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Jongo SA, Urbano Nsue Ndong Nchama V, Church LWP, Olotu A, Manock SR, Schindler T, Mtoro A, Kc N, Devinsky O, Zan E, Hamad A, Nyakarungu E, Mpina M, Deal A, Bijeri JR, Ondo Mangue ME, Ntutumu Pasialo BE, Nguema GN, Rivas MR, Chemba M, Ramadhani KK, James ER, Stabler TC, Abebe Y, Riyahi P, Saverino ES, Sax J, Hosch S, Tumbo A, Gondwe L, Segura JL, Falla CC, Phiri WP, Hergott DEB, García GA, Maas C, Murshedkar T, Billingsley PF, Tanner M, Ayekaba MO, Sim BKL, Daubenberger C, Richie TL, Abdulla S, Hoffman SL. Safety and Immunogenicity of Radiation-Attenuated PfSPZ Vaccine in Equatoguinean Infants, Children, and Adults. Am J Trop Med Hyg 2023:tpmd220773. [PMID: 37160281 DOI: 10.4269/ajtmh.22-0773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/08/2023] [Indexed: 05/11/2023] Open
Abstract
The radiation-attenuated Plasmodium falciparum sporozoites (PfSPZ) Vaccine has demonstrated safety and immunogenicity in 5-month-old to 50-year-old Africans in multiple trials. Except for one, each trial has restricted enrollment to either infants and children or adults < 50 years old. This trial was conducted in Equatorial Guinea and assessed the safety, tolerability, and immunogenicity of three direct venous inoculations of 1.8 × 106 or 2.7 × 106 PfSPZ, of PfSPZ Vaccine, or normal saline administered at 8-week intervals in a randomized, double-blind, placebo-controlled trial stratified by age (6-11 months and 1-5, 6-10, 11-17, 18-35, and 36-61 years). All doses were successfully administered. In all, 192/207 injections (93%) in those aged 6-61 years were rated as causing no or mild pain. There were no significant differences in solicited adverse events (AEs) between vaccinees and controls in any age group (P ≥ 0.17). There were no significant differences between vaccinees and controls with respect to the rates or severity of unsolicited AEs or laboratory abnormalities. Development of antibodies to P. falciparum circumsporozoite protein occurred in 67/69 vaccinees (97%) and 0/15 controls. Median antibody levels were highest in infants and 1-5-year-olds and declined progressively with age. Antibody responses in children were greater than in adults protected against controlled human malaria infection. Robust immunogenicity, combined with a benign AE profile, indicates children are an ideal target for immunization with PfSPZ Vaccine.
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Affiliation(s)
- Said A Jongo
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | | | - Ally Olotu
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ali Mtoro
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Natasha Kc
- Sanaria Inc., Rockville, Maryland
- Protein Potential LLC, Rockville, Maryland
| | - Orrin Devinsky
- New York University Langone Medical Center, New York, New York
| | - Elcin Zan
- New York University Langone Medical Center, New York, New York
| | - Ali Hamad
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Elizabeth Nyakarungu
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Maxmillian Mpina
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Deal
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - José Raso Bijeri
- Ministry of Health and Social Welfare, Government of Equatorial Guinea, Malabo, Equatorial Guinea
| | - Martin Eka Ondo Mangue
- Ministry of Health and Social Welfare, Government of Equatorial Guinea, Malabo, Equatorial Guinea
| | | | - Genaro Nsue Nguema
- Ministry of Health and Social Welfare, Government of Equatorial Guinea, Malabo, Equatorial Guinea
| | - Matilde Riloha Rivas
- Ministry of Health and Social Welfare, Government of Equatorial Guinea, Malabo, Equatorial Guinea
| | - Mwajuma Chemba
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Kamaka K Ramadhani
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | | | | | | | | | - Julian Sax
