1
|
Choi UY, Kim KH, Cho HK, Kim DH, Ma SH, Choi YY, Kim CS, Capeding MR, Kobashi IAR, Kim H, Ryu JH, Lee SJ, Park HK, Kim JH. Immunogenicity and Safety of a Newly Developed Live Attenuated Varicella Vaccine in Healthy Children: A Multi-National, Randomized, Double-Blinded, Active-Controlled, Phase 3 Study. Vaccines (Basel) 2023; 11:1416. [PMID: 37766093 PMCID: PMC10537027 DOI: 10.3390/vaccines11091416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Korean manufacturers have developed a new varicella vaccine, NBP608. This phase 3, randomized, double-blind, multicenter study aimed to compare the immunogenicity and safety of NBP608 in healthy children to those of VarivaxTM (control). Children aged 12 months to 12 years were randomized in a ratio of 1:1 to receive either NBP608 or the control vaccine. Serum samples were obtained before vaccination and within six to eight weeks after vaccination. In total, 499 participants (NBP608, n = 251; control, n = 248) were enrolled. The seroconversion rate (SCR) measured using a FAMA assay was 99.53% in the NBP608 group, and the lower limit of the 95% confidence interval (95% LCL) for the SCR difference (NBP608 minus the control) was 0.52%. This 95% LCL for the difference was higher than the specified non-inferiority margin of -15%. In an assessment using gpELISA, the SCR was 99.53% in the NBP608 group, and the 95% LCL for the SCR difference was 6.5%, which was higher than the specified non-inferiority margin of -15%. There were no significant differences between the NBP608 and control group with respect to the proportions of participants who demonstrated local and systemic solicited AEs. This study indicated that NBP608 had a clinically acceptable safety profile and was not immunologically inferior to VarivaxTM.
Collapse
Affiliation(s)
- Ui Yoon Choi
- Department of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea;
| | - Ki Hwan Kim
- Department of Pediatrics, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea;
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University College of Medicine, Incheon 21936, Republic of Korea;
| | - Dong Ho Kim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul 01812, Republic of Korea;
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon 51394, Republic of Korea;
| | - Young Youn Choi
- Department of Pediatrics, Chonnam National University Medical School, Gwangju 61469, Republic of Korea;
| | - Chun Soo Kim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Maria Rosario Capeding
- Department of Microbiology, Research Institute for Tropical Medicine, Manila 1781, Philippines;
| | | | - Hun Kim
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Ji Hwa Ryu
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Su Jeen Lee
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Ho Keun Park
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Jong-Hyun Kim
- Department of Pediatrics, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea
| |
Collapse
|
2
|
Faust SN, Le Roy M, Pancharoen C, Weber MAR, Cathie K, Behre U, Bernatoniene J, Snape MD, Helm K, Medina Pech CE, Henry O, Baccarini C, Povey M, Gillard P. Safety and immunogenicity of a varicella vaccine without human serum albumin (HSA) versus a HSA-containing formulation administered in the second year of life: a phase III, double-blind, randomized study. BMC Pediatr 2019; 19:50. [PMID: 30732648 PMCID: PMC6366055 DOI: 10.1186/s12887-019-1425-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/31/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A new formulation of the live-attenuated varicella vaccine Varilrix (GSK) produced without human serum albumin (HSA) was developed to minimize a theoretical risk of transmission of infectious diseases. A previous study showed that the vaccine was immunologically non-inferior to the HSA-containing vaccine and well-tolerated in toddlers; low-grade fever was numerically higher in children receiving the vaccine without HSA, but the study lacked power to conclude on this difference. METHODS In this phase III, double-blind, multi-center study, healthy 12-23-month-olds were randomized (1:1) to receive two doses of the varicella vaccine without (Var-HSA group) or with HSA (Var + HSA group) at days 0 and 42. The primary objective compared safety of the vaccines in terms of incidence of fever > 39.0 °C in the 15-day period post-first vaccination. The objective was considered met if the upper limit of the 95% confidence interval for the between-group difference in the incidence of fever > 39.0 °C was ≤5% (Var-HSA group minus