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Yonekawa M, Watanabe T, Kogawara O, Yoshii C, Yamaji M, Aizawa M, Erber W, Ito S, Jug B, Koelch D, de Solom R, Lockhart SP. Phase 3 immunogenicity and safety study of a tick-borne encephalitis vaccine in healthy Japanese participants 1 year of age and older. Vaccine 2024; 42:3180-3189. [PMID: 38614954 DOI: 10.1016/j.vaccine.2024.03.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/23/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Tick-borne encephalitis (TBE) virus infects the central nervous system and may lead to severe neurological complications or death. This study assessed immunogenicity, safety, and tolerability of TBE vaccine in Japanese participants 1 year of age and older. METHODS This phase 3, multicenter, single-arm, open-label study was conducted in Japanese adult (≥ 16 years) and pediatric (1-< 16 years) populations. Participants received a single 0.5-mL (adult) or 0.25-mL (pediatric) dose of TBE vaccine at each of 3 visits. The primary endpoint was the proportion of participants who were seropositive (neutralization test [NT] titer ≥ 1:10) 4 weeks after Dose 3. Secondary and exploratory endpoints included NT seropositivity rates 4 weeks after Dose 2, immunoglobulin G (IgG) seropositivity 4 weeks after Doses 2 and 3, NT geometric mean titers (GMTs), IgG geometric mean concentrations (GMCs), and geometric mean fold rises. Primary safety endpoints were frequencies of local reactions, systemic events, adverse events (AEs), and serious AEs. RESULTS Among 100 adult and 65 pediatric participants, 99.0 % and 100.0 % completed the study, respectively. NT seropositivity was achieved in 98.0 % adult and 100.0 % pediatric participants after Dose 3; seropositivity after Dose 2 was 93.0 % and 92.3 %, respectively. In both age groups, IgG seropositivity was ≥ 90.0 % and ≥ 96.0 % after Doses 2 and 3, respectively; GMTs and GMCs were highest 4 weeks after Dose 3. Reactogenicity events were generally mild to moderate in severity and short-lived. AEs were reported by 15.0 % (adult) and 43.1 % (pediatric) of participants. No life-threatening AEs, AEs leading to discontinuation, immediate AEs, related AEs, or deaths were reported. No serious AEs were considered related to TBE vaccine. CONCLUSIONS TBE vaccine elicited robust immune responses in Japanese participants 1 year of age and older. The 3-dose regimen was safe and well tolerated, and findings were consistent with the known safety profile of this TBE vaccine. CLINICALTRIALS gov: NCT04648241.
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Affiliation(s)
| | - Tohru Watanabe
- Watanabe Pediatric Allergy Clinic, Sapporo, Hokkaido, Japan
| | | | | | | | | | - Wilhelm Erber
- Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Vienna, Austria
| | - Shuhei Ito
- Vaccine Medical Affairs, Pfizer Japan Inc, Tokyo, Japan
| | - Bogdan Jug
- QC Logistics, Pfizer Manufacturing Austria GmbH, Orth an der Donau, Austria
| | - Doris Koelch
- Vaccines Analytical Development, Pfizer, Orth, Austria
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Pang Y, Cao D, Zhu X, Long Q, Tian F, Long X, Li Y. Safety and Efficacy of the Modified Vaccinia Ankara-Bavaria Nordic Vaccine Against Mpox in the Real World: Systematic Review and Meta-Analysis. Viral Immunol 2024; 37:216-219. [PMID: 38717823 DOI: 10.1089/vim.2023.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 05/14/2024] Open
Abstract
In May 2022, mpox began to spread worldwide, posing a serious threat to human public health. Modified Vaccinia Ankara-Bavaria Nordic (MVA-BN) is a live attenuated orthopoxvirus vaccine that has been authorized by the U.S. Food and Drug Administration as the vaccine of choice for the prevention of mpox. In this study, we conducted a meta-analysis of all currently published literature on the efficacy and safety of the MVA-BN vaccine in the real world, showing that the MVA-BN vaccine is effective and safe, with efficacy of up to 75% with a single dose and up to 80% with a two-dose vaccine. Meanwhile, we found that subcutaneous injection has lower local and systemic adverse events than intradermal injection, regardless of single- or two-dose vaccination, and subcutaneous injection is better tolerated in children, the elderly, or people with underlying medical conditions. These results have important reference value for clinical practice.
