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Zhou L, Liu J, Li J, Liu X, Zhang J, Nie F, Chen J, Chai J, Lv J, Wang M, Yu J, Wu W, Li Y, Zhang Y. A simulated, randomized study on the safety and immunogenicity of three consecutive commercial-scale batches of the CTN-1V strain human rabies vaccine to verify the inter-batch consistency. Hum Vaccin Immunother 2022; 18:2138049. [PMID: 36409064 DOI: 10.1080/21645515.2022.2138049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this study, we sought to evaluate the inter-batch consistency and safety of the CTN-1 V human rabies vaccine (Vero cells). A total of 594 healthy participants aged 10-60 years were enrolled from Mianzhu, Sichuan Province, and randomized into three batch groups to receive vaccination via the Essen Regimen, that is, a single dose on days 0, 3, 7, 14, and 28 in the deltoid muscle of the upper arm. The serum antibody geometric mean concentration (GMC) and positive conversion rate of each group were determined using a rapid fluorescence focus inhibition test (RFFIT) before the first-dose immunization, 14 d after the first-dose immunization, and 14 d and 12 mo after full immunization. Adverse events (AEs) 30 min and 30 d after immunization were observed in each group. There were 322 cases of AEs during the observation period, with an overall incidence of 54.4%. The incidences of AEs in groups A, B, and C were 57.4%, 51.5%, and 54.3%, respectively. There were no significant differences among the groups (P > .05). Moreover, there were no significant differences (P > .05) in the serum GMC or antibody-positive conversion rate between any two groups at any time point. The bilateral 95% confidence interval of the GMC ratio between any two groups 14 d after the first-dose immunization was within the range of 0.67-1.50. This study shows that the CTN-1 V human rabies vaccine (Vero cells) has reliable safety and stable immunogenicity between batches.
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Affiliation(s)
- Lei Zhou
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Jingjing Liu
- State Key Laboratory of Biotherapy, Sichuan University, Chengdu, China.,Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing, China
| | - Jia Li
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing, China
| | - Xuecheng Liu
- Vaccine Clinical Research Center, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Jingwu Zhang
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Fei Nie
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Jianmin Chen
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Jing Chai
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Jinchao Lv
- Quality Control Department, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Minghui Wang
- R&D Department, Dalian Aleph Biomedical Co., Ltd., Dalian, China
| | - Jiajie Yu
- Scientific Affairs Department, Simoon Record Beijing Co., Ltd., Beijing, China
| | - Wenjie Wu
- Project Management Department, Simoon Record Beijing Co., Ltd., Beijing, China
| | - Yuhua Li
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing, China
| | - Yuhui Zhang
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian, China
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Interferon Inhibition Enhances the Pilot-Scale Production of Rabies Virus in Human Diploid MRC-5 Cells. Viruses 2021; 14:v14010049. [PMID: 35062253 PMCID: PMC8779192 DOI: 10.3390/v14010049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 12/21/2022] Open
Abstract
Inactivated vaccines based on cell culture are very useful in the prevention and control of many diseases. The most popular strategy for the production of inactivated vaccines is based on monkey-derived Vero cells, which results in high productivity of the virus but has a certain carcinogenic risk due to non-human DNA contamination. Since human diploid cells, such as MRC-5 cells, can produce a safer vaccine, efforts to develop a strategy for inactivated vaccine production using these cells have been investigated using MRC-5 cells. However, most viruses do not replicate efficiently in MRC-5 cells. In this study, we found that rabies virus (RABV) infection activated a robust interferon (IFN)-β response in MRC-5 cells but almost none in Vero cells, suggesting that the IFN response could be a key limiting factor for virus production. Treatment of the MRC-5 cells with IFN inhibitors increased RABV titers by 10-fold. Additionally, the RABV titer yield was improved five-fold when using IFN receptor 1 (IFNAR1) antibodies. As such, we established a stable IFNAR1-deficient MRC-5 cell line (MRC-5IFNAR1−), which increased RABV production by 6.5-fold compared to normal MRC-5 cells. Furthermore, in a pilot-scale production in 1500 square centimeter spinner flasks, utilization of the MRC-5IFNAR1− cell line or the addition of IFN inhibitors to MRC cells increased RABV production by 10-fold or four-fold, respectively. Thus, we successfully established a human diploid cell-based pilot scale virus production platform via inhibition of IFN response for rabies vaccines, which could also be used for other inactivated virus vaccine production.
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Chen K, Li C, Wang Y, Shen Z, Guo Y, Li X, Zhang Y. Optimization of Vero Cells Grown on a Polymer Fiber Carrier in a Disposable Bioreactor for Inactivated Coxsackievirus A16 Vaccine Development. Vaccines (Basel) 2021; 9:vaccines9060613. [PMID: 34200441 PMCID: PMC8229131 DOI: 10.3390/vaccines9060613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022] Open
Abstract
At present, there are no vaccines available for hand, foot, and mouth disease, which is caused by Coxsackie virus A16 (CVA16) infection. In the present study, we isolated epidemic strains of CVA16 and optimized the production of the virus in Vero cells. The system comprised growing the infected cells on polymer fiber paper carriers in a serum-free medium containing 0.5% (w/v) lactalbumin hydrolysate a mini bioreactor. Disposable Bioflo310 and AmProtein Current perfusion bioreactors were used to monitor virus infection and Vero cell culture. The total number of cells increased from 1.5 × 109 to 3.0 × 1010. In our optimized culture process, the virus titer reached 7.8 × 107 TCID50/mL at three days after infection. The inactivated CVA16 prepared from our optimized culture procedure elicited a slightly higher neutralizing antibody titer compared with that derived from routine culture procedures. These results will promote the large-scale production of inactivated CVA16 vaccines using nonwoven polymer fiber paper cell cultures.
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Affiliation(s)
- Keda Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Chaonan Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Ying Wang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Zhenwei Shen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Yikai Guo
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Xiaoping Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Yanjun Zhang
- Department of Virus Inspection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
- Correspondence: ; Tel.: +86-138-5811-5856
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Sampath V, Rabinowitz G, Shah M, Jain S, Diamant Z, Jesenak M, Rabin R, Vieths S, Agache I, Akdis M, Barber D, Breiteneder H, Chinthrajah S, Chivato T, Collins W, Eiwegger T, Fast K, Fokkens W, O'Hehir RE, Ollert M, O'Mahony L, Palomares O, Pfaar O, Riggioni C, Shamji MH, Sokolowska M, Jose Torres M, Traidl-Hoffmann C, van Zelm M, Wang DY, Zhang L, Akdis CA, Nadeau KC. Vaccines and allergic reactions: The past, the current COVID-19 pandemic, and future perspectives. Allergy 2021; 76:1640-1660. [PMID: 33811364 PMCID: PMC8251022 DOI: 10.1111/all.14840] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/11/2022]
Abstract
Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur after vaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.
