life-threatening sequelae. After a tick bite, no post-exposure treatment including active/passive vaccination is available or recommended in the immunologically naive patient. Available vaccines have undergone a series of modifications and improvement in both composition (with special formulations for children) and schedules to further enhance the safety of immunization and to meet the needs of vaccinees. Efforts to develop internationally recognized recommendations for TBE vaccination for travellers are underway.
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Tick-borne encephalitis virus vaccines. Vaccines (Basel) 2008. [DOI: 10.1016/b978-1-4160-3611-1.50036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Heinz FX, Holzmann H, Essl A, Kundi M. Field effectiveness of vaccination against tick-borne encephalitis. Vaccine 2007; 25:7559-67. [PMID: 17869389 DOI: 10.1016/j.vaccine.2007.08.024] [Citation(s) in RCA: 193] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 08/08/2007] [Accepted: 08/13/2007] [Indexed: 11/16/2022]
Abstract
Tick-borne encephalitis (TBE) is a vaccine-preventable disease caused by a flavivirus (TBE virus) that is endemic in many European countries and large parts of Central and Eastern Asia. In Europe, highly purified formalin-inactivated whole virus vaccines are in widespread use, but the vaccination coverage differs significantly between countries with TBE endemicity. Austria presents an exceptional situation because 88% of the total population have a history of TBE vaccination, with 58% being regularly vaccinated within the recommended schedule. In this study, we investigated the field effectiveness of TBE vaccination in Austria for the years 2000-2006 in different age groups on the basis of the documented numbers of hospitalized cases in unvaccinated and vaccinated people and the sizes of these population groups as revealed by representative inquiries. We show that the overall effectiveness in regularly vaccinated persons is about 99% with no statistically significant difference between age groups. It is at least as high after the first two vaccinations, i.e. before the completion of the basic vaccination scheme by a third vaccination, but is significantly lower (about 95%) in those with a record of irregular vaccination. Our data confirm the excellent performance of TBE vaccine under field conditions and provide evidence that, in Austria, about 2800 cases were prevented by vaccination in the years 2000-2006.
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Affiliation(s)
- Franz X Heinz
- Institute of Virology, Medical University of Vienna, Kinderspitalgasse 15, AT-1095 Vienna, Austria.
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Rendi-Wagner P, Zent O, Jilg W, Plentz A, Beran J, Kollaritsch H. Persistence of antibodies after vaccination against tick-borne encephalitis. Int J Med Microbiol 2006; 296 Suppl 40:202-7. [PMID: 16524776 DOI: 10.1016/j.ijmm.2006.01.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Active vaccination against the tick-borne encephalitis (TBE) virus has successfully been implemented in endemic countries for many years. However, little was known about persistency of antibodies after completion of the primary vaccination and/or TBE booster immunization. Five recently performed serological follow-up studies in adults have now revealed that the persistence of protective immunity following at least one booster immunization was longer than expected. Notably, studies which analyzed different age groups indicate differences between younger adults aged 18-49 years and older adults aged > or = 50 years with respect to TBE antibody persistence and the immune response following a subsequent booster dose. To summarize, the serological studies included in this analysis generally support a reconsideration of current TBE booster recommendations and a prolongation of booster intervals at least in younger adults.
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Affiliation(s)
- Pamela Rendi-Wagner
- Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Austria
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Schöndorf I, Schönfeld C, Nicolay U, Zent O, Banzhoff A. Response to tick-borne encephalitis (TBE) booster vaccination after prolonged time intervals to primary immunization with the rapid schedule. Int J Med Microbiol 2006; 296 Suppl 40:208-12. [PMID: 16531118 DOI: 10.1016/j.ijmm.2006.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Tick-borne encephalitis can be prevented by active immunization, for which different schedules and booster recommendations exist. However, recommended booster intervals are often exceeded. In the present study, 178 adults aged 18-81 years received the first booster dose 2-11 years after primary immunization (instead of 12-18 months as recommended) according to the rapid schedule (vaccination on days 0, 7, and 21). The booster dose was well tolerated. All subjects showed a typical anamnestic response with an 11-fold increase in the geometric mean titre as measured both by neutralization test and ELISA.
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Affiliation(s)
- Ines Schöndorf
- Chiron Vaccines, Emil-von-Behring-Str. 76, D-35041 Marburg, Germany.
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