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Affiliation(s)
- Yi Pang
- Science and Technology Department, Youjiang Medical University for Nationalities, Baise, China
| | - Demin Cao
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
| | - Xiaoying Zhu
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
| | - Qinqin Long
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
| | - Fengqin Tian
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
| | - Xidai Long
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
| | - Yulei Li
- Clinicopathological Diagnosis & Research Center, the Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- Key Laboratory of Tumor Molecular Pathology of Guangxi Higher Education Institutes, Baise, China
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3
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Zhang S, Liu G, Zhang Y, Wang C, Xu X, Zhao Y, Xiang Z, Wu W, Yang L, Chen J, Guo A, Chen Y. Investigation of the safety and protective efficacy of an attenuated and marker M. bovis-BoHV-1 combined vaccine in bovines. Front Immunol 2024; 15:1367253. [PMID: 38646533 PMCID: PMC11027501 DOI: 10.3389/fimmu.2024.1367253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Bovine respiratory disease (BRD) is one of the most common diseases in the cattle industry worldwide; it is caused by multiple bacterial or viral coinfections, of which Mycoplasma bovis (M. bovis) and bovine herpesvirus type 1 (BoHV-1) are the most notable pathogens. Although live vaccines have demonstrated better efficacy against BRD induced by both pathogens, there are no combined live and marker vaccines. Therefore, we developed an attenuated and marker M. bovis-BoHV-1 combined vaccine based on the M. bovis HB150 and BoHV-1 gG-/tk- strain previously constructed in our lab and evaluated in rabbits. This study aimed to further evaluate its safety and protective efficacy in cattle using different antigen ratios. After immunization, all vaccinated cattle had a normal rectal temperature and mental status without respiratory symptoms. CD4+, CD8+, and CD19+ cells significantly increased in immunized cattle and induced higher humoral and cellular immune responses, and the expression of key cytokines such as IL-4, IL-12, TNF-α, and IFN-γ can be promoted after vaccination. The 1.0 × 108 CFU of M. bovis HB150 and 1.0 × 106 TCID50 BoHV-1 gG-/tk- combined strain elicited the most antibodies while significantly increasing IgG and cellular immunity after challenge. In conclusion, the M. bovis HB150 and BoHV-1 gG-/tk- combined strain was clinically safe and protective in calves; the mix of 1.0 × 108 CFU of M. bovis HB150 and 1.0 × 106 TCID50 BoHV-1 gG-/tk- strain was most promising due to its low amount of shedding and highest humoral and cellular immune responses compared with others. This study introduces an M. bovis-BoHV-1 combined vaccine for application in the cattle industry.
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MESH Headings
- Animals
- Cattle
- Herpesvirus 1, Bovine/immunology
- Vaccines, Combined/immunology
- Vaccines, Combined/administration & dosage
- Vaccines, Attenuated/immunology
- Vaccines, Attenuated/administration & dosage
- Mycoplasma bovis/immunology
- Viral Vaccines/immunology
- Viral Vaccines/administration & dosage
- Viral Vaccines/adverse effects
- Bacterial Vaccines/immunology
- Bacterial Vaccines/administration & dosage
- Bacterial Vaccines/adverse effects
- Cytokines/metabolism
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Antibodies, Bacterial/blood
- Antibodies, Bacterial/immunology
- Mycoplasma Infections/prevention & control
- Mycoplasma Infections/veterinary
- Mycoplasma Infections/immunology
- Vaccines, Marker/immunology
- Vaccines, Marker/administration & dosage
- Vaccination/veterinary
- Vaccine Efficacy
- Immunity, Humoral
- Bovine Respiratory Disease Complex/prevention & control
- Bovine Respiratory Disease Complex/immunology
- Bovine Respiratory Disease Complex/virology
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Affiliation(s)
- Sen Zhang
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Guoxing Liu
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
| | - Yisheng Zhang
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
| | - Chen Wang
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Xiaowen Xu
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Yuhao Zhao
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Zhijie Xiang
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
| | - Wenying Wu
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Li Yang
- Wuhan Keqian Biology Co., Ltd, Research and Development Department, Wuhan, China
| | - Jianguo Chen
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
| | - Aizhen Guo
