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Tong Y, Zhang X, Chen J, Chen W, Wang Z, Li Q, Duan K, Wei S, Yang B, Qian X, Li J, Hang L, Deng S, Li X, Guo C, Shen H, Liu Y, Deng P, Xie T, Li Q, Li L, Du H, Mao Q, Gao F, Lu W, Guan X, Huang J, Li X, Chen X. Immunogenicity and safety of an enterovirus 71 vaccine in children aged 36-71 months: A double-blind, randomised, similar vaccine-controlled, non-inferiority phase III trial. EClinicalMedicine 2022; 52:101596. [PMID: 35923425 PMCID: PMC9340505 DOI: 10.1016/j.eclinm.2022.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The enterovirus 71 (EV71) vaccine produced by Wuhan Institute of Biological Products Co., Ltd. (WIBP) (B-EV71) has been given to children aged 6-35 months, and it has shown good safety, immunogenicity and efficacy. However, the administration of EV71 vaccine in children aged 36-71 months, which is another target population, needs further exploration. METHODS We conducted a double-blind, randomised, controlled, non-inferiority phase III clinical trial in children aged 36-71 months, with a further comparison group of children aged 6-35 months in China. Children aged 6-71 months with no history of hand, foot and mouth disease or prior-vaccination of EV71 vaccine were eligible and recruited. Eligible participants aged 36-71 months were randomly assigned (1:1) to receive two doses of the B-EV71 vaccine (Older-B group) or the control EV71 vaccine (C-EV71 vaccine, produced by Institute of Medical Biology, Chinese Academy of Medical Sciences) (Older-C group), administered at a 30-day interval. Eligible participants aged 6-35 months were enrolled consecutively to receive two doses of the B-EV71 vaccine (Younger-B group) at a 30-day interval. Participants, investigators and those assessing outcomes were masked to the vaccine received. Non-inferiority analyses were conducted to compare the immunogenicity of EV71 vaccine in the Older-B group with that in the Older-C and Younger-B groups. Non-inferiority margins were 10% for seroconversion rate differences and 0.5 for geometric mean titre (GMT) ratios. The primary endpoints were the GMT level and seroconversion rate of anti-EV71 neutralising antibody 30 days after the second dose of vaccination. The primary analysis was performed in the per-protocol population. Safety analyses were conducted amongst participants receiving at least one dose of vaccine. This trial was registered at Chinadrugtrials.org.cn (#CTR20192345). FINDINGS Between June 3 and June 30, 2020, 1600 participants were enrolled and assigned, including 625 participants in the Older-B group, 625 participants in the Older-C group and 350 participants in the Younger-B group. The seroconversion rate of anti-EV71 neutralising antibody in the Older-B group (99.66%; 95% CI: 99.18%-100.00%) was non-inferior to that of the Older-C (99.32%; 95% CI: 98.65%-99.98%) and Younger-B groups (100.00%; 95% CI: 100.00%-100.00%). The differences in seroconversion rates in the Older-B group to those in the Older-C and Younger-B groups were 0.34% (95%CI: -2.17%-2.86%) and -0.34% (95%CI: -2.78%-2.09%). The GMT of the anti-EV71 neutralising antibody in the Older-B group (693.87) was also non-inferior to that in the Older-C (289.37) and Younger-B groups (634.80). The ratios of GMTs in the Older-B group to those in the Older-C and Younger-B groups were 2.67 (95%CI: 2.00-3.00) and 1.00 (95%CI: 0.75-1.00), respectively. The incidence of any adverse event (AE) related to vaccination was similar amongst the three groups (34/625 [5.44%] in the Older-B group, 32/623 [5.14%] in the Older-C group, and 26/349 [7.45%] in the Younger-B group), with only 2 (0.57%) participants having grade 3 AEs in the Younger-B group. Fifteen (0.94%) participants from these three groups had reported serious AEs (SAEs), all of which were unrelated to vaccines. INTERPRETATION EV71 vaccine produced by WIBP could extend to be administered to children aged 36-71 months against EV71 infection. However, the persistence of vaccine-induced immunities needs to be further investigated. FUNDING Hubei Province's young medical talent program (20191229), Hubei Province's young talent program (2021), Hubei Province's young public health talent program (2021); and the Wuhan Institute of Biological Products Co., Ltd.
