1
|
Hannawi S, Yan L, Saifeldin L, Abuquta A, Alamadi A, Mahmoud SA, Hassan A, Zhang M, Gao C, Chen Y, Gai W, Xie L. Safety and immunogenicity of multivalent SARS-CoV-2 protein vaccines: a randomized phase 3 trial. EClinicalMedicine 2023; 64:102195. [PMID: 37731938 PMCID: PMC10507195 DOI: 10.1016/j.eclinm.2023.102195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Background COVID-19 vaccines that offer broad-spectrum protection are needed. We aimed to evaluate the safety and immunogenicity of multivalent vaccines, SCTV01E and SCTV01C, and compare them with an inactivated vaccine. Methods In the phase 3 trial (ClinicalTrials.gov: NCT05323461), adult participants previously vaccinated with Sinopharm's inactivated SARS-CoV-2 vaccine (BBBIP-CorV) were assigned to receive one booster dose of BBBIP-CorV, 20 μg SCTV01C, or 30 μg SCTV01E. The primary endpoint was to evaluate the geometric mean titers (GMT) of neutralizing antibody (nAb) against the Delta and Omicron BA.1 variants on day 28 after injection. Additional endpoints included GMTs of nAb against Delta (B.1.617.2) and Omicron BA.1 variants on day 180, GMTs against BA.5 on day 28, as well as solicited adverse events (AEs) within seven days, unsolicited AEs within 28 days, and serious AEs, AEs of special interest within 180 days after vaccination. Findings Between May 30, 2022 and October 28, 2022, a total of 1351 participants were randomized to BBBIP-CorV, SCTV01C, or SCTV01E in a 1:1:1 ratio, with immunogenicity assessments performed on the first 300 participants. For BBBIP-CorV, SCTV01C, and SCTV01E groups, the day 28 GMTs of neutralizing antibody against Omicron BA.1 were a 2.38-, 19.37-, and 28.06-fold increase from baseline; the GMTs against Omicron BA.5 were 2.07-, 15.89- and 21.11-fold increases; the GMTs against Delta variants were 1.97-, 12.76-, and 15.88-fold increases, respectively. The day 28 geometric mean ratio (GMR) of SCTV01C/BBIBP-CorV for Omicron BA.1 was 6.49 (95% CI: 4.75, 8.88), while the GMR of SCTV01E/BBIBP-CorV was 9.56 (95% CI: 6.85, 13.33). For the Delta variant, the day 28 GMR of SCTV01C/BBIBP-CorV was 6.26 (95% CI: 4.78, 8.19), and the day 28 GMR of SCTV01E/BBIBP-CorV was 7.26 (95% CI: 5.51, 9.56). On Day 180, the GMTs against Omicron BA.1 were 2.80-, 9.51-, and 15.56-fold increase from baseline, while those against Delta were 1.58-, 5.49-, and 6.63-fold for BBBIP-CorV, SCTV01C, and SCTV01E groups, respectively. Subgroup analyses showed that SCTV01C and SCTV01E induced uniformly high GMTs against both BA.1 and BA.5, demonstrating its superiority over BBIBP-CorV, regardless of baseline GMT levels. Safety and reactogenicity were similar among the three vaccines. Most AEs were Grade 1 or 2. There were 15 ≥Grade 3 AEs: 6 in the BBIBP-CorV group, 4 in the SCTV01C group and 5 in the SCTV01E group. No SAE was reported and one grade 1 AESI (Bell's palsy) was observed in SCTV01C group. Interpretation A booster dose of the tetravalent vaccine SCTV01E consistently induced high neutralizing antibody responses against Omicron BA.1, BA.5, and Delta variants, demonstrating superiority over inactivated vaccine. There is evidence to suggest that SCTV01E may have GMT superiority over bivalent vaccine SCTV01C against Delta, BA.1 and BA.5 variants. Funding This study was sponsored by Sinocelltech Ltd., and funded by the Beijing Science and Technology Planning Project [Z221100007922012] and the National Key Research and Development Program of China [2022YFC0870600].