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
| | - Yingyu Chen
- State Key Laboratory of Agricultural Microbiology, Hubei Hongshan Laboratory, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China
- Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture and Rural Affair, Wuhan, China
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Rao S, Erku D, Mahalingam S, Taylor A. Immunogenicity, safety and duration of protection afforded by chikungunya virus vaccines undergoing human clinical trials. J Gen Virol 2024; 105. [PMID: 38421278 DOI: 10.1099/jgv.0.001965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/02/2024] Open
Abstract
Background. Chikungunya virus (CHIKV) causes chikungunya fever and has been responsible for major global epidemics of arthritic disease over the past two decades. Multiple CHIKV vaccine candidates are currently undergoing or have undergone human clinical trials, with one vaccine candidate receiving FDA approval. This scoping review was performed to evaluate the 'efficacy', 'safety' and 'duration of protection' provided by CHIKV vaccine candidates in human clinical trials.Methods. This scoping literature review addresses studies involving CHIKV vaccine clinical trials using available literature on the PubMed, Medline Embase, Cochrane Library and Clinicaltrial.gov databases published up to 25 August 2023. Covidence software was used to structure information and review the studies included in this article.Results. A total of 1138 studies were screened and, after removal of duplicate studies, 12 relevant studies were thoroughly reviewed to gather information. This review summarizs that all seven CHIKV vaccine candidates achieved over 90 % seroprotection against CHIKV after one or two doses. All vaccines were able to provide neutralizing antibody protection for at least 28 days.Conclusions. A variety of vaccine technologies have been used to develop CHIKV vaccine candidates. With one vaccine candidate having recently received FDA approval, it is likely that further CHIKV vaccines will be available commercially in the near future.
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Affiliation(s)
- Shambhavi Rao
- The Emerging Viruses, Inflammation and Therapeutics Group, Menzies Health Institute Queensland, Griffith University, Gold Coast, Southport, QLD, 4215, Australia
- Global Virus Network (GVN) Centre of Excellence in Arboviruses, Griffith University, Gold Coast, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Daniel Erku
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Gold Coast, Southport, QLD, 4215, Australia
| | - Suresh Mahalingam
- The Emerging Viruses, Inflammation and Therapeutics Group, Menzies Health Institute Queensland, Griffith University, Gold Coast, Southport, QLD, 4215, Australia
- Global Virus Network (GVN) Centre of Excellence in Arboviruses, Griffith University, Gold Coast, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Adam Taylor
- The Emerging Viruses, Inflammation and Therapeutics Group, Menzies Health Institute Queensland, Griffith University, Gold Coast, Southport, QLD, 4215, Australia
- Global Virus Network (GVN) Centre of Excellence in Arboviruses, Griffith University, Gold Coast, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
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5
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Pekkarinen HM, Karkamo VK, Vainio-Siukola KJ, Hautaniemi MK, Kinnunen PM, Gadd TK, Holopainen RH. Post-vaccinal distemper-like disease in two dog litters with confirmed infection of vaccine virus strain. Comp Immunol Microbiol Infect Dis 2024; 105:102114. [PMID: 38142559 DOI: 10.1016/j.cimid.2023.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/19/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Modified live canine distemper virus (CDV) vaccines are widely used and considered both safe and effective. Although there are occasional literature reports of suspected vaccine-induced disease, there are none where the vaccine strain has been identified in affected tissues. Here we describe two such cases in different litters. In litter A, five of ten puppies presented with fever, anorexia, vomiting, and diarrhea a few days post-vaccination. Four puppies died or were euthanized, and autopsy revealed atypical necrosis of the lymphoid tissue. In litter B, two of five puppies developed typical neurological signs some months post-vaccination and autopsy revealed encephalitis. In all cases, affected organs tested positive for CDV on immunohistochemistry, and CDV RNA extracted from the lesions confirmed the presence of vaccine strain. Since multiple puppies from each litter were affected, it cannot be excluded without further studies that some undiagnosed inherited immunodeficiency disorder may have been involved.