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Affiliation(s)
- Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
| | - Grace Rabinowitz
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
| | - Mihir Shah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
| | - Surabhi Jain
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
| | - Zuzana Diamant
- Departmentt of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Clinical Pharmacy &Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Milos Jesenak
- Department of Pediatrics and Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Center for Vaccination in Special Situations, University Hospital in Martin, Comenius University in Bratislava, Bratislava, Slovakia
| | - Ronald Rabin
- Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Stefan Vieths
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | | | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Zurich, Switzerland
| | - Domingo Barber
- Departamento de CienciasMédicasBásicas, Facultad de Medicina, Instituto de Medicina Molecular Aplicada (IMMA), Universidad San Pablo-CEU, CEU Universities, Madrid, España
- Instituto de Salud Carlos III, RETIC ARADYAL, Madrid, Spain
| | - Heimo Breiteneder
- Division of Medical Biotechnology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | - Tomas Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - William Collins
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
- Department of Medicine, Division of Hospital Medicine, Stanford University, Stanford, CA, USA
| | - Thomas Eiwegger
- Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, ON, Canada
- Translational Medicine, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Katharine Fast
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
| | - Wytske Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Robyn E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Monash University, and Alfred Health, Melbourne, Vic, Australia
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Liam O'Mahony
- Department of Medicine and School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University, Madrid, Spain
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Carmen Riggioni
- Department of Paediatrics, Allergy and Clinical Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Mohamed H Shamji
- Department of National Heart and Lung Institute, Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Imperial College London, London, UK
- Centre in Allergic Mechanisms of Asthma, London, UK
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Zurich, Switzerland
| | - Maria Jose Torres
- Allergy Unit, Malaga Regional University Hospital-UMA-ARADyAL, Málaga, Spain
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Medical Faculty, University Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Menno van Zelm
- Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia
- Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, VIC, Australia
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Zurich, Switzerland
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
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Wang H, Guo S, Li Z, Xu X, Shao Z, Song G. Suspension culture process for H9N2 avian influenza virus (strain Re-2). Arch Virol 2017; 162:3051-3059. [DOI: 10.1007/s00705-017-3460-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/20/2017] [Indexed: 01/18/2023]
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Moro PL, Woo EJ, Paul W, Lewis P, Petersen BW, Cano M. Post-Marketing Surveillance of Human Rabies Diploid Cell Vaccine (Imovax) in the Vaccine Adverse Event Reporting System (VAERS) in the United States, 1990‒2015. PLoS Negl Trop Dis 2016; 10:e0004846. [PMID: 27410239 PMCID: PMC4943633 DOI: 10.1371/journal.pntd.0004846] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/22/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In 1980, human diploid cell vaccine (HDCV, Imovax Rabies, Sanofi Pasteur), was licensed for use in the United States. OBJECTIVE To assess adverse events (AEs) after HDCV reported to the US Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting surveillance system. METHODS We searched VAERS for US reports after HDCV among persons vaccinated from January 1, 1990-July 31, 2015. Medical records were requested for reports classified as serious (death, hospitalization, prolonged hospitalization, disability, life-threatening-illness), and those suggesting anaphylaxis and Guillain-Barré syndrome (GBS). Physicians reviewed available information and assigned a primary clinical category to each report using MedDRA system organ classes. Empirical Bayesian (EB) data mining was used to identify disproportional AE reporting after HDCV. RESULTS VAERS received 1,611 reports after HDCV; 93 (5.8%) were serious. Among all reports, the three most common AEs included pyrexia (18.2%), headache (17.9%), and nausea (16.5%). Among serious reports, four deaths appeared to be unrelated to vaccination. CONCLUSIONS This 25-year review of VAERS did not identify new or unexpected AEs after HDCV. The vast majority of AEs were non-serious. Injection site reactions, hypersensitivity reactions, and non-specific constitutional symptoms were most frequently reported, similar to findings in pre-licensure studies.
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Affiliation(s)
- Pedro L. Moro
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Emily Jane Woo
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Wendy Paul
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Paige Lewis
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Brett W. Petersen
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, NCZEID, CDC, Atlanta, Georgia, United States of America
| | - Maria Cano
- Immunization Safety Office, Division of Healthcare Quality Promotion (DHQP), National Center for Zoonotic and Emerging Infectious Diseases (NCZEID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
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Huang D, Peng WJ, Ye Q, Liu XP, Zhao L, Fan L, Xia-Hou K, Jia HJ, Luo J, Zhou LT, Li BB, Wang SL, Xu WT, Chen Z, Tan WS. Serum-Free Suspension Culture of MDCK Cells for Production of Influenza H1N1 Vaccines. PLoS One 2015; 10:e0141686. [PMID: 26540170 PMCID: PMC4634975 DOI: 10.1371/journal.pone.0141686] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 10/12/2015] [Indexed: 01/03/2023] Open
Abstract
Development of serum-free suspension cell culture processes is very important for influenza vaccine production. Previously, we developed a MDCK suspension cell line in a serum-free medium. In the present study, the growth kinetics of suspension MDCK cells and influenza virus production in the serum-free medium were investigated, in comparison with those of adherent MDCK cells in both serum-containing and serum-free medium. It was found that the serum-free medium supported the stable subculture and growth of both adherent and suspension cells. In batch culture, for both cell lines, the growth kinetics in the serum-free medium was comparable with those in the serum-containing medium and a commercialized serum-free medium. In the serum-free medium, peak viable cell density (VCD), haemagglutinin (HA) and median tissue culture infective dose (TCID50) titers of the two cell lines reached 4.51×106 cells/mL, 2.94Log10(HAU/50 μL) and 8.49Log10(virions/mL), and 5.97×106 cells/mL, 3.88Log10(HAU/50 μL), and 10.34Log10(virions/mL), respectively. While virus yield of adherent cells in the serum-free medium was similar to that in the serum-containing medium, suspension culture in the serum-free medium showed a higher virus yield than adherent cells in the serum-containing medium and suspension cells in the commercialized serum-free medium. However, the percentage of infectious viruses was lower for suspension culture in the serum-free medium. These results demonstrate the great potential of this suspension MDCK cell line in serum-free medium for influenza vaccine production and further improvements are warranted.