Var + HSA group). Safety, reactogenicity and immune responses were evaluated. RESULTS Six hundred fifteen children in the Var-HSA group and 616 in the Var + HSA group received ≥1 vaccination. Fever > 39.0 °C was reported in 3.9 and 5.2% of participants in the Var-HSA and Var + HSA groups, with a between-group difference of - 1.29 (95% confidence interval: - 3.72-1.08); therefore, the primary objective was achieved. Fever rates post-each dose and the incidence of solicited local and general adverse events (AEs) were comparable between groups. Unsolicited AEs were reported for 43.9 and 36.5% of children in the Var-HSA group and 45.8 and 36.0% of children in the Var + HSA group, during 43 days post-dose 1 and 2, respectively. Serious AEs occurred in 2.1% (group Var-HSA) and 2.4% (group Var + HSA) of children, throughout the study. In a sub-cohort of 364 children, all had anti-varicella-zoster virus antibody concentrations ≥50 mIU/mL post-dose 2; comparable geometric mean concentrations were observed between the groups. CONCLUSIONS The varicella vaccine formulated without HSA did not induce higher rates of fever during the 15 day-post-vaccination period, as compared with the original HSA-containing vaccine. The two vaccines displayed similar safety and immunogenicity profiles in toddlers. TRIAL REGISTRATION NCT02570126 , registered on 5 October 2015 (www.clinicaltrials.gov).
Collapse
Affiliation(s)
- Saul N Faust
- NIHR Southampton Clinical Research Facility, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
| | | | - Chitsanu Pancharoen
- Department of Pediatrics and Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand
| | - Miguel Angel Rodriguez Weber
- Instituto Nacional de Pediatria, Insurgentes Sur 3700C Col. Insurgentes Cuicuilco, Coyoacan, 04530, Mexico City, Mexico
| | - Katrina Cathie
- NIHR Southampton Clinical Research Facility, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Ulrich Behre
- Private Practice, Hauptstrasse 240, 77694, Kehl, Germany
| | - Jolanta Bernatoniene
- Pediatric Infectious Disease Department, Education Centre Level 6, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8AE, UK
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Headington, Oxford, OX3 9DU, UK
| | - Klaus Helm
- Private practice, Paulinenstrasse 71a, 32756, Detmold, Germany
| | - Carlos Eduardo Medina Pech
- Medical Care and Research SA de CV, Calle 32 No. 217 Col. Garcia Gineres, 97070, Mérida, Yucatán, Mexico
| | - Ouzama Henry
- GSK, 14200 Shady Grove Rd, Rockville, MD, 20850, USA
| | - Carmen Baccarini
- GSK at the time of study conduct, 160 North Gulph Road, King of Prussia, PA, 19406, USA
| | | | | |
Collapse
|
3
|
Huang L, Chen Z, Hu Y, Xie Z, Qiu P, Zhu L, Bao M, Quan Y, Zeng J, Wang Y, Cui X, Yuan L, Xia S, Meng F. Safety, immunogenicity, and lot-to-lot consistency of live attenuated varicella vaccine in 1-3 years old children: a double-blind, randomized phase III trial. Hum Vaccin Immunother 2019; 15:822-827. [PMID: 30481106 DOI: 10.1080/21645515.2018.1551701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The study was to evaluate the safety, immunogenicity and lot-to-lot consistency of live attenuated varicella vaccine in Chinese population aged 1-3 years. The double-blind, randomized phase III trial was conducted in Henan Province, China. In total, 1197 subjects were included in this study. Subjects were randomly assigned into four groups in a 2:2:2:1 ratio to receive one of the three lots of commercial scale (CS) vaccine or the licensed pilot scale (LPS) vaccine. Seroconversion rate and neutralizing antibody titers (NATb) were assessed at day 0 pre-vaccination and at day 30 post-vaccination. Safety data were recorded for 30 days post-vaccination. After vaccination, the geometric mean titers (GMTs) of the three CS groups were 25.04 (95% confidence interval [CI], 22.85 to 27.44), 24.47 (95% CI, 22.35 to 26.78) and 25.88 (95% CI, 23.61 to 28.36), respectively (P= 0.6928). The ratio of GMTs adjusted for covariates of each pair of lots were all between 0.67 to 1.50 in susceptible subjects. The difference of seroconversion rate between pooled CS group and LPS group was 3.82 (95% CI, 0.55 to 8.81). Meanwhile, the percentage of solicited local, systemic and unsolicited adverse reactions showed no difference across the four groups, and most of the adverse reactions were mild or moderate in intensity. The CS group was comparable to the LPS group in safety and immunogenicity. The consistency of three consecutive CS lots was reliable. Moreover, the CS group was non-inferior to the LPS group.