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Affiliation(s)
| | - Veera K Karkamo
- Finnish Food Authority, Mustialankatu 3, FI-00790 Helsinki, Finland
| | | | | | - Paula M Kinnunen
- MSD Animal Health Finland, Keilaniementie 1, FI-02150 Espoo, Finland
| | - Tuija K Gadd
- Finnish Food Authority, Mustialankatu 3, FI-00790 Helsinki, Finland
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6
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Miller C, Taylor-Salmon E, Emuren L, Landry M, Gershon A, Miller G. Progressive shingles in a toddler due to reactivation of Varicella Zoster vaccine virus four days after infection with SARS-CoV-2; a case report. BMC Infect Dis 2023; 23:854. [PMID: 38057696 PMCID: PMC10698951 DOI: 10.1186/s12879-023-08809-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/04/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Herpes zoster (HZ) is the clinical syndrome associated with reactivation of latent varicella-zoster virus (VZV). Several factors have been implicated to promote VZV reactivation; these include immunosuppression, older age, mechanical trauma, physiologic stress, lymphopenia, and more recently, infection with severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2). Recent reports suggest an increase in the number of HZ cases in the general population during the global COVID-19 pandemic. However, it is unknown what proportion of HZ during the pandemic is due to reactivation of wild-type or vaccine-strain VZV. CASE Here we report the first known case of HZ concomitant with SARS-CoV2 infection in a 20-month-old female who was treated with a single dose of dexamethasone, due to reactivation of the vaccine-type strain of VZV after presenting with a worsening vesicular rash. CONCLUSION In this case, we were able to show vaccine-strain VZV reactivation in the context of a mild acute symptomatic COVID-19 infection in a toddler. Being able to recognize HZ quickly and effectively in a pediatric patient can help stave off the significant morbidity and mortality associated with disease process.
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Affiliation(s)
- Christine Miller
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Emma Taylor-Salmon
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Leonard Emuren
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Marie Landry
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Anne Gershon
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - George Miller
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA.
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7
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Kumar N, Barua S, Kumar R, Khandelwal N, Kumar A, Verma A, Singh L, Godara B, Chander Y, Kumar G, Riyesh T, Sharma DK, Pathak A, Kumar S, Dedar RK, Mehta V, Gaur M, Bhardwaj B, Vyas V, Chaudhary S, Yadav V, Bhati A, Kaul R, Bashir A, Andrabi A, Yousuf RW, Koul A, Kachhawaha S, Gurav A, Gautam S, Tiwari HA, Munjal VK, Gupta MK, Kumar R, Gulati BR, Misri J, Kumar A, Mohanty AK, Nandi S, Singh KP, Pal Y, Dutt T, Tripathi BN. Evaluation of the safety, immunogenicity and efficacy of a new live-attenuated lumpy skin disease vaccine in India. Virulence 2023; 14:2190647. [PMID: 36919498 PMCID: PMC10038050 DOI: 10.1080/21505594.2023.2190647] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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] [Indexed: 03/16/2023] Open
Abstract
Lumpy skin disease (LSD) was reported for the first time in India in 2019 and since then, it has become endemic. Since a homologous (LSD-virus based) vaccine was not available in the country, goatpox virus (GPV)-based heterologous vaccine was authorized for mass immunization to induce protection against LSD in cattle. This study describes the evaluation of safety, immunogenicity and efficacy of a new live-attenuated LSD vaccine developed by using an Indian field strain, isolated in 2019 from cattle. The virus was attenuated by continuous passage (P = 50) in Vero cells. The vaccine (50th LSDV passage in Vero cells, named as Lumpi-ProVacInd) did not induce any local or systemic reaction upon its experimental inoculation in calves (n = 10). At day 30 post-vaccination (pv), the vaccinated animals were shown to develop antibody- and cell-mediated immune responses and exhibited complete protection upon virulent LSDV challenge. A minimum Neethling response (0.018% animals; 5 out of 26,940 animals) of the vaccine was observed in the field trials conducted in 26,940 animals. There was no significant reduction in the milk yield in lactating animals (n = 10108), besides there was no abortion or any other reproductive disorder in the pregnant animals (n = 2889). Sero-conversion was observed in 85.18% animals in the field by day 30 pv.