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Affiliation(s)
- Ding Huang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Wen-Juan Peng
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Qian Ye
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Xu-Ping Liu
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
- * E-mail: (X-PL); (W-ST)
| | - Liang Zhao
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Li Fan
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Kang Xia-Hou
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Han-Jing Jia
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Jian Luo
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Lin-Ting Zhou
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Bei-Bei Li
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Shi-Lei Wang
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Wen-Ting Xu
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Ze Chen
- Shanghai Institute of Biological Products Co., Ltd., Shanghai 200052, China
| | - Wen-Song Tan
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai 200237, China
- * E-mail: (X-PL); (W-ST)
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Ren Z, Lu Z, Wang L, Huo Z, Cui J, Zheng T, Dai Q, Chen C, Qin M, Chen M, Yang R. Rapid production of a H9N2 influenza vaccine from MDCK cells for protecting chicken against influenza virus infection. Appl Microbiol Biotechnol 2015; 99:2999-3013. [DOI: 10.1007/s00253-015-6406-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 01/10/2015] [Accepted: 01/14/2015] [Indexed: 01/17/2023]
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Nakonechna A, Abuzakouk M. Human albumin causes anaphylaxis during bee venom immunotherapy. Ann Allergy Asthma Immunol 2014; 112:559-60. [PMID: 24785838 DOI: 10.1016/j.anai.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/07/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Alla Nakonechna
- Department of Immunology and Allergy, Hull and East Yorkshire NHS Trust Hospitals, Hull, United Kingdom.
| | - Mohamed Abuzakouk
- Department of Immunology and Allergy, Hull and East Yorkshire NHS Trust Hospitals, Hull, United Kingdom
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Griffioen M, Halsey N. Gender differences in immediate hypersensitivity reactions to vaccines: a review of the literature. Public Health Nurs 2013; 31:206-14. [PMID: 24720655 DOI: 10.1111/phn.12073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine published studies of immediate hypersensitivity reactions (IHS) following vaccination and to determine whether women are at an increased risk of developing IHS after vaccination. DESIGN AND SAMPLE PubMed was reviewed for vaccine articles reporting IHS by gender through June 2012. Data were abstracted on type of study, vaccine, hypersensitivity reaction, and statistic reported. MEASURES Articles were included if they described experimental, quasi-experimental, correlational or descriptive studies and IHS was reported by gender. RESULTS Of 847 articles found in PubMed, 11 met the inclusion criteria. In eight studies, more women than men reported IHS, in two studies more men than women reported IHS and in one study the count was even. CONCLUSION Limited data from these studies suggest that women may have higher rates of IHS reactions following vaccination than men. Limitations to the available data include the lack of denominator data and that the definition of IHS was not consistent across the studies. Large-scale population-based studies are indicated to determine if there are differences in rates by gender and biologic basis for these differences.
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Affiliation(s)
- Mari Griffioen
- School of Nursing, University of Maryland, Baltimore, Maryland
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Abstract
The rabies virus is transmitted through exposure to infected saliva during either a bite or direct contact with mucosal tissues. Infection with this virus results in a progressive encephalitis, ultimately leading to coma, end-organ damage, and death. Because rabies-associated mortality is strikingly high, preventing viral transmission associated with an exposure is paramount. Fortunately, 2 available options exist for this purpose and include the rabies vaccine and the associated immunoglobulin. Patients presenting for consideration of rabies postexposure prophylaxis constitute a frequent complaint seen in the emergency department (ED) in most geographical areas. Management of these patients should be guided by an accurate and thorough discussion of the circumstances surrounding their exposure to attain maximum pharmacological benefit and avoid viral transmission. This article provides an overview of the practice recommendations surrounding rabies virus prophylaxis and their associated pharmacological characteristics in the ED.
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Abstract
Rabies is a devastating encephalitis caused by RNA viruses that use mammals as reservoirs. In the United States, most naturally acquired human cases have come from bats. The use of appropriate preexposure and postexposure prophylaxis can be nearly 100% effective. If prophylaxis is not used, or is implemented incorrectly, the patient may develop clinical rabies, which is almost universally fatal. All health care practitioners should be familiar with the appropriate evaluation of patients presenting with a possible rabies exposure and ensure that expeditious and appropriate prophylaxis is provided to help prevent the development of this lethal disease.
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Affiliation(s)
- Kyle A Weant
- North Carolina Public Health Preparedness and Response, North Carolina Department of Health and Human Services, Raleigh, NC 27699-1900, USA.
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Yu P, Huang Y, Zhang Y, Tang Q, Liang G. Production and evaluation of a chromatographically purified Vero cell rabies vaccine (PVRV) in China using microcarrier technology. Hum Vaccin Immunother 2012; 8:1230-5. [PMID: 22894963 PMCID: PMC3579903 DOI: 10.4161/hv.20985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
China is a high population country with millions of animal bite cases every year; thus, it is necessary to explore and develop more effective and productive rabies vaccines for human use. To establish a safe, effective, inexpensive and high-yield rabies vaccine, a non-adjuvant purified Vero cell rabies vaccine produced in the SPEEDA PVRV microcarrier bioreactor was developed by Liaoning Chengda Biology Co. Ltd. in China. This vaccine was produced using Vero cells that were cultured in a microcarrier bioreactor. A microcarrier bioreactor containing 25 g/L of Cytodex-1 was used for perfusion culture. The Vero cell culture density was up to 1.2-1.5 × 10(7) cells/ml, viruses could be constantly harvested for 18-22 days, and the resulting vaccine immunizing potency was ≥ 4.5 IU/ml. Vaccine safety and immunogenicity post-immunization were also assessed. A total of 602 volunteers were enrolled and divided into two groups that were vaccinated with either SPEEDA PVRV or VERORAB PVRV on days 0, 3, 7, 14 and 28. All subjects vaccinated with SPEEDA PVRV showed no serious local or systemic adverse effects. The positive conversion rate of serum neutralizing antibodies against the rabies virus reached 100% in both the test and control groups (inoculated with VERORAB PVRV) at 14 days and 45 days after vaccination, and no significant difference was found between the neutralizing antibody geometric mean titers (GMTs) of the two groups. SPEEDA PVRV is appropriate for mass production and shows satisfactory clinical safety and immunogenicity for human post-exposure prophylaxis of rabies.
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Affiliation(s)
- Pengcheng Yu
- State Key Laboratory for Infectious Disease Prevention and Control, Institute for Viral Disease Control and Prevention; Beijing, P. R. China
| | - Ying Huang
- State Key Laboratory for Infectious Disease Prevention and Control, Institute for Viral Disease Control and Prevention; Beijing, P. R. China
| | - Yibin Zhang
- Liaoning Chengda Biology Co., Ltd; Hai Dian District; Beijing, P. R. China
| | - Qing Tang
- State Key Laboratory for Infectious Disease Prevention and Control, Institute for Viral Disease Control and Prevention; Beijing, P. R. China
| | - Guodong Liang
- State Key Laboratory for Infectious Disease Prevention and Control, Institute for Viral Disease Control and Prevention; Beijing, P. R. China
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Nishizono A, Yamada K, Khawplod P, Shiota S, Perera D, Matsumoto T, Wimalaratne O, Mitui MT, Ahmed K. Evaluation of an improved rapid neutralizing antibody detection test (RAPINA) for qualitative and semiquantitative detection of rabies neutralizing antibody in humans and dogs. Vaccine 2012; 30:3891-6. [DOI: 10.1016/j.vaccine.2012.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 03/11/2012] [Accepted: 04/01/2012] [Indexed: 11/29/2022]
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Abstract
With advances in global health care, ageing populations are expected to grow worldwide throughout the 21st century. Increased lifespan is a testament to modern medical and social practices, but also presents a growing challenge to a system with limited resources. Elderly populations present specific concerns related to preventative health practices, especially vaccination. Although the power of vaccination is unquestionable in controlling infectious disease, immunosenescence can lead to reduced immune responses following immunization in the elderly, and increased morbidity and mortality. Further complicating this issue, some vaccines themselves may pose a substantial safety risk in the elderly when compared to younger counterparts. Though any health care intervention must balance risk and reward, safety and immunogenicity are often poorly characterized in older populations. This review explores several domestic and travel vaccines, examining what is known concerning efficacy and safety in the elderly, and considers future alternatives.