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Affiliation(s)
- Yeqing Tong
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Xinyue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhua Chen
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Wei Chen
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Zhao Wang
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Qiong Li
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Kai Duan
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Beifang Yang
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Xiaoai Qian
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Jiahong Li
- Xiangzhou District Centre for Disease Control and Prevention, Wuhan, China
| | - Lianju Hang
- Xiangzhou District Centre for Disease Control and Prevention, Wuhan, China
| | - Shaoyong Deng
- Xiangzhou District Centre for Disease Control and Prevention, Wuhan, China
| | - Xinguo Li
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Changfu Guo
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Heng Shen
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Yan Liu
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Peng Deng
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
| | - Tingbo Xie
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Qingliang Li
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Li Li
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Hongqiao Du
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
| | - Qunying Mao
- National Institutes for Food and Drug Control, Beijing, China
| | - Fan Gao
- National Institutes for Food and Drug Control, Beijing, China
| | - Weiwei Lu
- National Vaccine &Serum Institute, Beijing, China
| | - Xuhua Guan
- Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China
- Corresponding authors.
| | - Jiao Huang
- Centre for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Corresponding authors.
| | - Xiuling Li
- Shanghai Institute of Biological Products Co., Ltd, Shanghai, China
- Corresponding authors.
| | - Xiaoqi Chen
- Wuhan Institute of Biological Products Co., Ltd, Wuhan, China
- Corresponding authors.
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Hong J, Liu F, Qi H, Tu W, Ward MP, Ren M, Zhao Z, Su Q, Huang J, Chen X, Le J, Ren X, Hu Y, Cowling B, Li Z, Chang Z, Zhang Z. Changing epidemiology of hand, foot, and mouth disease in China, 2013-2019: a population-based study. Lancet Reg Health West Pac 2022; 20:100370. [PMID: 35036978 DOI: 10.1016/j.lanwpc.2021.100370] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Hand, foot, and mouth disease (HFMD) is an important public health problem. A monovalent EV-A71 vaccine was launched in China in 2016. Previous studies showed that inactivated monovalent EV-A71 vaccines were highly efficient against HFMD associated with EV-A71 but not against HFMD with other etiologies, leading to a hypothesis that the introduction of EV-A71 vaccines might change the pathogen spectrum and epidemiological trend of HFMD. In this study, we described for the first time the changing epidemiological characteristics of HFMD after the launch of the EV-A71 vaccine. Methods We extracted individual-based epidemiological data on HFMD cases reported to the Chinese Center for Disease Control and Prevention between January 2013 and December 2019. We described the changing epidemiological characteristics of HFMD before and after vaccine launch according to the distribution of diseases characteristics (demographic, temporal, and geographical) and evaluated the potential changes in risk factors of severe patients. All analyses were stratified by the phase before and after vaccine launch, and by enterovirus serotype. Findings During 2013-2019, 15,316,710 probable cases of HFMD were reported. Of these, 787,197 (5·1%) were laboratory confirmed and 76,982 (0·5%) were severe. After the launch of the EV-A71 vaccine, the median age of HFMD patients infected with EV-A71 increased from 2·24 years (IQR:1·43, 3·56) to 2·81 years (IQR:1·58, 4·01). The proportion of patients less than 3 years of age decreased while the proportion of patients 3-5 years of age increased. There was a large decrease (60·7%) in the proportion of severe cases as well as a decline (28·3%) in HFMD patients infected with EV-A71. After the launch of the EV-A71 vaccine, the severe illness rate and mortality rate of HFMD patients in all age groups has decreased sharply, 62·20% and 83·78% respectively. The timing of the HFMD epidemic peak was delayed (1-2 months) . After the launch of EV-A71 vaccine, the risk of becoming a severe case for EV-A71 serotype was decreased, whereas that risk was instead increased for CV-A16 (from 0·17 (95% CI:0·16, 0·18) to 0·23 (95% CI:0·21, 0·25)) and other enterovirus compared to EV-A71 (from 0·38 (95% CI:0·37, 0·39) to 0·58 (95% CI:0·56, 0·61)). The longer the time from onset to diagnosis, the higher was the risk of being a severe case, but the effect size was decreased. Interpretation The introduction of the EV-A71 vaccine has effectively reduced the proportion of severe HFMD cases and mortality, but changes to the dominant serotypes should be closely monitored. Development of multivalent vaccines to avoid an increased case burden due to other enteroviruses is greatly needed. Funding This research was supported by the National Natural Science Foundation of China (81973102, 81773487), Public Health Talents Training Program of Shanghai Municipality (GWV-10.2-XD21), the 5th Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System (GWV-10.1-XK05), the Major Project of Scientific and Technical Winter Olympics from National Key Research and Development Program of China (2021YFF0306000), 13th Five-Year National Science and Technology Major Project for Infectious Diseases (2018ZX10725-509) and Key projects of the PLA logistics Scientific research Program (BHJ17J013).