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Affiliation(s)
- Naveen Kumar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Sanjay Barua
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Ram Kumar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Nitin Khandelwal
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Amit Kumar
- Indian Veterinary Research Institute, Mukteswar, India
| | - Assim Verma
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Lokender Singh
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Bhagraj Godara
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Yogesh Chander
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Garvit Kumar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Thachamvally Riyesh
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Deepak Kumar Sharma
- Department of Veterinary Microbiology, College of Veterinary and Animal Science, Udaipur, India
| | - Anubha Pathak
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Sanjay Kumar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Ramesh Kumar Dedar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Vishal Mehta
- Department of Animal Husbandry, Banswara, Rajasthan, India
| | - Mitesh Gaur
- Department of Veterinary Gynaecology and Obstetrics, College of Veterinary and Animal Science, Udaipur, India
| | | | - Vithilesh Vyas
- Department of Animal Husbandry, Jodhpur, Rajasthan, India
| | | | | | - Adrish Bhati
- Livestock Research station, Nohar, Rajasthan, India
| | - Rakesh Kaul
- Animal Husbandry Department, Jammu and Kashmir, India
| | - Arif Bashir
- Animal Husbandry Department, Jammu and Kashmir, India
| | - Anjum Andrabi
- Animal Husbandry Department, Jammu and Kashmir, India
| | | | | | - Subhash Kachhawaha
- Krishi Vigyan Kendra, ICAR-Central Arid Zone Research Institute, Jodhpur, India
| | - Amol Gurav
- Indian Veterinary Research Institute, Mukteswar, India
| | | | | | | | - Madhurendu K Gupta
- Department of Veterinary Pathology, Birsa Agricultural University, Ranchi, India
| | - Rajender Kumar
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Baldev R Gulati
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Jyoti Misri
- Animal Science Division, Indian Council of Agricultural Research, India
| | - Ashok Kumar
- Animal Science Division, Indian Council of Agricultural Research, India
| | | | - Sukdeb Nandi
- Centre for Animal Disease Research and Diagnosis, Indian Veterinary Research Institute, Izatnagar, India
| | - Karam Pal Singh
- Centre for Animal Disease Research and Diagnosis, Indian Veterinary Research Institute, Izatnagar, India
| | - Yash Pal
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
| | - Triveni Dutt
- Centre for Animal Disease Research and Diagnosis, Indian Veterinary Research Institute, Izatnagar, India
| | - Bhupendra N Tripathi
- National Centre for Veterinary Type Cultures, ICAR-National Research Centre on Equines, Hisar, India
- Animal Science Division, Indian Council of Agricultural Research, India
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8
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Hao X, Li J, Wang J, Zhou Z, Yuan X, Pan S, Zhu J, Zhang F, Yin S, Yang Y, Hu S, Shang S. Co-administration of chicken IL-2 alleviates clinical signs and replication of the ILTV chicken embryo origin vaccine by pre-activating natural killer cells and cytotoxic T lymphocytes. J Virol 2023; 97:e0132223. [PMID: 37882519 PMCID: PMC10688355 DOI: 10.1128/jvi.01322-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/08/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
IMPORTANCE Chickens immunized with the infectious laryngotracheitis chicken embryo origin (CEO) vaccine (Medivac, PT Medion Farma Jaya) experience adverse reactions, hindering its safety and effective use in poultry flocks. To improve the effect of the vaccine, we sought to find a strategy to alleviate the respiratory reactions associated with the vaccine. Here, we confirmed that co-administering the CEO vaccine with chIL-2 by oral delivery led to significant alleviation of the vaccine reactions in chickens after immunization. Furthermore, we found that the co-administration of chIL-2 with the CEO vaccine reduced the clinical signs of the CEO vaccine while enhancing natural killer cells and cytotoxic T lymphocyte response to decrease viral loads in their tissues, particularly in the trachea and conjunctiva. Importantly, we demonstrated that the chIL-2 treatment can ameliorate the replication of the CEO vaccine without compromising its effectiveness. This study provides new insights into further applications of chIL-2 and a promising strategy for alleviating the adverse reaction of vaccines.