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Affiliation(s)
- Ian J Amanna
- Najít Technologies, Inc. 505 NW 185 th Avenue Beaverton, OR 97006, USA
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17
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da Costa-Silva TA, da Silva Meira C, Frazzatti-Gallina N, Pereira-Chioccola VL. Toxoplasma gondii antigens: recovery analysis of tachyzoites cultivated in Vero cell maintained in serum free medium. Exp Parasitol 2012; 130:463-9. [PMID: 22306070 DOI: 10.1016/j.exppara.2012.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 10/24/2011] [Accepted: 01/10/2012] [Indexed: 01/18/2023]
Abstract
Vero cells have been used successfully in Toxoplasma gondii maintenance. Medium supplementation for culture cells with fetal bovine serum is necessary for cellular growth. However, serum in these cultures presents disadvantages, such as the potential to induce hypersensitivity, variability of serum batches, possible presence of contaminants, and the high cost of good quality serum. Culture media formulated without any animal derived components, designed for serum-free growth of cell lines have been used successfully for different virus replication. The advantages of protozoan parasite growth in cell line cultures using serum-free medium remain poorly studied. Thus, this study was designed to determine whether T. gondii tachyzoites grown in Vero cell cultures in serum-free medium, after many passages, are able to maintain the same antigenic proprieties as those maintained in experimental mice. The standardization of Vero cell culture in serum-free medium for in vitro T. gondii tachyzoite production was performed establishing the optimal initial cell concentration for the confluent monolayer formation, which was 1×10(6) Vero cell culture as initial inoculum. The total confluent monolayer formatted after 96 h and the best amount of harvested tachyzoites was 2.1×10(7) using parasite inoculum of 1.5×10(6) after 7 days post-infection. The infectivity of tachyzoites released from Vero cells maintained in serum-free medium was evaluated using groups of Swiss mice infected with cell-culture tachyzoites. The parasite concentrations were similar to those for mice infected with tachyzoites collected from other infected mice. The data from both in vivo and in vitro experiments showed that in at least 30 culture cell passages, the parasites maintained the same infectivity as maintained in vivo. Another question was to know whether in the several continued passages, immunogenic progressive loss could occur. The nucleotide sequences studied were the same between the different passages, which could mean no change in their viability in the lysate antigen. Thus, the antigen production by cell culture has clear ethical and cost-saving advantages. Moreover, the use of culture media formulated without any human or animal derived components, designed for serum-free growth of cell lines, successfully produced tachyzoites especially for antigen production.
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18
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Hassanzadeh SM, Zavareh A, Shokrgozar MA, Ramezani A, Fayaz A. High vero cell density and rabies virus proliferation on fibracel disks versus cytodex-1 in spinner flask. Pak J Biol Sci 2011; 14:441-8. [PMID: 21902056 DOI: 10.3923/pjbs.2011.441.448] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To achieve higher titer of rabies virus higher density of host cells will need. In this study, capability of FibraCel disks packed in 500 mL spinner basket versus Cytodex-1 in 500 mL spinner flask was investigated for propagation of Vero cells and PV rabies virus proliferation. Minimal Essential Medium (MEM) + 10% Foetal Calf Serum (FCS) and Virus Production- Serum Free Medium (VP-SFM) +4 mM L-glutamine were used in growth phase and MEM+ 0.2% Bovine Serum Albumin (BSA) and VP-SFM were used in virus production phase. Adapted Vero cells grown in VP-SFM were used in all SFM experiments while batch and stepwise perfusion modes were applied and compared in growth stage. The highest Vero cell density were achieved in the trials with 10 g FibraCel disk in stepwise perfusion mode equal to 6.12 x 10(6) and 5.87 x 10(6) cells mL(-1) in MEM and VP-SFM, respectively while with 2.73 g Cytodex-1 lower density equal to 4.2 x 10(6) and 4.0 x 10(6) cells mL(-1) were achieved. The highest titer of rabies virus and overall virus production rate were resulted in VP-SFM and on 10 g disks equal to 2.9 x 10(7) Fluorescent Focus Unit (FFU) mL(-1) and 0.14 FFU/Cell/h, respectively versus 1.7 x 10(7) FFU mL(-1) and 0.08 FFU/cell/h on cytodex-1 in similar conditions. The second harvest of virus was also satisfactory in experiment with 10 g disks (1.7 x 10(7) FFU mL(-1)) in compare to Cytodex-1 (0.51 x 10(7) FFU mL(-1)). An equal surface area at 6600 and 12000 cm(-2) were provided in all comparable trials with seeding density of 12.5 x 10(3) cells cm(-2). Adapted Vero cells grown in VP-SFM were used in all SFM experiments while batch and stepwise perfusion modes were applied and compared in growth stage.
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Affiliation(s)
- S Mehdi Hassanzadeh
- WHO-Collaborating Centre for Reference and Research on Rabies, Pasteur Institute of Iran, Tehran, Iran
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19
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Wang LY, Sun MP, Zhang XC, Suo LD, Xu RH, Zou YJ, Zuo LB, Qi H. Safety and immunogenicity of two freeze-dried Vero cell rabies vaccines for human use in post-exposure prophylaxis. Vaccine 2011; 29:2679-81. [PMID: 21296694 DOI: 10.1016/j.vaccine.2011.01.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 01/06/2011] [Accepted: 01/19/2011] [Indexed: 11/16/2022]
Abstract
To provide basis for human rabies vaccination in China, the safety and immunogenicity of two freeze-dried Vero cell rabies vaccines for human use were assessed. A total of 250 volunteers were enrolled and divided into two groups: volunteers in Group A (n=200) were vaccinated five doses of Speeda Vero cell rabies vaccine manufactured by Liaoning Chengda Biotechnology Co. Ltd. on day 0, 3, 7, 14, 28 after exposure. Volunteers in Group B (n=50) were treated with Verorab Vero cell rabies vaccine manufactured by Sanofi Pasteur on the same schedule. The local and systematic adverse reactions were observed. Serum neutralizing antibody levels of 80 individuals in Group A and 50 individuals in Group B were tested with RFFIT on day 7, 14, 45, 180, 360 after the first dose. The seroconversion rates in Groups A and B were 40.3% and 37.0% on day 7 after the first dose, 95.5% and 97.7% on day 14, 100% and 100% on day 45, 100% and 100% on day 180, 89.1% and 89.5% on day 360 respectively, indicating no significant differences between the two groups. And no significant differences were found between the neutralizing antibody geometric mean titers (GMTs) of the two groups on day 7, 14, 45, 180 and 360 after the first dose, with the GMTs of day 14, 45, 180 and 360 all higher than 0.5IU/ml. Antibody levels of the two groups peaked around 2 weeks after the full vaccination program, followed by a 55% decrease up to day 180 and another 76% decrease up to day 360. Both groups experienced occasions of transient fever, rash, edema, and scleroma after vaccination. Neither group had any severe adverse reactions. It was concluded that both vaccines showed satisfactory safety and immunogenicity. Booster vaccination is recommended following another exposure after six months since the full vaccination program.