Collapse
Affiliation(s)
- Lili Huang
- a Henan Center for Disease Control and Prevention , Vaccine Clinical Trail & Lab for Infectious Disease Control and Prevention , Zhengzhou , Henan , China
| | - Zhen Chen
- b Department of Respiratory Virus , National Institutes for Food and Drug Control , Beijing , China
| | - Yuansheng Hu
- c Research and Development Center , Sinovac Biotech Co., LTD , Beijing , China
| | - Zhiqiang Xie
- a Henan Center for Disease Control and Prevention , Vaccine Clinical Trail & Lab for Infectious Disease Control and Prevention , Zhengzhou , Henan , China
| | - Ping Qiu
- b Department of Respiratory Virus , National Institutes for Food and Drug Control , Beijing , China
| | - Lang Zhu
- c Research and Development Center , Sinovac Biotech Co., LTD , Beijing , China
| | - Manli Bao
- a Henan Center for Disease Control and Prevention , Vaccine Clinical Trail & Lab for Infectious Disease Control and Prevention , Zhengzhou , Henan , China
| | - Yaru Quan
- b Department of Respiratory Virus , National Institutes for Food and Drug Control , Beijing , China
| | - Ji Zeng
- d Clinical Research Department , Sinovac Biotech Co., LTD , Beijing , China
| | - Yanxia Wang
- a Henan Center for Disease Control and Prevention , Vaccine Clinical Trail & Lab for Infectious Disease Control and Prevention , Zhengzhou , Henan , China
| | - Xiaoyu Cui
- b Department of Respiratory Virus , National Institutes for Food and Drug Control , Beijing , China
| | - Liyong Yuan
- b Department of Respiratory Virus , National Institutes for Food and Drug Control , Beijing , China
| | - Shengli Xia
- a Henan Center for Disease Control and Prevention , Vaccine Clinical Trail & Lab for Infectious Disease Control and Prevention , Zhengzhou , Henan , China
| | - Fanhong Meng
- e Research and Development Center , Sinovac (Dalian) Vaccine Technology Co., LTD , Dalian , China
| |
Collapse
|
4
|
Lalwani S, Chatterjee S, Balasubramanian S, Bavdekar A, Mehta S, Datta S, Povey M, Henry O. Immunogenicity and safety of early vaccination with two doses of a combined measles-mumps-rubella-varicella vaccine in healthy Indian children from 9 months of age: a phase III, randomised, non-inferiority trial. BMJ Open 2015; 5:e007202. [PMID: 26362659 PMCID: PMC4567664 DOI: 10.1136/bmjopen-2014-007202] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study (NCT00969436) compared the immunogenicity and safety of measles-mumps-rubella (MMR) followed by MMR+varicella (V) vaccines to (1) 2 doses of combined MMRV and (2) MMR followed by MMRV, in Indian children. DESIGN Phase III, open, randomised, non-inferiority study. SETTING 6 tertiary care hospitals located in India. PARTICIPANTS Healthy participants aged 9-10 months not previously vaccinated against/exposed to measles, mumps, rubella and varicella or without a history of these diseases. INTERVENTIONS Participants were randomised (2:2:1) to receive 2 doses of either MMRV (MMRV/MMRV group) or MMR followed by MMRV (MMR/MMRV group) or MMR followed by MMR+V (MMR/MMR+V, control group) at 9 and 15 months of age. Antibody titres against measles, mumps and rubella were measured using ELISA and against varicella using an immunofluorescence assay. MAIN OUTCOME MEASURES To demonstrate non-inferiority