1
|
Sáez-Llorens X, Norero X, Mussi-Pinhata MM, Luciani K, de la Cueva IS, Díez-Domingo J, Lopez-Medina E, Epalza C, Brzostek J, Szymański H, Boucher FD, Cetin BS, De Leon T, Dinleyici EC, Gabriel MÁM, Ince T, Macias-Parra M, Langley JM, Martinón-Torres F, Rämet M, Kuchar E, Pinto J, Puthanakit T, Baquero-Artigao F, Gattinara GC, Arribas JMM, Ramos Amador JT, Szenborn L, Tapiero B, Anderson EJ, Campbell JD, Faust SN, Nikic V, Zhou Y, Pu W, Friel D, Dieussaert I, Lopez AG, McPhee R, Stoszek SK, Vanhoutte N. Safety and Immunogenicity of a ChAd155-Vectored Respiratory Syncytial Virus Vaccine in Infants 6-7 Months of age: A Phase 1/2 Randomized Trial. J Infect Dis 2024; 229:95-107. [PMID: 37477875 PMCID: PMC10786261 DOI: 10.1093/infdis/jiad271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/16/2023] [Accepted: 07/20/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infections in infants. This phase 1/2, observer-blind, randomized, controlled study assessed the safety and immunogenicity of an investigational chimpanzee-derived adenoviral vector RSV vaccine (ChAd155-RSV, expressing RSV F, N, and M2-1) in infants. METHODS Healthy 6- to 7-month-olds were 1:1:1-randomized to receive 1 low ChAd155-RSV dose (1.5 × 1010 viral particles) followed by placebo (RSV_1D); 2 high ChAd155-RSV doses (5 × 1010 viral particles) (RSV_2D); or active comparator vaccines/placebo (comparator) on days 1 and 31. Follow-up lasted approximately 2 years. RESULTS Two hundred one infants were vaccinated (RSV_1D: 65; RSV_2D: 71; comparator: 65); 159 were RSV-seronaive at baseline. Most solicited and unsolicited adverse events after ChAd155-RSV occurred at similar or lower rates than after active comparators. In infants who developed RSV infection, there was no evidence of vaccine-associated enhanced respiratory disease (VAERD). RSV-A neutralizing titers and RSV F-binding antibody concentrations were higher post-ChAd155-RSV than postcomparator at days 31, 61, and end of RSV season 1 (mean follow-up, 7 months). High-dose ChAd155-RSV induced stronger responses than low-dose, with further increases post-dose 2. CONCLUSIONS ChAd155-RSV administered to 6- to 7-month-olds had a reactogenicity/safety profile like other childhood vaccines, showed no evidence of VAERD, and induced a humoral immune response. Clinical Trials Registration. NCT03636906.
Collapse
Affiliation(s)
- Xavier Sáez-Llorens
- Department of Infectious Diseases, Hospital del Niño Dr. José Renán Esquivel
- Vaccine Research Department, Centro de Vacunación Internacional
- Sistema Nacional de Investigación
- Secretaria Nacional de Ciencia y Tecnologia, Panama City, Panama
| | - Ximena Norero
- Department of Infectious Diseases, Hospital del Niño Dr. José Renán Esquivel
- Vaccine Research Department, Centro de Vacunación Internacional
| | - Marisa Márcia Mussi-Pinhata
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Kathia Luciani
- Department of Infectious Diseases, Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Caja de Seguro Social, Panama City, Panama
| | | | - Javier Díez-Domingo
- FISABIO Fundación para el Fomento Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Valencia, Spain
| | - Eduardo Lopez-Medina
- Centro de Estudios en Infectología Pediátrica, Department of Pediatrics, Universidad del Valle, Clínica Imbanaco, Grupo Quironsalud, Cali, Colombia
| | - Cristina Epalza
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Research and Clinical Trials Unit, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Jerzy Brzostek
- Oddział Dziecięcy, Zespół Opieki Zdrowotnej w Dębicy, Dębica
| | - Henryk Szymański
- Department of Pediatrics, St Hedwig of Silesia Hospital, Trzebnica, Poland
| | - François D Boucher
- Department of Pediatrics, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Benhur S Cetin
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tirza De Leon
- Department of Vaccines, Cevaxin Sede David, Chiriquí, Panama
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Miguel Ángel Marín Gabriel
- Departamento de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain
| | - Tolga Ince
- Department of Social Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Joanne M Langley
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, Canada
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela
- Vaccines, Infections and Pediatrics Research Group, Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela
- Centro de Investigación Biomédica en Red of Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Mika Rämet
- Vaccine Research Center, Tampere University, Tampere, Finland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Jorge Pinto
- Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario Infantil La Paz, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, ISCIII, Madrid, Spain
| | - Guido Castelli Gattinara
- Centro Vaccinazioni, Dipartimento Pediatrico Universitario Ospedaliero, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Pediatrico Bambino Gesù, Lazio, Rome, Italy
| | | | - Jose Tomas Ramos Amador
- Department of Pediatrics, Universidad Complutense–Instituto de Investigación Sanitaria del Hospital Clínico San Carlos
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Bruce Tapiero
- Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Canada
| | - Evan J Anderson
- Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - James D Campbell
- Center for Vaccine Development and Global Health, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Saul N Faust
- National Institute for Health and Care Research Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton National Health Service Foundation Trust, and Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | | | | | - Wenji Pu
- GSK, Biostatistics, Rockville, Maryland
| | | | | | | | | | | | | |
Collapse
|
2
|
DiPiazza AT, Leist SR, Abiona OM, Moliva JI, Werner A, Minai M, Nagata BM, Bock KW, Phung E, Schäfer A, Dinnon KH, Chang LA, Loomis RJ, Boyoglu-Barnum S, Alvarado GS, Sullivan NJ, Edwards DK, Morabito KM, Mascola JR, Carfi A, Corbett KS, Moore IN, Baric RS, Graham BS, Ruckwardt TJ. COVID-19 vaccine mRNA-1273 elicits a protective immune profile in mice that is not associated with vaccine-enhanced disease upon SARS-CoV-2 challenge. Immunity 2021; 54:1869-1882.e6. [PMID: 34270939 PMCID: PMC8249710 DOI: 10.1016/j.immuni.2021.06.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/30/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022]
Abstract
Vaccine-associated enhanced respiratory disease (VAERD) was previously observed in some preclinical models of severe acute respiratory syndrome (SARS) and MERS coronavirus vaccines. We used the SARS coronavirus 2 (SARS-CoV-2) mouse-adapted, passage 10, lethal challenge virus (MA10) mouse model of acute lung injury to evaluate the immune response and potential for immunopathology in animals vaccinated with research-grade mRNA-1273. Whole-inactivated virus or heat-denatured spike protein subunit vaccines with alum designed to elicit low-potency antibodies and Th2-skewed CD4+ T cells resulted in reduced viral titers and weight loss post challenge but more severe pathological changes in the lung compared to saline-immunized animals. In contrast, a protective dose of mRNA-1273 induced favorable humoral and cellular immune responses that protected from viral replication in the upper and lower respiratory tract upon challenge. A subprotective dose of mRNA-1273 reduced viral replication and limited histopathological manifestations compared to animals given saline. Overall, our findings demonstrate an immunological signature associated with antiviral protection without disease enhancement following vaccination with mRNA-1273.
Collapse
Affiliation(s)
- Anthony T DiPiazza
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sarah R Leist
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Olubukola M Abiona
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Juan I Moliva
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Anne Werner
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mahnaz Minai
- Infectious Disease Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Bianca M Nagata
- Infectious Disease Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kevin W Bock
- Infectious Disease Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Emily Phung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alexandra Schäfer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kenneth H Dinnon
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lauren A Chang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rebecca J Loomis
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Seyhan Boyoglu-Barnum
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gabriela S Alvarado
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Kaitlyn M Morabito
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Kizzmekia S Corbett
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ian N Moore
- Infectious Disease Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ralph S Baric
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Tracy J Ruckwardt
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
| |
Collapse
|