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Jiang L, Jiang H, Tian X, Xia X, Huang T. Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008-2019. BMC Infect Dis 2021; 21:751. [PMID: 34348655 PMCID: PMC8336324 DOI: 10.1186/s12879-021-06462-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/25/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. METHODS Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. RESULTS A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. CONCLUSIONS Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.
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Affiliation(s)
- Li Jiang
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Hongchao Jiang
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Xin Tian
- Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China
| | - Xueshan Xia
- Kunming University of Science and Technology, Kunming, Yunnan, People's Republic of China
| | - Tian Huang
- Yunnan Provincial Center for Disease Control and Prevention, 158 Dongsi Street, Kunming, Yunnan, 650022, People's Republic of China.
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Gao J, Tang F, Wang Z, Yu J, Hu R, Liu L, Kang G. Post-marketing safety surveillance for inactivated Enterovirus 71 vaccines in Jiangsu, China from 2017 to 2019. Vaccine 2021; 39:1415-1419. [PMID: 33541795 DOI: 10.1016/j.vaccine.2021.01.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/05/2021] [Accepted: 01/16/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Two types of enterovirus 71 (EV71) vaccines, manufactured using human diploid (H2) and Vero cells, have been administered in Jiangsu Province, China since 2017. In this study, we evaluated their safety profiles using records collected from the Chinese National Adverse Events Following Immunization (AEFIs) Information System (CNAEFIS) and Electronic Immunization Registries System (EIRS) between 2017 and 2019. METHODS Demographic characteristics of the patients, AEFI incidence rates(IRs), symptoms, and time intervals were summarized from the reported AEFI data in the CNAEFIS. Also, the administered doses of the two vaccines were exported from the EIRS to calculate the IRs of AEFIs and thus compare the AEFIs between the two types of EV71 vaccines. RESULTS In total, 209, 407, and 344 AEFIs cases following EV71 vaccine administration were reported during 2017, 2018, and 2019, respectively, yielding IRs of 59.2, 48.2, and 54.2 per 100,000 doses, respectively. Fever, irritability, allergic eruptions, fatigue, loss of appetite, redness and induration at the injection site were the most commonly reported AEFIs. No significant differences in rare reactions were found between the two types of EV71 vaccinations. The majority of AEFIs were developed within 30 min to 3 days after administration. CONCLUSION EV71 vaccines showed satisfactory safety profiles since their first use 3 years ago in the Jiangsu Province. The AEFI profiles were identical to those in pre-marketing studies; most AEFIs after vaccination were mild and common. More active surveillance studies should be performed to provide more comprehensive post-marketing safety data.
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Affiliation(s)
- Jun Gao
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Fenyang Tang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Zhiguo Wang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Jing Yu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Ran Hu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Li Liu
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China
| | - Guodong Kang
- Jiangsu Provincial Centre of Disease Control and Prevention, Jiangsu Province, China.