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Salome Hosch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Anneth Tumbo
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Linda Gondwe
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - J Luis Segura
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | - Carl Maas
- Marathon EG Production, Ltd., Malabo Dos, Equatorial Guinea
| | | | | | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mitoha Ondo'o Ayekaba
- Ministry of Health and Social Welfare, Government of Equatorial Guinea, Malabo, Equatorial Guinea
| | - B Kim Lee Sim
- Sanaria Inc., Rockville, Maryland
- Protein Potential LLC, Rockville, Maryland
| | - Claudia Daubenberger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Salim Abdulla
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
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Jongo SA, Church LWP, Nchama VUNN, Hamad A, Chuquiyauri R, Kassim KR, Athuman T, Deal A, Natasha KC, Mtoro A, Mpina M, Nyakarungu E, Bidjimi GO, Owono MA, Mayé ERM, Mangue MEO, Okomo GNN, Pasialo BEN, Mandumbi DMO, Mikue MSAL, Mochomuemue FL, Obono MO, Besahá JCM, Bijeri JR, Abegue GM, Veri YR, Bela IT, Chochi FC, Lima Sánchez JE, Pencelli V, Gayozo G, Nlang JAEM, Schindler T, James ER, Abebe Y, Lemiale L, Stabler TC, Murshedkar T, Chen MC, Schwabe C, Ratsirarson J, Rivas MR, Ayekaba MO, Milang DVN, Falla CC, Phiri WP, García GA, Maas CD, Nlavo BM, Tanner M, Billingsley PF, Kim Lee Sim B, Daubenberger C, Hoffman SL, Abdulla S, Richie TL. Multi-Dose Priming Regimens of PfSPZ Vaccine: Safety and Efficacy against Controlled Human Malaria Infection in Equatoguinean Adults. Am J Trop Med Hyg 2022; 106:1215-1226. [PMID: 35130487 PMCID: PMC8991366 DOI: 10.4269/ajtmh.21-0942] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/15/2021] [Indexed: 11/22/2022] Open
Abstract
Plasmodium falciparum sporozoite (PfSPZ) Vaccine is composed of radiation-attenuated, aseptic, purified cryopreserved PfSPZ. Multiple clinical trials empirically assessing two to six doses have shown multi-dose priming (two to four doses the first week) to be optimal for protection in both 4- and 16-week regimens. In this randomized, double-blind, normal saline (NS) placebo-controlled trial, four groups (G) of 18- to 32-year-old Equatoguineans received multi-dose priming regimens with or without a delayed final dose at 4 or 16 weeks. The regimens were G1: days 1, 3, 5, 7, and 113; G2: days 1, 3, 5, and 7; G3: days 1, 3, 5, 7, and 29; and G4: days 1, 8, and 29. All doses were 9 × 105 PfSPZ. Tolerability, safety, immunogenicity, and vaccine efficacy (VE) against homologous controlled human malaria infection (CHMI) 6-7 weeks after vaccination were assessed to down-select the best regimen. All four regimens were safe and well tolerated, with no significant differences in adverse events (AEs) between vaccinees (N = 84) and NS controls (N = 20) or between regimens. Out of 19 controls, 13 developed Pf parasitemia by quantitative polymerase chain reaction (qPCR) after CHMI. Only the vaccine regimen administered on study days 1, 8, and 29 gave significant protection (7/21 vaccinees versus 13/19 controls infected, VE 51.3%, P = 0.03, Barnard's test, two-tailed). There were no significant differences in antibodies against Pf circumsporozoite protein (PfCSP), a major SPZ antigen, between protected and nonprotected vaccinees or controls pre-CHMI. The six controls not developing Pf parasitemia had significantly higher antibodies to blood stage antigens Pf exported protein 1 (PfEXP1) and Pf merozoite surface protein 1 (PfMSP1) than the controls who developed parasitemia, suggesting naturally acquired immunity against Pf limited infections in controls. This study identified a safe, protective, 4-week, multi-dose prime vaccination regimen for assessment in future trials of PfSPZ Vaccine.