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Affiliation(s)
- Xiaoli Hao
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonosis, Yangzhou University, Yangzhou, China
| | - Jiaqi Li
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Jiongjiong Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Zhou Zhou
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Xinjie Yuan
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Shan Pan
- Dalian Sanyi Animal Medicine Co., Ltd, Dalian, China
| | - Jie Zhu
- Shandong Binzhou Wohua Biotech Co., Ltd, Binzhou, China
| | - Fan Zhang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Shi Yin
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
| | - Yi Yang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonosis, Yangzhou University, Yangzhou, China
| | - Shunlin Hu
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonosis, Yangzhou University, Yangzhou, China
- International Corporation Laboratory of Agriculture and Agricultural Products Safety, Yangzhou University, Yangzhou, Jiangsu, China
| | - Shaobin Shang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonosis, Yangzhou University, Yangzhou, China
- International Corporation Laboratory of Agriculture and Agricultural Products Safety, Yangzhou University, Yangzhou, Jiangsu, China
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9
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Khalil NW, Elshorbagy MA, Elboraay EM, Helal AM. Live IBD vaccine exacerbates disease and pathological effects of Asian lineage H9N2 LPAIV in chickens. Avian Pathol 2023; 52:351-361. [PMID: 37439655 DOI: 10.1080/03079457.2023.2236994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/10/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/14/2023]
Abstract
Avian influenza H9N2 is one of the most commonly circulating viruses in numerous Egyptian poultry farms. The Asian lineage H9N2 exhibits an immunosuppressive effect, and its pathogenicity is amplified when it co-infects with other pathogens, especially with the immunosuppressive infectious bursal disease virus (IBDV), resulting in increased mortality rates. Both vaccines and field infection can exacerbate the pathogenicity of H9N2, particularly in the bursa of Fabricius, causing more significant lymphoid depletion. To comprehend the impact of the IBD vaccine on the viral and pathogenic effect of H9N2 infection in specific pathogen-free chicks (SPF), the experiment was designed as four groups; group 1 served as the negative control, group 2 received (228E) IBD vaccine, group 3 was challenged with H9N2, and group-4 was vaccinated by the IBD vaccine then challenged with H9N2. The clinical signs, relative immune organs weights and histopathological lesion scores were recorded. The tracheal and cloacal H9N2 viral shedding were also measured. Group 4 exhibited a significant decrease (P ≤ 0.05) in the relative bursal weight and an increase in the bursal lesion score when compared with groups 1 and 3 at 4 and 8 days post-challenge (dpc). The tracheal lesion score of group-4 recorded a significant increase when compared with groups 1 and 3. The renal lesion score of group 4 achieved a significant increase when compared with 1 and 3 at 8 dpc. Also, group 4 recorded a significant increase in H9N2 shedding in comparison with groups 1 and 3. Consequently, our study concluded that routine vaccination with the IBD intermediate plus vaccine exacerbates the silent infection of H9N2 resulting in outbreaks.
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Affiliation(s)
- N W Khalil
- Avian and Rabbit Diseases Department, Faculty of Veterinary Medicine, Benha University, Benha, Egypt
| | - M A Elshorbagy
- Avian and Rabbit Diseases Department, Faculty of Veterinary Medicine, Benha University, Benha, Egypt
| | - E M Elboraay
- Avian and Rabbit Diseases Department, Faculty of Veterinary Medicine, Benha University, Benha, Egypt
| | - A M Helal
- Central Laboratory for Evaluation of Veterinary Biologics, Cairo, Egypt
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10
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Ezzemani W, Windisch MP, Altawalah H, Guessous F, Saile R, Benjelloun S, Kettani A, Ezzikouri S. Design of a multi-epitope Zika virus vaccine candidate - an in-silico study. J Biomol Struct Dyn 2023; 41:3762-3771. [PMID: 35318896 DOI: 10.1080/07391102.2022.2055648] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/15/2022] [Indexed: 01/12/2023]
Abstract