Collapse
Affiliation(s)
- Suad Hannawi
- Internal Medicine Department, Al Kuwait-Dubai (ALBaraha) Hospital, Dubai, United Arab Emirates
| | - Lixin Yan
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Linda Saifeldin
- General Surgery Department, Al Kuwait-Dubai (ALBaraha) Hospital, Dubai, United Arab Emirates
| | - Alaa Abuquta
- Internal Medicine Department, Al Kuwait-Dubai (ALBaraha) Hospital, Dubai, United Arab Emirates
| | - Ahmad Alamadi
- Ear, Nose and Throat Department (ENT), Al Kuwait-Dubai (ALBaraha) Hospital, Dubai, United Arab Emirates
| | | | - Aala Hassan
- Internal Medicine Department, Al Kuwait-Dubai (ALBaraha) Hospital, Dubai, United Arab Emirates
| | - Miaomiao Zhang
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Cuige Gao
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Yuanxin Chen
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Wenlin Gai
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Liangzhi Xie
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| |
Collapse
|
2
|
Affiliation(s)
- Ran Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Virology Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Beijing 100045, China.,Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China
| | - Fu-Jia Yang
- Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China
| | - Xiao-Yan Zheng
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Second Clinical Medical College of Capital Medical University, Beijing 100050, China
| | - Xian-Zheng Liao
- Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China
| | - Dong-Ying Fan
- Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China
| | - Hui Chen
- Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China
| | - Jing An
- Department of Microbiology, School of Basic Medical Sciences, Chinese Capital Medical University, Beijing 100069, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100069, China. E-mail:
| |
Collapse
|
3
|
Batista ICA, Quinan BR, Rocha Alves ÉA, Jangola STG, Oliveira ES, Colombarolli SG, Ferreira JGG, Rocha ESDO, Kroon EG, de Assis RR, de Oliveira JG, Fiuza JA, Calzavara-Silva CE. Design and production of dengue virus chimeric proteins useful for developing tetravalent vaccines. Vaccine 2020; 38:2005-2015. [PMID: 31982262 DOI: 10.1016/j.vaccine.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 12/05/2019] [Accepted: 01/03/2020] [Indexed: 01/09/2023]
Abstract
Dengue virus (DENV) is a Flavivirus estimated to cause 390 million infections/year. Currently, there is no anti-viral specific treatment for dengue, and efficient DENV vector control is still unfeasible. Here, we designed and produced chimeric proteins containing potential immunogenic epitopes from the four DENV serotypes in an attempt to further compose safer, balanced tetravalent dengue vaccines. For this, South American DENV isolate sequences were downloaded from the NCBI/Virus Variation/Dengue virus databases and intraserotype-aligned to generate four consensuses. Four homologous DENV sequences were retrieved using BLAST and then interserotype-aligned. In parallel, sequences were subjected to linear B epitope prediction analysis. Regions of the envelope and NS1 proteins that are highly homologous among the four DENV serotypes, non-conserved antigenic regions and the most antigenic epitopes found in the C, prM, E and NS1 DENV proteins were used to construct 11 chimeric peptides. Genes encoding the chimeric proteins were commercially synthesized, and proteins were expressed, purified by affinity chromatography and further subjected to ELISA assays using sera from individuals infected with DENVs 1, 2, 3 or 4. As a proof-of-concept, the chimeric EnvEpII protein was selected to immunize BALB/c and C57BL/6 mice strains. The immunization with EnvEpII protein associated with aluminum induced an increased number of T CD4+ and CD8+ cells, high production of IgG1 and IgG2 antibodies, and increased levels of IL-2 and IL-17 cytokines, in both mouse strains. Because the EnvEpII protein associated with aluminum induced an efficient cellular response by stimulating the production of IL-2, IL-4, IL-17 and induced a robust humoral response in mice, we conclude that it resembles an efficient specific response against DENV infection. Although further experiments are required, our results indicate that epitope selection by bioinformatic tools is efficient to create recombinant proteins that can be used as candidates for the development of vaccines against infectious diseases.
Collapse
Affiliation(s)
- Izabella Cristina Andrade Batista
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Bárbara Resende Quinan
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 110 Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
| | - Érica Alessandra Rocha Alves
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Soraya Torres Gaze Jangola
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Eneida Santos Oliveira
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Stella Garcia Colombarolli
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Jorge Gomes Goulart Ferreira
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | | | - Erna Geessien Kroon
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, ICB, Av. Presidente Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil.
| | - Rafael Ramiro de Assis
- Vaccine Research and Development Center, Department of Physiology, University of California Irvine, USA.
| | - Jaquelline Germano de Oliveira
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Jacqueline Araújo Fiuza
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| | - Carlos Eduardo Calzavara-Silva
- Grupo de Imunologia Celular e Molecular, Fundação Oswaldo Cruz, IRR, Av. Augusto de Lima, 1715 Barro Preto, Belo Horizonte, MG, Brazil.