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Affiliation(s)
- Ling-yun Wang
- Beijing Center for Diseases Prevention and Control, Beijing 100013, China.
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20
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Production of inactivated influenza H5N1 vaccines from MDCK cells in serum-free medium. PLoS One 2011; 6:e14578. [PMID: 21283675 PMCID: PMC3025921 DOI: 10.1371/journal.pone.0014578] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 12/31/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Highly pathogenic influenza viruses pose a constant threat which could lead to a global pandemic. Vaccination remains the principal measure to reduce morbidity and mortality from such pandemics. The availability and surging demand for pandemic vaccines needs to be addressed in the preparedness plans. This study presents an improved high-yield manufacturing process for the inactivated influenza H5N1 vaccines using Madin-Darby canine kidney (MDCK) cells grown in a serum-free (SF) medium microcarrier cell culture system. PRINCIPAL FINDING The current study has evaluated the performance of cell adaptation switched from serum-containing (SC) medium to several commercial SF media. The selected SF medium was further evaluated in various bioreactor culture systems for process scale-up evaluation. No significant difference was found in the cell growth in different sizes of bioreactors studied. In the 7.5 L bioreactor runs, the cell concentration reached to 2.3 × 10(6) cells/mL after 5 days. The maximum virus titers of 1024 Hemagglutinin (HA) units/50 µL and 7.1 ± 0.3 × 10(8) pfu/mL were obtained after 3 days infection. The concentration of HA antigen as determined by SRID was found to be 14.1 µg/mL which was higher than those obtained from the SC medium. A mouse immunogenicity study showed that the formalin-inactivated purified SF vaccine candidate formulated with alum adjuvant could induce protective level of virus neutralization titers similar to those obtained from the SC medium. In addition, the H5N1 viruses produced from either SC or SF media showed the same antigenic reactivity with the NIBRG14 standard antisera. CONCLUSIONS The advantages of this SF cell-based manufacturing process could reduce the animal serum contamination, the cost and lot-to-lot variation of SC medium production. This study provides useful information to manufacturers that are planning to use SF medium for cell-based influenza vaccine production.
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21
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Beran J, Ambrozaitis A, Laiskonis A, Mickuviene N, Bacart P, Calozet Y, Demanet E, Heijmans S, Van Belle P, Weber F, Salamand C. Intradermal influenza vaccination of healthy adults using a new microinjection system: a 3-year randomised controlled safety and immunogenicity trial. BMC Med 2009; 7:13. [PMID: 19341446 PMCID: PMC2676311 DOI: 10.1186/1741-7015-7-13] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 04/02/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intradermal vaccination provides direct and potentially more efficient access to the immune system via specialised dendritic cells and draining lymphatic vessels. We investigated the immunogenicity and safety during 3 successive years of different dosages of a trivalent, inactivated, split-virion vaccine against seasonal influenza given intradermally using a microinjection system compared with an intramuscular control vaccine. METHODS In a randomised, partially blinded, controlled study, healthy volunteers (1150 aged 18 to 57 years at enrollment) received three annual vaccinations of intradermal or intramuscular vaccine. In Year 1, subjects were randomised to one of three groups: 3 microg or 6 microg haemagglutinin/strain/dose of inactivated influenza vaccine intradermally, or a licensed inactivated influenza vaccine intramuscularly containing 15 microg/strain/dose. In Year 2 subjects were randomised again to one of two groups: 9 microg/strain/dose intradermally or 15 microg intramuscularly. In Year 3 subjects were randomised a third time to one of two groups: 9 microg intradermally or 15 microg intramuscularly. Randomisation lists in Year 1 were stratified for site. Randomisation lists in Years 2 and 3 were stratified for site and by vaccine received in previous years to ensure the inclusion of a comparable number of subjects in a vaccine group at each centre each year. Immunogenicity was assessed 21 days after each vaccination. Safety was assessed throughout the study. RESULTS In Years 2 and 3, 9 microg intradermal was comparably immunogenic to 15 microg intramuscular for all strains, and both vaccines met European requirements for annual licensing of influenza vaccines. The 3 microg and 6 microg intradermal formulations were less immunogenic than intramuscular 15 microg. Safety of the intradermal and intramuscular vaccinations was comparable in each year of the study. Injection site erythema and swelling was more common with the intradermal route. CONCLUSION An influenza vaccine with 9 microg of haemagglutinin/strain given using an intradermal microinjection system showed comparable immunogenic and safety profiles to a licensed intramuscular vaccine, and presents a promising alternative to intramuscular vaccination for influenza for adults younger than 60 years. TRIAL REGISTRATION (Clinicaltrials.gov) NCT00703651.
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Affiliation(s)
- Jiri Beran
- Vaccination and Travel Medicine Centre, Hradec Kralove, Czech Republic.
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22
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Tiwari M, Parida M, Santhosh SR, Khan M, Dash PK, Rao PVL. Assessment of immunogenic potential of Vero adapted formalin inactivated vaccine derived from novel ECSA genotype of Chikungunya virus. Vaccine 2009; 27:2513-22. [PMID: 19368794 DOI: 10.1016/j.vaccine.2009.02.062] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 02/07/2009] [Accepted: 02/12/2009] [Indexed: 10/21/2022]
Abstract
The recent resurgence of Chikungunya virus (CHIKV) in India and Indian Ocean Islands with unusual clinical severity is a matter of great public health concern. Despite the fact that CHIKV resurgence is associated with epidemic of unprecedented magnitude, no approved licensed vaccine is currently available. In the present study, a Vero cell adapted purified formalin inactivated prototype vaccine candidate was prepared using a current Indian strain implicated with the explosive epidemic during 2006. The bulk preparation of the vaccine candidate was undertaken in microcarrier based spinner culture using cytodex-1 in virus production serum free medium. The inactivation of the virus was accomplished through standard formalin inactivation protocol. The mice were immunized subcutaneously with alhydrogel gel formulation of inactivated virus preparation. The assessment of both humoral and cell-mediated immune response was accomplished through ELISA, plaque reduction neutralization test (PRNT), microcytotoxicity assay and cytokine production assay. The results revealed that formalin inactivated vaccine candidate induced both high titered ELISA (1:51,200) and plaque reduction neutralizing antibodies (1:6400) with peak antibody titer being observed during 6 -- 8 weeks of post-vaccination. In the absence of suitable murine challenge model, the protective efficacy was established by both in vitro and in vivo neutralization tests. Further assessment of cellular immunity through in vitro stimulation of spleenocytes from immunized mice revealed augmentation of high levels of both pro- and anti-inflammatory cytokines, indicating a mixed balance of Th1 and Th2 response. These findings suggest that the formalin inactivated Chikungunya vaccine candidate reported in this study has very good immunogenic potential to neutralize the virus infectivity by augmenting both humoral and cell-mediated immune response.