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Wang Y, Meng F, Li J, Li G, Hu J, Cao J, Yu Q, Liang Q, Zhu F. Willingness of parents to vaccinate their 6-60-month-old children with EV71 vaccines: a cross-sectional study in rural areas of northern Jiangsu Province. Hum Vaccin Immunother 2020; 16:1579-1585. [PMID: 32209003 DOI: 10.1080/21645515.2020.1737465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Enterovirus 71 (EV71) is the dominant pathogen in severe and fatal hand-foot-mouth disease (HFMD) cases. Since 2015, three inactivated EV71 vaccines have been approved in China. The vaccination coverage of the EV71 vaccine has been relatively low, especially in rural areas. A cross-sectional survey from July 19 to August 22, 2018, was conducted in three rural counties of northern Jiangsu Province among parents of children aged 6-60 months. We adopted a pretested validated questionnaire to assess knowledge, awareness, and attitude of HFMD and EV71 vaccines among respondents and used univariate and multivariate binary logistic analyses to explore potential factors associated with the acceptance of EV71 vaccines. Of the 1,112 parents who participated, 87.8% were willing to vaccinate their children with EV71 vaccines. Parents over 40 y old were less likely to have their children vaccinated [adjusted odds ratio (aOR) = 2.12, 95% confidence interval (CI): 1.13-3.97]. Parents who lived in Ganyu (aOR = 0.50, 95% CI: 0.31-0.79) or Xinyi county (aOR = 0.33, 95% CI: 0.20-0.53), had a university or higher degree (aOR = 0.26, 95% CI: 0.11-0.64), had good knowledge of EV71 vaccines (aOR = 0.81, 95% CI: 0.67-0.98), perceived their children's disease susceptibility, and worried about the severity of HFMD had a higher willingness to vaccinate their children. Most parents were willing to vaccinate their children against EV71-related HFMD. Parental age, location, education level, knowledge of EV71 vaccines, concern about susceptibility, and severity of HFMD were all factors that influenced willingness to vaccinate.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health, Nanjing Medical University , Nanjing, PR China
| | - Fanyu Meng
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Guifan Li
- Department of Registration, Beijing Minhai Biotechnology Co. Ltd ., Beijing, PR China
| | - Jialei Hu
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Jiaqian Cao
- School of Public Health, Nanjing Medical University , Nanjing, PR China
| | - Qiufan Yu
- School of Public Health, Southeast University , Nanjing, PR China
| | - Qi Liang
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China
| | - Fengcai Zhu
- School of Public Health, Nanjing Medical University , Nanjing, PR China.,Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, PR China.,Center for Global Health, Nanjing Medical University , Nanjing, PR China
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Tambyah PA, Oon J, Asli R, Kristanto W, Hwa SH, Vang F, Karwal L, Fuchs J, Santangelo JD, Gordon GS, Thomson C, Rao R, Dean H, Das SC, Stinchcomb DT. An inactivated enterovirus 71 vaccine is safe and immunogenic in healthy adults: A phase I, double blind, randomized, placebo-controlled, study of two dosages. Vaccine 2019; 37:4344-4353. [PMID: 31230881 DOI: 10.1016/j.vaccine.2019.06.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD), especially that caused by enterovirus 71 (EV71) infection, is a public health concern in the Asia-Pacific region. We report a phase I clinical trial of an EV71 candidate vaccine (INV21) based on a binary ethylenimine inactivated B2 sub-genotype formulated with aluminum hydroxide. METHODS In this double-blind, placebo-controlled, randomized, dose escalation study adult volunteers received two vaccinations 28 days apart of low or high dose formulations of the candidate vaccine and were then monitored for safety and reactogenicity for four weeks after each dose, and for their immune responses up to 28 weeks. RESULTS Of 36 adults enrolled, 35 completed the study as planned. Either no or mild adverse events were observed, mainly injection site pain and tiredness. Seroconversion was 100% after two vaccinations. High geometric mean neutralizing antibody titers (GMT) were observed 14 days post first dose, peaking 14 days post second dose (at Day 42) in both high and low dose groups; GMTs on days 14, 28, 42, and 56 were 128, 81, 323, 203 and 144, 100, 451, 351 in low- and high-dose groups, respectively. Titers for both doses declined gradually to Day 196 but remained higher than baseline and the placebo groups, which had low GMTs throughout the duration of the study. Cross-neutralizing antibody activity against heterologous sub-genotypes was demonstrated. CONCLUSION These data show that the EV71 candidate vaccine is safe and immunogenic in adults and supports further clinical development as a potential pediatric vaccine by initiating a dose-escalation study for determining the dose-dependent safety and immunogenicity of the vaccine in young naïve children.