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Affiliation(s)
- Said Abdallah Jongo
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | | | | | - Ali Hamad
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | | | | | - Thabit Athuman
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Anna Deal
- Clinical Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - KC Natasha
- Sanaria Inc., Rockville, Maryland
- Protein Potential LLC, Rockville, Maryland
| | - Ali Mtoro
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Maxmillian Mpina
- Clinical Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Elizabeth Nyakarungu
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | | | - Marta Alene Owono
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | | | | | | | | | | | | | | | - Mariano Obiang Obono
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | | | - José Raso Bijeri
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | - Gabriel Mbá Abegue
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | - Yolanda Rimoy Veri
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | - Ines Toichoa Bela
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | | | | | | | - Griselda Gayozo
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | | | - Tobias Schindler
- Clinical Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | | | - Josea Ratsirarson
- Medical Care Development International (MCDI), Silver Spring, Maryland
| | - Matilde Riloha Rivas
- Ministry of Health and Social Welfare, Equatorial Guinea, Malabo, Equatorial Guinea
| | | | | | | | - Wonder P. Phiri
- Medical Care Development International (MCDI), Silver Spring, Maryland
| | | | - Carl D. Maas
- Marathon EG Production, Ltd., Bioko Norte, Equatorial Guinea
| | | | - Marcel Tanner
- Clinical Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - B. Kim Lee Sim
- Sanaria Inc., Rockville, Maryland
- Protein Potential LLC, Rockville, Maryland
| | - Claudia Daubenberger
- Clinical Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Salim Abdulla
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
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Jongo SA, Urbano V, Church LWP, Olotu A, Manock SR, Schindler T, Mtoro A, Kc N, Hamad A, Nyakarungu E, Mpina M, Deal A, Bijeri JR, Ondo Mangue ME, Ntutumu Pasialo BE, Nguema GN, Owono SN, Rivas MR, Chemba M, Kassim KR, James ER, Stabler TC, Abebe Y, Saverino E, Sax J, Hosch S, Tumbo AM, Gondwe L, Segura JL, Falla CC, Phiri WP, Hergott DEB, García GA, Schwabe C, Maas CD, Murshedkar T, Billingsley PF, Tanner M, Ayekaba MO, Sim BKL, Daubenberger C, Richie TL, Abdulla S, Hoffman SL. Immunogenicity and Protective Efficacy of Radiation-Attenuated and Chemo-Attenuated PfSPZ Vaccines in Equatoguinean Adults. Am J Trop Med Hyg 2021; 104:283-293. [PMID: 33205741 PMCID: PMC7790068 DOI: 10.4269/ajtmh.20-0435] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Plasmodium falciparum sporozoite (PfSPZ) Vaccine (radiation-attenuated, aseptic, purified, cryopreserved PfSPZ) and PfSPZ-CVac (infectious, aseptic, purified, cryopreserved PfSPZ administered to subjects taking weekly chloroquine chemoprophylaxis) have shown vaccine efficacies (VEs) of 100% against homologous controlled human malaria infection (CHMI) in nonimmune adults. Plasmodium falciparum sporozoite-CVac has never been assessed against CHMI in African vaccinees. We assessed the safety, immunogenicity, and VE against homologous CHMI of three doses of 2.7 × 106 PfSPZ of PfSPZ Vaccine at 8-week intervals and three doses of 1.0 × 105 PfSPZ of PfSPZ-CVac at 4-week intervals with each arm randomized, double-blind, placebo-controlled, and conducted in parallel. There were no differences in solicited adverse events between vaccinees and normal saline controls, or between PfSPZ Vaccine and PfSPZ-CVac recipients during the 6 days after administration of investigational product. However, from days 7–13, PfSPZ-CVac recipients had significantly more AEs, probably because of Pf parasitemia. Antibody responses were 2.9 times higher in PfSPZ Vaccine recipients than PfSPZ-CVac recipients at time of CHMI. Vaccine efficacy at a median of 14 weeks after last PfSPZ-CVac dose was 55% (8 of 13, P = 0.051) and at a median of 15 weeks after last PfSPZ Vaccine dose was 27% (5 of 15, P = 0.32). The higher VE in PfSPZ-CVac recipients of 55% with a 27-fold lower dose was likely a result of later stage parasite maturation in the liver, leading to induction of cellular immunity against a greater quantity and broader array of antigens.
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Affiliation(s)
- Said A Jongo
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Vicente Urbano
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | | | - Ally Olotu
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | | | - Ali Mtoro
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Natasha Kc
- 3Sanaria Inc., Rockville, Maryland.,5Protein Potential LLC, Rockville, Maryland
| | - Ali Hamad
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Elizabeth Nyakarungu
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | - Anna Deal
- 4Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - José Raso Bijeri
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | - Martin Eka Ondo Mangue
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | | | - Genaro Nsue Nguema
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | - Salomon Nguema Owono
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | - Matilde Riloha Rivas
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | - Mwajuma Chemba
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Kamaka R Kassim
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | | | | | | | | | - Julian Sax
- 4Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Salome Hosch
- 4Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Linda Gondwe
- 4Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - J Luis Segura
- 6Medical Care Development International, Silver Spring, Maryland
| | | | | | | | | | | | - Carl D Maas
- 7Marathon EG Production, Ltd., Bioko Norte, Equatorial Guinea
| | | | | | - Marcel Tanner
- 4Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Mitoha Ondo'o Ayekaba
- 2Ministry of Health and Social Welfare, Government of Equatorial Guinea, Bioko Norte, Equatorial Guinea
| | - B Kim Lee Sim
- 3Sanaria Inc., Rockville, Maryland.,5Protein Potential LLC, Rockville, Maryland
| | | | | | - Salim Abdulla
- 1Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
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