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Affiliation(s)
- Mugdha Tiwari
- Defence Research & Development Establishment, Gwalior, M.P., India
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23
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Rabies vaccines. Vaccines (Basel) 2008. [DOI: 10.1016/b978-1-4160-3611-1.50031-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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Abstract
The incidence of anaphylactic or severe allergic reactions to vaccines is very low, less than one case per million vaccine doses. Larger studies from later years report no deaths. The cause of the reaction is usually not the immunizing antigen itself, but rather some other vaccine ingredient such as egg protein from the production process or gelatin added as a stabilizer. Most people with egg allergy can be vaccinated without any reaction. Vasovagal reactions with or without hyperventilation are common after vaccination. They can be rather dramatic and are often mistaken for anaphylactic reactions. Correct diagnosis is important in making it possible to vaccinate those who might otherwise run the risk of serious infections.
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Affiliation(s)
- Hanne Nokleby
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway.
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25
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Howdieshell TR, Heffernan D, Dipiro JT. Surgical Infection Society Guidelines for Vaccination after Traumatic Injury. Surg Infect (Larchmt) 2006; 7:275-303. [PMID: 16875461 DOI: 10.1089/sur.2006.7.275] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recommendations for vaccination of injured patients against infection are evolving. Newly-recognized infections, safety considerations, changing epidemiology, and redefinition of patient groups at risk are factors that may influence vaccine development priorities and recommendations for immunization. However, recommendations must often be formulated based on incomplete data, forcing reliance on expert opinion to address some crucial questions. These guidelines provide evidence-based recommendations for the prevention or treatment of infectious morbidity and mortality after traumatic injury, such as soft tissue wounds, human or animal bites, or after splenectomy. METHODS A panel of experts conducted a thorough review of published literature, as well as information posted on the internet at the websites of the U.S. Centers for Disease Control and Prevention, among others. MEDLINE was searched for the period 1966-2004 using relevant terms including "anthrax," "rabies," "tetanus," "tetanus toxoid," and " splenectomy," in combination with "vaccine" and "immunization." The Cochrane database was searched also. Reference lists were cross-referenced for additional relevant citations. All published reports were analyzed for quality and graded, with the strength of the recommendation proportionate to the quality of the supporting evidence. RESULTS Recommendations are provided for pre- and post-exposure prophylaxis of rabies and anthrax. For tetanus prophylaxis, recommendations are provided for prophylaxis of acute wounds stratified y age and prior immunization status, and for immunization of persons at high risk. After splenectomy, it is recommended that all persons ages 2-64 years receive 23- valent pneumococcal vaccine and meningococcal vaccine, with Haemophilus influenzae type B vaccine administered to high-risk patients as well (all are Grade D recommendations). Vaccination should be given two weeks before elective splenectomy (Grade C), or two weeks after emergency splenectomy (Grade D). A booster dose of pneumococcal vaccine is recommended after five years (Grade D); no re- vaccination recommendation is made for meningococcal or Haemophilus influenzae type B vaccine. Recommendations for prophylaxis of splenectomized children under the age of five years are also provided. CONCLUSION There are limited data on the use of vaccines after injury. This document brings together a disparate literature of variable quality into a discussion of the infectious risks after injury relevant to vaccine administration, a summary of safety and adverse effects of vaccines, and evidence-based recommendations for vaccination.
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Affiliation(s)
- Thomas R Howdieshell
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA.
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26
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Suwansrinon K, Wilde H, Benjavongkulchai M, Banjongkasaena U, Lertjarutorn S, Boonchang S, Suttisri R, Khowplod P, Daviratanasilpa S, Sitprija V. Survival of neutralizing antibody in previously rabies vaccinated subjects: A prospective study showing long lasting immunity. Vaccine 2006; 24:3878-80. [PMID: 16530893 DOI: 10.1016/j.vaccine.2006.02.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 02/13/2006] [Indexed: 11/17/2022]
Abstract
Physicians dealing with potential rabies exposures and travel medicine are frequently asked how long previous pre- or post-exposure rabies vaccination induced immunity persists. We therefore carried out a prospective study on 118 rabies vaccine recipients who had received pre- or post-exposure regimens with tissue culture rabies vaccines by intramuscular or intradermal schedules 5-21 years previously. Rabies neutralizing antibody was detectable in the sera of all subjects on day 0. They then received one intradermal 0.1 mL booster injection on days 0 and 3. Neutralizing antibody determination was carried out on days 5, 7 and 14. All except one subject showed an accelerated antibody response following the two booster injections. Vaccination with a WHO recognized tissue culture rabies vaccine evokes long lasting immunity. This study supports current recommendations that immunity is long lasting and that boosters without immunoglobulin are sufficient even when prior vaccination was longer than 5 years previously.
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Affiliation(s)
- K Suwansrinon
- Queen Saovabha Memorial Institute, Thai Red Cross Society (WHO Collaborating Center for Research in Rabies), 1871 Rama IV Road, Bangkok 10330, Thailand.
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27
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Affiliation(s)
- Charles E Rupprecht
- Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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28
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Huang DB, Wu JJ, Tyring SK. A review of licensed viral vaccines, some of their safety concerns, and the advances in the development of investigational viral vaccines. J Infect 2004; 49:179-209. [PMID: 15337336 PMCID: PMC7126106 DOI: 10.1016/j.jinf.2004.05.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2004] [Indexed: 02/03/2023]
Abstract
Viral vaccines could be considered among the most important medical achievements of the 20th century. They have prevented much suffering and saved many lives. Although some curative antiviral drugs exist, we desperately depend on efforts by academic, governmental and industrial scientists in the advancement of viral vaccines in the prevention and control of infectious diseases. In the next decade, we hope to see advancement in the development of current and investigational viral vaccines against childhood and adult infections. In this article, we will review the licensed viral vaccines, some of their safety concerns, and the advances in the development of investigational viral vaccines.