| |
Collapse
|
4
|
Tian X, Jiang Z, Fan Y, Qiu S, Zhang L, Li X, Zhou Z, Liu T, Ma Q, Lu X, Zhong B, Zhou R. A tetravalent vaccine comprising hexon-chimeric adenoviruses elicits balanced protective immunity against human adenovirus types 3, 7, 14 and 55. Antiviral Res 2018; 154:17-25. [PMID: 29626491 DOI: 10.1016/j.antiviral.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/02/2018] [Indexed: 12/17/2022]
Abstract
Human adenovirus (Ad) species B contains several of the most important types associated with acute respiratory diseases, Ad3, -7, -14 and -55, which often lead to severe lower respiratory tract diseases and epidemic outbreaks. However, there is currently no Ad vaccine approved for general use. The major capsid protein, hexon, is the primary determinant recognized by neutralizing antibodies (NAbs). In this study, four recombinant Ads that have the same genome sequence as Ad3 with the exception of the hexon genes, rAd3EGFP, rAd3H7, rAd3H14 and rAd3H55, were combined as a tetravalent Ad candidate vaccine against Ad3, -7, -14 and -55. The replication efficiencies of chimeric rAd3H14, rAd3H7 and rAd3H55 were similar to that of rAd3EGFP. Recombinant rAd3EGFP, rAd3H7, rAd3H14 and rAd3H55 induced high titers of NAbs against Ad3, -7, -14 and -55, respectively, which were comparable to those induced by wild-type Ads. The mixture of the four recombinant Ads in equal proportions, rAdMix, or rAdMix inactivated by β-propiolactone, induced balanced NAb responses against Ad3, -7, -14 and -55 in mice without reciprocal immunological interference. In co-culture the four recombinant Ads replicated with a similar efficiency without reciprocal inhibition, and the progeny virions may be chimeric. Purified co-culture, rAdMix-C, also elicited balanced immune responses, suggesting a simple method for multivalent vaccine production. These results indicate the possible advantage of the four Ads as a live combined vaccine. Importantly, pre-immunization with rAdMix conferred protection against Ad3, -7, -14 or -55 challenge in mice in vivo. Thus, this research provides a novel tetravalent Ad vaccine candidate against Ad3, -7, -14 and -55.
Collapse
|
5
|
Spiri AM, Rodriguez-Campos S, Matos JM, Glaus TM, Riond B, Reusch CE, Hofmann-Lehmann R, Willi B. Clinical, serological and echocardiographic examination of healthy field dogs before and after vaccination with a commercial tetravalent leptospirosis vaccine. BMC Vet Res 2017; 13:138. [PMID: 28545521 PMCID: PMC5445508 DOI: 10.1186/s12917-017-1056-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/11/2017] [Indexed: 01/08/2023] Open
Abstract
Background Leptospirosis is a re-emerging bacterial zoonosis caused by spirochetes of the genus Leptospira. Severe disease has been reported in dogs in Europe despite vaccination with bivalent Leptospira vaccines. Recently, a tetravalent canine Leptospira vaccine (Nobivac® L4) was licenced in Europe. The goal of this study was to investigate clinical signs, microscopic agglutination test (MAT) titres, haematology, blood biochemistry, cardiac (c) Troponin I levels and echocardiography before and after vaccination with this tetravalent vaccine. Forty-eight healthy dogs were prospectively enrolled and vaccinated twice, 3–4 weeks apart (T0 and T1). Before vaccination (T0) and 16–31 days after the second vaccination (T2), MAT (n = 48), haematology (n = 48), blood biochemistry (n = 36) and cTroponin I measurements (n = 29) were performed, and MAT was repeated 347–413 days after the second vaccination (T3, n = 44). Echocardiography was performed before the first and second vaccination (T0 and T1, n = 24). Results Mild and transient clinical signs within 5 days following the first and second vaccination occurred in 23% and 10% of the dogs, respectively. Before the first vaccination (T0), all dogs showed negative MAT titres for the tested serovars except for Canicola (50% with titres 100–400). At T2, positive MAT titres to the serovars Canicola (100%), Australis (89%), Grippotyphosa (86%), Bratislava (60%), Autumnalis (58%), Copenhageni (42%), Pomona (12%), Pyrogenes (8%) and Icterohaemorrhagiae (2%) were found. Median to high titres (≥ 400) were most common to the serovar Canicola (92%) and less common to the serovars Australis (41%), Grippotyphosa (21%), Bratislava (12%), Autumnalis (4%), Pyrogenes (4%) and Pomona (2%). At T3, positive MAT titres (titre range: 100–400) were found in 2–18% of the dogs to serovars of the vaccine serogroups and in 2–18% of the dogs to the non-vaccine serovars Pomona, Autumnalis, Pyrogenes and Ballum. Haematology, blood biochemistry, cTroponin I levels and echocardiography results did not change significantly following vaccination. Conclusions Clinical signs following vaccination with Nobivac® L4 were transient and mild in all cases. Seroconversion differed considerably among individual dogs and among the vaccine serogroups. Electronic supplementary material The online version of this article (doi:10.1186/s12917-017-1056-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Andrea M Spiri
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland.,Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Sabrina Rodriguez-Campos
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Länggassstr. 122, 3001 Bern, Switzerland
| | - José M Matos
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Tony M Glaus
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Barbara Riond
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Claudia E Reusch
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Regina Hofmann-Lehmann
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland.,Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland
| | - Barbara Willi
- Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland. .,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 260, 8057, Zurich, Switzerland.