of the 2 vaccination regimens versus the control in terms of seroconversion rates, defined as a group difference with a lower bound of the 95% CI >-10% for each antigen, 43 days postdose 2. Parents/guardians recorded solicited local and general symptoms for a 4-day and 43-day period after each vaccine dose, respectively. RESULTS Seroconversion rates postdose 1 ranged from 87.5% to 93.2% for measles, 83.3% to 86.1% for mumps and 98.7% to 100% for rubella across the 3 vaccine groups. The seroconversion rates postdose 2 were 100% for measles, mumps and rubella and at least 95.8% for varicella across the 3 vaccine groups. Non-inferiority of MMRV/MMRV and MMR/MMRV to MMR/MMR+V was achieved for all antigens, 43 days postdose 2. The 3 vaccination regimens were generally well tolerated in terms of solicited local and general symptoms. CONCLUSIONS The immune responses elicited by the MMRV/MMRV and MMR/MMRV vaccination regimens were non-inferior to those elicited by the MMR/MMR+V regimen for all antigens. The 3 vaccination schedules also exhibited an acceptable safety profile in Indian children. TRIAL REGISTRATION NUMBER NCT00969436.
Collapse
Affiliation(s)
- Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Sukanta Chatterjee
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | | | - Ashish Bavdekar
- Department of Pediatrics, KEM Hospital, Pune, Maharashtra, India
| | | | | | | | - Ouzama Henry
- GSK Vaccines, King of Prussia, Philadelphia, USA
| |
Collapse
|
5
|
Mitra M, Faridi M, Ghosh A, Shah N, Shah R, Chaterjee S, Narang M, Bhattacharya N, Bhat G, Choudhury H, Kadhe G, Mane A, Roy S. Safety and immunogenicity of single dose live attenuated varicella vaccine (VR 795 Oka strain) in healthy Indian children: a randomized controlled study. Hum Vaccin Immunother 2015; 11:443-9. [PMID: 25692656 PMCID: PMC4514385 DOI: 10.1080/21645515.2014.1004031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Varicella, an acute viral systemic infection that may cause lifelong latent infection with the potential for causing clinical reactivation, may be prevented by immunization. The present study was an open label, randomized, controlled, phase III, multicentre trial, conducted to evaluate and compare the safety, tolerability and immunogenicity of a freeze dried live attenuated Oka strain Varicella Vaccine (VR 795 Oka strain) with Varilrix (Oka-RIT strain) in children. A total of 268 healthy Indian children aged 12 months to 12 y with baseline VZV IgG antibody (<100 mIU/ mL) were enrolled, and 256 children completed the study. The extent of rise of VZV IgG antibody titer assessed as 3-fold and 4-fold rise from baseline was found to be significantly higher (89.1% and 85.2%) in the test group as compared to control group (73.4% and 61.7%). The post-vaccination GMT of the test group was significantly higher (112.5 mIU/mL) as compared with the control group (67.8 mIU/mL) (P < 0.001). The seroconversion rate considering the 5 gp ELISA units/ml equivalent to 10mIU/ml were similar in the control (96.5%) and the test (98.3%) groups. The adverse events were not different in the control and test groups (P > 0.05). The test live attenuated vaccine was found to be highly immunogenic, safe and comparable to Varilrix used in control arm.