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Affiliation(s)
- David B Huang
- Division of Infectious Diseases, Department of Internal Medicine, Baylor College of Medicine, Houston, TX, USA
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Arora A, Moeller L, Froeschle J. Safety and immunogenicity of a new chromatographically purified rabies vaccine in comparison to the human diploid cell vaccine. J Travel Med 2004; 11:195-9. [PMID: 15541220 DOI: 10.2310/7060.2004.19001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although human diploid cell vaccine (HDCV) has been available for over two decades and has a proven record of efficacy, it is very expensive to produce and can only be made in small quantities. METHODS In this trial, we compared the safety and immunogenicity of a new, chromatographically purified rabies vaccine (CPRV) with those of HDCV. One hundred and thirty-five healthy veterinary students were randomized in a 2:1 ratio between CPRV and HDCV respectively. Each student subsequently received an intramuscular injection of 0.5 mL of CPRV or 1mL of HDCV on days 0, 7, and 28, according to the standard preexposure regimen. Local safety data were collected for 7 days following each dose and systemic safety data for 42 days following the first dose. Vaccine administration and safety evaluation were performed by different site personnel. Sera for immunogenicity analysis were collected on days 0 (prevaccination), 28 and 42. RESULTS All subjects achieved an antirabies antibody titer greater than or equal to the World Health Organization (WHO) accepted threshold level of seroconversion of 0.5 IU/mL after only two of three doses of vaccine in both groups. The geometric mean titers (IU/mL) in the CPRV and HDCV groups respectively were 6.54 (range 0.50 to 64.80) and 10.22 (range 0.70 to 51.40) on day 28, and 40.51 (range 5.40 to 278.00) and 37.71 (range 5.40 to 278.00) on day 42. The percentage of subjects experiencing local reactions within 3 days after any dose ranged from 65.2% to 80.9% in the CPRV group and from 77.3% to 84.4% in the HDCV group. The local reaction reported by the greatest percentage of subjects after each dose was pain/tenderness at the injection site, and most reactions were mild. Most of the reported local reactions resolved within 0 to 3 days postvaccination. Systemic reactions decreased from 76.4% after dose 1 to 36.0% after dose 3 in the CPRV group, and similarly from 55.6% to 31.8% in the HDCV group. For all postdose periods, the systemic reaction reported by the highest percentage of subjects was myalgia. No subjects experienced an immediate local or systemic reaction. CONCLUSIONS In healthy adults, vaccination with CPRV using a preexposure schedule resulted in a safety and immunogenicity profile similar to that of HDCV.
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Affiliation(s)
- Ashoni Arora
- Aventis Pasteur, Discovery Drive, Swiftwater, PA, USA
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30
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Abstract
Many infections encountered by international travelers can be prevented by adherence to personal protective measures and appropriate vaccinations. This review outlined the incidence and importance of the major vaccine-preventable infectious diseases encountered by U.S. travelers, as well as the indications, contraindications, and side effects of available vaccines. Official proof of yellow fever vaccine often is required for entry into some countries. Based on endemic or epidemic infections at destinations, planned activities, and age and medical history of international travelers, other vaccines may be recommended. Many clinicians will be familiar with some of the infections and vaccines that may be used in travelers; other vaccines may be encountered infrequently and associated with significant risk of adverse effects. Since vaccines do not provide complete protection and some travel-related infections do not have vaccines available yet (e.g., malaria and dengue fever), physicians need to be vigilant concerning febrile illness in returning travelers.
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Affiliation(s)
- Matthew J Thompson
- Department of Family Medicine, University of Washington, Seattle, WA 98195-4696, USA
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31
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Abstract
Rabies remains as one of the most feared zoonotic diseases in the world. All warm-blooded animals are susceptible to infection by the virus, but the main vectors of human infection are dogs and cats. The control of rabies largely depends on the prevention of infection of dogs and cats by vaccination in endemic areas and the control of their movement, including measures of quarantine and vaccination, in rabies-free countries. This paper provides an overview on recent developments in rabies, with particular emphasis on the epidemiology, pathogenesis, diagnosis, and control.
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Affiliation(s)
- Zerai Woldehiwet
- Department of Veterinary Pathology, Veterinary Teaching Hospital, University of Liverpool, Leahurst, Neston Wirral, CH64 7TE, UK.
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Leder K, Weller PF, Wilson ME. Travel vaccines and elderly persons: review of vaccines available in the United States. Clin Infect Dis 2001; 33:1553-66. [PMID: 11588700 DOI: 10.1086/322968] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2000] [Revised: 05/04/2001] [Indexed: 11/04/2022] Open
Abstract
Aging is associated with alterations in immune responses and may lead to clinically significant changes in the safety, immunogenicity, and protective efficacy of certain vaccines. This review summarizes published data regarding the effects of age on responses after immunization with vaccines generally administered before travel. The specific vaccines discussed in detail include hepatitis A, typhoid, yellow fever, Japanese encephalitis, and rabies vaccines. There is some evidence of diminished serological responses to hepatitis A and rabies vaccines in older individuals. In addition, increased toxic effects following yellow fever vaccination in elderly recipients have recently been reported. However, many travel-related vaccines have never been studied specifically in elderly populations. Consideration of potential age-related differences in responses to travel vaccines is becoming increasingly important as elderly persons more frequently venture to exotic destinations.
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Affiliation(s)
- K Leder
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Dennehy PH. Active immunization in the United States: developments over the past decade. Clin Microbiol Rev 2001; 14:872-908, table of contents. [PMID: 11585789 PMCID: PMC89007 DOI: 10.1128/cmr.14.4.872-908.2001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The Centers for Disease Control and Prevention has identified immunization as the most important public health advance of the 20th century. The purpose of this article is to review the changes that have taken place in active immunization in the United States over the past decade. Since 1990, new vaccines have become available to prevent five infectious diseases: varicella, rotavirus, hepatitis A, Lyme disease, and Japanese encephalitis virus infection. Improved vaccines have been developed to prevent Haemophilus influenzae type b, pneumococcus, pertussis, rabies, and typhoid infections. Immunization strategies for the prevention of hepatitis B, measles, meningococcal infections, and poliomyelitis have changed as a result of the changing epidemiology of these diseases. Combination vaccines are being developed to facilitate the delivery of multiple antigens, and improved vaccines are under development for cholera, influenza, and meningococcal disease. Major advances in molecular biology have enabled scientists to devise new approaches to the development of vaccines against diseases ranging from respiratory viral to enteric bacterial infections that continue to plague the world's population.
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Affiliation(s)
- P H Dennehy
- Division of Pediatric Infectious Diseases, Rhode Island Hospital, Providence, Rhode Island 02903, USA.
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Jones RL, Froeschle JE, Atmar RL, Matthews JS, Sanders R, Pardalos J, Moeller L, Chin JE, Famula M, Briggs DJ, Lang J. Immunogenicity, safety and lot consistency in adults of a chromatographically purified Vero-cell rabies vaccine: a randomized, double-blind trial with human diploid cell rabies vaccine. Vaccine 2001; 19:4635-43. [PMID: 11535311 DOI: 10.1016/s0264-410x(01)00238-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The immunogenicity and safety of a chromatographically purified rabies vaccine (CPRV) was evaluated using US veterinary medical students. In the first study, 242 healthy adults were enrolled in a randomized, modified double-blind, multicenter trial and received five doses of either CPRV or human diploid cell vaccine (HDCV) by intramuscular injection on days 0, 3, 7, 14, and 28 concurrently with human rabies immunoglobulin in a simulated post-exposure prophylaxis regimen. Post-immunization titers in the CPRV and HDCV groups reached 0.5 IU/ml (the WHO-recommended minimally acceptable titer) or greater in all subjects in both vaccine groups by day 14 and remained above that level through day 90. In the second study, 438 healthy adults were enrolled in a randomized, double-blind, multicenter trial and assigned to receive five doses from one of three lots of CPRV by intramuscular injection on days 0, 3, 7, 14, and 28 in a simulated post-exposure prophylaxis regimen to evaluate lot consistency. Post-immunization titers rapidly increased to over 0.5 IU/ml by day 14 for all subjects and remained above that level through day 42 when the study was terminated. The three lots were considered equivalent. The percentage of subjects with at least one local reaction during the five-dose regimen was slightly lower in the CPRV group than in the HDCV group (P=0.06). The most frequently reported local reaction for all doses of vaccine was pain at the injection site. Headache, myalgia, and malaise were the most frequently reported systemic events. The percentage of subjects with at least one systemic event was significantly lower for CPRV (P=0.0084). No vaccine-related serious adverse reaction was reported in these studies. The results of these studies indicate that CPRV administered intramuscularly to healthy adults is immunogenic and is associated with fewer local and systemic reactions than HDCV.