Zika virus (ZIKV), an RNA virus, rapidly spreads Aedes mosquito-borne sickness. Currently, there are neither effective vaccines nor therapeutics available to prevent or treat ZIKV infection. In this study, to address these unmet medical needs, we aimed to design B- and T-cell candidate multi-epitope-based subunit against ZIKV using an in silico approach. In this study we applied immunoinformatics, molecular docking, and dynamic simulation assessments targeting the most immunogenic proteins; the capsid (C), envelope (E) proteins and the non-stuctural protein (NS1), described in our previous study, and which predicted immunodominant B and T cell epitopes. The final non-allergenic and highly antigenic multi-epitope was constituted of immunogenic screened-epitopes (3 CTL and 3 HTL) and the β-defensin as an adjuvant that have been linked using EAAAK, AAY, and GPGPG linkers, respectively. The final construct containing 143 amino acids was characterized for its allergenicity, antigenicity, and physiochemical properties; and found to be safe and immunogenic with a good prediction of solubility. The existence of IFN-γ epitopes asserts the capacity to trigger strong immune responses. Subsequently, the molecular docking among vaccine and immune receptors (TLR2/TLR4) was revealed with a good binding affinity with and stable molecular interactions. Molecular dynamics simulation confirmed the stability of the complexes. Finally, the construct was subjected to in silico cloning demonstrating the efficiently of its expression in E.coli. However, this study needs the experimental validation to demonstrate vaccine safety and efficacy.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Wahiba Ezzemani
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Marc P Windisch
- Applied Molecular Virology Laboratory, Discovery Biology Department, Institut Pasteur Korea, Gyeonggi-do, South Korea
| | - Haya Altawalah
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
- Virology Unit, Yacoub Behbehani center, Sabah Hospital, Ministry of Health, Kuwait
| | - Fadila Guessous
- Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Rachid Saile
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Anass Kettani
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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11
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Zolfaghari MA, Ghadiri Moghaddam F, Rajput S, Karimi A, Naghi Vishteh M, Mahmoodpoor A, Dolati S, Yousefi M. SARS-CoV-2 vaccines: A double-edged sword throughout rapid evolution of COVID-19. Cell Biol Int 2022; 46:2009-2017. [PMID: 36047303 PMCID: PMC9539123 DOI: 10.1002/cbin.11903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 07/12/2022] [Accepted: 08/24/2022] [Indexed: 11/11/2022]
Abstract
After more than 2 years of the coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2, several questions have remained unanswered that affected our daily lives. Although substantial vaccine development could resist this challenge, emerging new variants in different countries could be considered as potent concerns regarding the adverse effects of reinfection or postvaccination. Precisely, these concerns address some significant and probable outcomes in vaccinated or reinfected models, followed by some virus challenges, such as antibody-dependent enhancement and cytokine storm. Therefore, the importance of evaluating the effectiveness of neutralizing antibodies (nAbs) elicited by vaccination and the rise of new variants must be addressed.
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Affiliation(s)
- Mohammad Ali Zolfaghari
- Student Research CommitteeTabriz University of Medical SciencesTabrizIran
- Department of Molecular Medicine, Faculty of Advanced Medical SciencesTabriz University of Medical SciencesTabrizIran
| | | | - Shabnam Rajput
- Department of Pediatrics, School of MedicineJahrom University of Medical SciencesJahromIran
| | - Abbas Karimi
- Department of Molecular Medicine, Faculty of Advanced Medical SciencesTabriz University of Medical SciencesTabrizIran
- Biotechnology Research CenterTabriz University of Medical SciencesTabrizIran
| | - Mohadeseh Naghi Vishteh
- Department of Genetics and Molecular Biology, School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Ata Mahmoodpoor
- Department of AnesthesiologyTabriz University of Medical SciencesTabrizIran
| | - Sanam Dolati
- Physical Medicine and Rehabilitation Research Center, Aging Research InstituteTabriz University of Medical SciencesTabrizIran
| | - Mehdi Yousefi
- Stem Cell Research CenterTabriz University of Medical SciencesTabrizIran
- Department of Immunology, Faculty of MedicineTabriz University of Medical SciencesTabrizIran
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12