Collapse
Affiliation(s)
- Monjori Mitra
- Institute of Child Health; Kolkata, India
- Correspondence to: Monjori Mitra;
| | - Mma Faridi
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital Dilshad Garden, Delhi, India
| | | | - Nitin Shah
- Department of Pediatrics; Lion's Tarachand Bapa Hospital Sion West; Mumbai, India
| | - Raju Shah
- Ankur Children's Hospital; Ahmedabad, India
| | - Suparna Chaterjee
- Department of Pharmacology; Institute of Postgraduate Medical Education & Research; Kolkata, India
| | - Manish Narang
- Department of Pediatrics; University College of Medical Sciences; GTB Hospital Dilshad Garden, Delhi, India
| | | | - Gandhali Bhat
- Department of Pediatrics; Lion's Tarachand Bapa Hospital Sion West; Mumbai, India
| | | | | | - Amey Mane
- Medical Affairs Wockhardt; East Mumbai, India
| | - Sucheta Roy
- Medical Affairs Wockhardt; East Mumbai, India
| |
Collapse
|
6
|
Sasadeusz J, Prince H, Schwarer A, Szer J, Stork A, Bock H, Povey M, Nicholson O, Innis B. Immunogenicity and safety of a two-dose live attenuated varicella vaccine given to adults following autologous hematopoietic stem cell transplantation. Transpl Infect Dis 2014; 16:1024-31. [DOI: 10.1111/tid.12295] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/01/2014] [Accepted: 08/21/2014] [Indexed: 11/30/2022]
Affiliation(s)
- J. Sasadeusz
- Victorian Infectious Disease Service; Royal Melbourne Hospital; Melbourne Australia
| | - H.M. Prince
- Haematology Department; Peter MacCallum Centre; Melbourne Australia
- Department of Medicine; University of Melbourne; Melbourne Australia
| | - A. Schwarer
- Malignant Haematology and Stem Cell Transplant Service; The Alfred Hospital; Melbourne Australia
| | - J. Szer
- Victorian Infectious Disease Service; Royal Melbourne Hospital; Melbourne Australia
- Department of Medicine; University of Melbourne; Melbourne Australia
| | - A. Stork
- Medical Department; Ipsen Pty Ltd; Melbourne Australia
| | - H.L. Bock
- Development; Novartis Vaccines; Singapore
| | - M. Povey
- Department of Statistics; GlaxoSmithKline Vaccines; Wavre Belgium
| | - O. Nicholson
- Vaccine Discovery and Development; GlaxoSmithKline Vaccines; King of Prussia Pennsylvania USA
| | - B.L. Innis
- Vaccine Discovery and Development; GlaxoSmithKline Vaccines; King of Prussia Pennsylvania USA
| |
Collapse
|
7
|
Abstract
Herpes zoster is caused by reactivation from previous varicella zoster virus (VZV) infection, and affects millions of people worldwide. It primarily affects older adults and those with immune system dysfunction, most likely as a result of reduced or lost VZV-specific cell-mediated immunity. Complications include post-herpetic neuralgia, a potentially debilitating and chronic pain syndrome. Current treatment of herpes zoster and post-herpetic neuralgia involves antiviral agents and analgesics, and is associated with significant economic cost. Results from several clinical trials have determined that a live, attenuated VZV vaccine using the Oka/Merck strain (Zostavax) is safe, elevates VZV-specific cell-mediated immunity, and significantly reduces the incidence of herpes zoster and post-herpetic neuralgia in people over 60 years of age. Regulatory approval has recently been obtained and once launched, it is expected that this vaccine will significantly reduce the morbidity and financial costs associated with herpes zoster. Durability of vaccine response and possible booster vaccination will still need to be determined.
Collapse
Affiliation(s)
- Mark Holodniy
- VA Palo Alto Health Care System, 3801 Miranda Ave. (132), Palo Alto, CA 94306, USA.