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Affiliation(s)
- R L Jones
- Department of Microbiology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523-1677, USA.
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Ghaffari G, Passalacqua DJ, Bender BS, Briggs DJ, Goodenow MM, Sleasman JW. Human lymphocyte proliferation responses following primary immunization with rabies vaccine as neoantigen. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:880-3. [PMID: 11527796 PMCID: PMC96164 DOI: 10.1128/cdli.8.5.880-883.2001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Evaluation of the T-cell immune response following primary antigenic challenge with a neoantigen is a critical aspect of assessment of the cellular immune response. While many antigens can be used to accurately assess in vitro T-cell proliferation to a recall antigen, only a few neoantigens have been tested for their capacities to measure T-cell responses in vitro to a primary immunization. Rabies vaccination is an excellent candidate for the testing of T-cell proliferation responses to a primary immunization because few individuals have been exposed to rabies virus antigens. In the present study 14 rabies vaccine-naïve, healthy adult volunteers were immunized against rabies virus, and T-cell proliferation and antibody responses were measured before and after vaccination. Optimal lymphocyte proliferation to soluble rabies virus antigen occurred after 8 days in culture. The average level of uptake of tritiated thymidine postimmunization was 29,620 +/- 4,448 cpm, whereas preimmunization levels were 12,660 +/- 3,448 cpm (P = 0.002). All individuals showed increases in rabies virus antibody titers from <0.05 to 5.59 +/- 1.64 IU/ml. The degree of proliferation to tetanus toxoid as a recall antigen was similar to the response to rabies virus antigen among the cohort. Due to high levels of preimmunization proliferation, four subjects failed to demonstrate a twofold increase in response to rabies virus antigen. The high levels of T-cell responses may be due to a viral superantigen effect in some individuals. Rabies vaccination offers a safe and effective means for measurement of both T- and B-cell immune responses to a neoantigen in healthy and immune suppressed individuals.
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Affiliation(s)
- G Ghaffari
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, 32610, USA
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Abstract
Human rabies is fatal except in the small number of patients who received rabies immunization before the onset of clinical rabies. Therapy has been futile in all other cases once rabies has developed. Rabies is always preventable after an exposure if current recommendations are followed. After a potential rabies exposure, details about the contact, the animal, and the local epidemiologic situation are important in making a decision whether to initiate postexposure prophylaxis (PEP). Rabies PEP includes thorough local wound cleansing and both active and passive immunization. Five doses of rabies vaccine should be administered intramuscularly in the deltoid muscle on days 0, 3, 7, 14, and 28 in individuals previously unimmunized against rabies virus. Human rabies immune globulin (20 IU/kg) should be given on day 0 with administration into and around the wounds; the remaining volume is given intramuscularly at a site distant from the vaccine site. Certain individuals at high risk for rabies exposure are candidates for preexposure prophylaxis with three doses of rabies vaccine. Booster doses should be given as required.
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Affiliation(s)
- AC Jackson
- Departments of Medicine and of Microbiology and Immunology, Queen's University, Kingston General Hospital, Connell 725, 76 Stuart Street, Kingston, ON K7L 2V7, Canada.
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Murray KO, Arguin PM. Decision-based evaluation of recommendations for preexposure rabies vaccination. J Am Vet Med Assoc 2000; 216:188-91. [PMID: 10649751 DOI: 10.2460/javma.2000.216.188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- K O Murray
- Viral and Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA 30333, USA
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Abstract
Rabies is one of the oldest known diseases of mankind, yet it has been only slightly more than 100 years since Pasteur developed the first vaccine for post-exposure treatment. Since this first crude nerve tissue vaccine, numerous other rabies vaccines for human use have been developed and used with varying degrees of effectiveness and safety. When used appropriately, new cell culture vaccines provide nearly 100% protection with a high degree of safety: yet over 40,000 people world-wide die from rabies each year. Several pre- and post-exposure controlled vaccine trials and clinical studies have shown that the purified chick embryo cell (PCEC) vaccine, Rabipur, is as safe and effective as the rabies human diploid cell vaccine (HDCV), which is currently considered the gold standard. Additionally, PCEC vaccine does not result in immune-mediated hypersensitivity reactions following booster doses seen in about 6% of those receiving HDCV boosters following an initial series of HDCV.
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Affiliation(s)
- D W Dreesen
- Department of Medical Microbiology, College of Veterinary Medicine, University of Georgia, Athens 30602, USA
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Briggs DJ, Dreesen DW, Morgan P, Chin JE, Seedle CD, Cryz L, Glück R, Cryz SJ. Safety and immunogenicity of Lyssavac Berna human diploid cell rabies vaccine in healthy adults. Vaccine 1996; 14:1361-5. [PMID: 9004446 DOI: 10.1016/s0264-410x(96)00049-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A clinical trial testing the safety and immunogenicity of a newly developed human diploid cell rabies vaccine (Lyssavac-HDC) was conducted on subjects at three colleges of veterinary medicine in the United States. Lyssavac-HDC is a sterile lyophilized vaccine containing no antibiotics or preservatives and is administered intramuscularly as a 0.5 ml dose of vaccine containing at least 2.5 i.u. of rabies inactivated antigen per dose. Subjects were given either a three dose pre-exposure series (days 0, 7, and 28), followed by one booster dose of vaccine (day 360); or a five dose simulated post-exposure series of injections (days 0, 3, 7, 14, and 28). All subjects in the post-exposure and pre-exposure groups possessed adequate levels of rabies neutralizing antibody (> or = 5) when tested on day 14 and day 28, respectively. Subjects in the pre-exposure group demonstrated a vigorous anamnestic response after the administration of one booster dose of vaccine on day 360. The type and severity of local and systemic reactions observed were comparable to other primary cell culture rabies vaccines. Significantly, there were no type III hypersensitivity reactions reported in subjects previously immunized with Lyssavac-HDC after the administration of a booster dose of vaccine on day 360.
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Affiliation(s)
- D J Briggs
- College of Veterinary Medicine, Kansas State University, Manhattan 66506-5601, USA
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