| |
Collapse
|
6
|
Van Damme P, Leroux-Roels G, Simon P, Foidart JM, Donders G, Hoppenbrouwers K, Levin M, Tibaldi F, Poncelet S, Moris P, Dessy F, Giannini SL, Descamps D, Dubin G. Effects of varying antigens and adjuvant systems on the immunogenicity and safety of investigational tetravalent human oncogenic papillomavirus vaccines: results from two randomized trials. Vaccine 2014; 32:3694-705. [PMID: 24674663 DOI: 10.1016/j.vaccine.2014.03.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 02/17/2014] [Accepted: 03/13/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND A prophylactic human papillomavirus (HPV) vaccine targeting oncogenic HPV types in addition to HPV-16 and -18 may broaden protection against cervical cancer. Two Phase I/II, randomized, controlled studies were conducted to compare the immunogenicity and safety of investigational tetravalent HPV L1 virus-like particle (VLP) vaccines, containing VLPs from two additional oncogenic genotypes, with the licensed HPV-16/18 AS04-adjuvanted vaccine (control) in healthy 18-25 year-old women. METHODS In one trial (NCT00231413), subjects received control or one of 6 tetravalent HPV-16/18/31/45 AS04 vaccine formulations at months (M) 0,1,6. In a second trial (NCT00478621), subjects received control or one of 5 tetravalent HPV-16/18/33/58 vaccines formulated with different adjuvant systems (AS04, AS01 or AS02), administered on different schedules (M0,1,6 or M0,3 or M0,6). RESULTS One month after the third injection (Month 7), there was a consistent trend for lower anti-HPV-16 and -18 geometric mean antibody titers (GMTs) for tetravalent AS04-adjuvanted vaccines compared with control. GMTs were statistically significantly lower for an HPV-16/18/31/45 AS04 vaccine containing 20/20/10/10 μg VLPs for both anti-HPV-16 and anti-HPV-18 antibodies, and for an HPV-16/18/33/58 AS04 vaccine containing 20/20/20/20 μg VLPs for anti-HPV-16 antibodies. There was also a trend for lower HPV-16 and -18-specific memory B-cell responses for tetravalent AS04 vaccines versus control. No such trends were observed for CD4(+) T-cell responses. Immune interference could not always be overcome by increasing the dose of HPV-16/18 L1 VLPs or by using a different adjuvant system. All formulations had acceptable reactogenicity and safety profiles. Reactogenicity in the 7-day post-vaccination period tended to increase with the introduction of additional VLPs, especially for formulations containing AS01. CONCLUSIONS HPV-16 and -18 antibody responses were lower when additional HPV L1 VLPs were added to the HPV-16/18 AS04-adjuvanted vaccine. Immune interference is a complex phenomenon that cannot always be overcome by changing the antigen dose or adjuvant system.
Collapse
Affiliation(s)
- Pierre Van Damme
- Universiteit Antwerpen, Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, Building R, 2nd Floor, Universiteitsplein 1, 2610 Antwerpen, Belgium.
| | - Geert Leroux-Roels
- Center for Vaccinology, Ghent University and Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Philippe Simon
- Service de Gynécologie Obstétrique, Hôpital Erasme, Route de Lennik 808, 1070 Bruxelles, Belgium.
| | - Jean-Michel Foidart
- CHR Citadelle, Service de Gynécologie Obstétrique, Boulevard du 12ieme de Ligne 1, 4000 Liège, Belgium.
| | - Gilbert Donders
- Gynaecologie, Heilig Hartziekenhuis, Kliniekstraat 45, 3300 Tienen, Belgium.
| | | | - Myron Levin
- University of Colorado School of Medicine, Building 401, 1784 Racine St., Aurora, CO 80045, USA.
| | - Fabian Tibaldi
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, 1330 Rixensart, Belgium.
| | - Sylviane Poncelet
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, 1330 Rixensart, Belgium.
| | - Philippe Moris
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, 1330 Rixensart, Belgium.
| | - Francis Dessy
- GlaxoSmithKline Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium.
| | - Sandra L Giannini
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, 1330 Rixensart, Belgium.
| | | | - Gary Dubin
- GlaxoSmithKline SA, 2301 Renaissance Boulevard, RN0220, King of Prussia, PA 19406, USA.
| |
Collapse
|