| |
Collapse
|
8
|
Single-dose varicella vaccine effectiveness in school settings in China. Vaccine 2013; 31:3834-8. [PMID: 23845816 DOI: 10.1016/j.vaccine.2013.06.075] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/25/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Varicella vaccine has been available in the private sector in China for a decade as a single-dose regimen, but varicella vaccine effectiveness (VE) has not been fully examined in school settings yet. METHODS A matched case-control study was carried out in elementary schools and daycares in Tai'an prefecture, Shandong province, China. Clinical diagnosis of varicella and breakthrough disease was used for this study. Four controls were randomly selected from classmates; two from classmates of the case and two from another class of the same grade without cases. Vaccination status, date of vaccination, and vaccine product received if vaccinated were collected from home and clinic immunization records. Vaccination status of all students in schools/daycares with varicella cases from home immunization records or parental recall was used to calculate vaccination coverage. RESULTS The overall varicella VE was 83.4% (95% confidence interval 71.4-90.3%). Receipt of varicella vaccine five years or more years before the outbreak was significantly associated with breakthrough varicella (odds ratio=4.7, P<0.001), while age at vaccination (<15 vs. ≥15 months) was not (odds ratio=1.5, P=0.62). Varicella vaccination coverage was 41% with substantial variation across schools (range of 0-93.8%). CONCLUSIONS Single-dose varicella vaccine is highly effective in school settings. Maintaining limited vaccination coverage might shift varicella disease burden to older individuals, who are more prone to develop severe outcomes if varicella occurs.
Collapse
|
9
|
Abstract
BACKGROUND The attenuated live varicella vaccine had been shown to be effective in preventing varicella and reducing the disease burden in the United States. However, little work has been done on investigating vaccine effectiveness in China where 3 varicella vaccines are available. Although the vaccines contain the same strain of virus, the vaccines licensed in China were from manufacturers different from the one licensed in the United States. We conducted a matched case-control study to assess the effectiveness of the 3 varicella vaccines in use in China. METHODS In 2005, we enrolled 1000 cases from Guangzhou, China and 1000 controls matched by age and place of residence. The cases were children clinically diagnosed with acute onset of a diffuse maculopapulovesicular rash without other apparent cause. We interviewed the legal guardians of the participants for demographic information and disease history after obtaining informed consent. We collected information on vaccination status from electronic vaccination records. RESULTS The 3 varicella vaccines in China (Varilrix from GlaxoSmithKline, Changchun and Shanghai from Changchun and Shanghai Institutes of Biologic Products, respectively) had similar effectiveness: Varilrix 86.4% (95% confidence interval [CI]: 72.6, 93.2), Changchun 79.5% (95% CI: 58.1, 90.0), and Shanghai 92.6% (95% CI: 68.9, 98.2). Vaccine effectiveness was higher during the first year after vaccination than during the subsequent 5 years, but the differences did not reach statistical significance. CONCLUSIONS The varicella vaccines in China are highly effective in preventing clinical varicella. Further studies on laboratory-confirmed cases are needed to verify the change of vaccine-induced immunity over time.
Collapse
|
10
|
Czajka H, Schuster V, Zepp F, Esposito S, Douha M, Willems P. A combined measles, mumps, rubella and varicella vaccine (Priorix-Tetra): immunogenicity and safety profile. Vaccine 2009; 27:6504-11. [PMID: 19665608 DOI: 10.1016/j.vaccine.2009.07.076] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 06/29/2009] [Accepted: 07/22/2009] [Indexed: 10/20/2022]
Abstract
Priorix-Tetra (GlaxoSmithKline Biologicals) is a combined measles, mumps, rubella and varicella (MMRV) vaccine. Eight studies involving more than 3000 children were reviewed. Compared with co-administration of MMR (Priorix) and varicella (Varilrix) vaccines, the MMRV vaccine showed: similar immunogenicity, with immunity shown up to 3 years post-vaccination; a higher rate of fever after the first dose; a slight increase in mild local reactions after the second dose. This MMRV vaccine can be used either as a two-dose vaccine or as a second dose in children primed with separate MMR and/or varicella vaccines, offering a convenient way to introduce varicella vaccination into routine vaccination programmes.
Collapse
Affiliation(s)
- Hanna Czajka
- Vaccination Outpatient Clinic, Szpital sw. Ludwika, ul. Strzelecka 2, 31-503 Cracow, Poland.
| | | | | | | | | | | |
Collapse
|