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Affiliation(s)
- Paul A Tambyah
- Department of Medicine, NUH Investigational Medicine Unit, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - Jolene Oon
- Department of Medicine, NUH Investigational Medicine Unit, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - Rosmonaliza Asli
- Department of Medicine, NUH Investigational Medicine Unit, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - William Kristanto
- Department of Medicine, NUH Investigational Medicine Unit, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - Shi-Hsia Hwa
- Vaccine Business Unit, Takeda Pharmaceuticals Asia Pacific Pte Ltd, 21 Biopolis Road, Nucleos South Tower Level 4, Singapore 138567, Singapore
| | - Fue Vang
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA
| | - Lovkesh Karwal
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA
| | - Jeremy Fuchs
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA
| | - Joseph D Santangelo
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA
| | - Gilad S Gordon
- Takeda Vaccines, Inc., Takeda Pharmaceuticals USA, Fort Collins, CO, USA
| | - Cynthia Thomson
- Vaccine Business Unit, Takeda Pharmaceuticals Asia Pacific Pte Ltd, 21 Biopolis Road, Nucleos South Tower Level 4, Singapore 138567, Singapore
| | - Raman Rao
- Vaccine Business Unit, Takeda Pharmaceuticals Asia Pacific Pte Ltd, 21 Biopolis Road, Nucleos South Tower Level 4, Singapore 138567, Singapore
| | - Hansi Dean
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA
| | - Subash C Das
- Vaccine Business Unit, Takeda Pharmaceuticals USA, 40 Landsdowne Street, Cambridge, MA 02139, USA.
| | - Dan T Stinchcomb
- Takeda Vaccines, Inc., Takeda Pharmaceuticals USA, Fort Collins, CO, USA
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Zhu W, Jin P, Li JX, Zhu FC, Liu P. Correlates of protection for inactivated enterovirus 71 vaccine: the analysis of immunological surrogate endpoints. Expert Rev Vaccines 2017; 16:945-949. [PMID: 28548626 DOI: 10.1080/14760584.2017.1335603] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Inactivated Enterovirus 71 (EV71) vaccines showed significant efficacy against the diseases associated with EV71 and a neutralizing antibody (NTAb) titer of 1:16-1:32 was suggested as the correlates of the vaccine protection. This paper aims to further estimate the immunological surrogate endpoints for the protection of inactivated EV71 vaccines and the effect factors. METHODS Pre-vaccination NTAb against EV71 at baseline (day 0), post-vaccination NTAb against EV71 at day 56, and the occurrence of laboratory-confirmed EV71-associated diseases during a 24-months follow-up period were collected from a phase 3 efficacy trial of an inactivated EV71 vaccine. We used the mixed-scaled logit model and the absolute sigmoid function by some extensions in continuous models to estimate the immunological surrogate endpoint for the EV71 vaccine protection, respectively. RESULTS For children with a negative baseline of EV71 NTAb titers, an antibody level of 26.6 U/ml (1:30) was estimated to provide at least a 50% protection for 12 months, and an antibody level of 36.2 U/ml (1:42) may be needed to achieve a 50% protective level of the population for 24 months. CONCLUSION Both the pre-vaccination NTAb level and the vaccine protective period could affect the estimation of the immunological surrogate for EV71 vaccine. A post-vaccination NTAb titer of 1:42 or more may be needed for long-term protection. CLINICAL TRIAL REGISTRATION NCT01508247.
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Affiliation(s)
- Wenbo Zhu
- a Department of Public Health , Southeast University , Nanjing , China
| | - Pengfei Jin
- b Vaccine Clinical Trials Institute, Jiangsu Province Center for Disease Control and Prevention , Nanjing , China.,c Zhejiang Province Center for Disease Control and Prevention , Hangzhou , China
| | - Jing-Xin Li
- b Vaccine Clinical Trials Institute, Jiangsu Province Center for Disease Control and Prevention , Nanjing , China
| | - Feng-Cai Zhu
- b Vaccine Clinical Trials Institute, Jiangsu Province Center for Disease Control and Prevention , Nanjing , China
| | - Pei Liu
- a Department of Public Health , Southeast University , Nanjing , China
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