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Yeo JG, Chia WN, Teh KL, Book YX, Hoh SF, Gao X, Das L, Zhang J, Sutamam N, Lim AJM, Poh SL, Tay SH, Nay Yaung K, Ong XM, Hazirah SN, Chua CJH, Leong JY, Wang LF, Albani S, Arkachaisri T. Robust neutralizing antibody response to SARS-CoV-2 mRNA vaccination in adolescents and young adults with childhood-onset rheumatic diseases. Rheumatology (Oxford) 2022; 61:4472-4481. [PMID: 35199166 PMCID: PMC8903460 DOI: 10.1093/rheumatology/keac105] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/09/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Immunogenicity to the SARS-CoV-2 mRNA vaccines in adolescents and young adults (AYA) with childhood-onset rheumatic diseases (cRD) is unknown. We aimed to evaluate the humoral immunogenicity and safety of the vaccines in our AYA with cRD. METHODS A monocentric observational study with 159 AYA (50.3% female and 70.4% Chinese). Humoral immunogenicity was assessed at 2-3 and 4-6 weeks following first and second vaccination by cPass™ SARS-CoV-2 Neutralization Antibody Assay. Inhibition signal of ≥30% defined the cut-off for positive detection of the SARS-CoV-2 neutralizing antibodies. Vaccine safety and disease activity were assessed within 6 weeks after second vaccination. RESULTS A total of 64.9% and 99.1% of 159 patients (median age: 16.9, IQR: 14.7-19.5) mounted positive SARS-CoV-2 neutralizing responses after first and second vaccination, respectively. Most patients (89.8%) had ≥90% inhibition signal after second vaccination. Methotrexate and mycophenolate mofetil increased the risk associated with negative cPass neutralization responses following the first vaccination. Holding both medications after each vaccination did not affect immunogenicity. There was no symptomatic COVID-19 infection. Local reaction remained the most common (23.3-25.2%) adverse event, without serious complication. Two and seven patients flared following the first and second vaccination, respectively. Subgroup analyses of the 12-18-year-old cohort did not show any differences in vaccine efficacy, predictors of poor response and general safety, but higher proportion of disease flares. CONCLUSIONS SARS-CoV-2 mRNA vaccines were efficacious after the two-dose regimen in almost all AYA with cRD without serious adverse event. The rate of disease flare observed is 4.4% after the second mRNA vaccine dose.
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Affiliation(s)
- Joo Guan Yeo
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
- Duke-NUS Medical School
| | | | - Kai Liang Teh
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
| | - Yun Xin Book
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
| | - Sook Fun Hoh
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore
| | - Xiaocong Gao
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore
| | - Lena Das
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
| | | | - Nursyuhadah Sutamam
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
| | - Amanda Jin Mei Lim
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
| | - Su Li Poh
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
| | - Shi Huan Tay
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
- Duke-NUS Medical School
| | - Katherine Nay Yaung
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
- Duke-NUS Medical School
| | | | | | | | - Jing Yao Leong
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
| | | | - Salvatore Albani
- Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
- Duke-NUS Medical School
| | - Thaschawee Arkachaisri
- Rheumatology and Immunology Service, Department of Paediatric Subspecialities, KK Women’s and Children’s Hospital
- Duke-NUS Medical School
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13
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Akgün Ö, Çakmak F, Guliyeva V, Demirkan FG, Tanatar A, Hançerli Torun S, Çin D, Meşe S, Ağaçfidan A, Aktay Ayaz N. Humoral response and safety of BNT162b2 mRNA vaccine in children with rheumatic diseases. Rheumatology (Oxford) 2022; 61:4482-4490. [PMID: 35353139 PMCID: PMC9383626 DOI: 10.1093/rheumatology/keac140] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/02/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) vaccine represents a cornerstone in tackling the pandemic and with the approval of the BNT162b2 mRNA vaccine in December 2020, it has become a beacon of hope for people around the world, including children. This study aimed to present the data on the humoral response and safety of vaccine in a cohort of patients with paediatric rheumatic diseases receiving immunomodulatory treatments. METHODS Forty-one children with paediatric rheumatic diseases were included and were vaccinated with the BNT162b2 mRNA vaccine (two doses of 30 µg administered 3-4 weeks apart). To assess the humoral response, IgG antibodies developed against the S1/Receptor-binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein at baseline and 3-4 weeks after the second dose were measured. The possible local and systemic side effects and disease activity scores were evaluated during the study period. RESULTS After the second dose of vaccine, markedly elevated anti-RBD IgG titres were observed in all patients with a median titre of 20 474 AU/ml [interquartile range (IQR) 6534-36 151] with a good safety profile. The median disease duration was 4.3 (IQR 3.5-5.6) years. In the cohort, 14 (34.1%) received conventional DMARDs (cDMARDs), 16 (39%) received biologic DMARDs (bDMARDs) and 11 (26.8%) received a combined therapy (cDMARDs and bDMARDs). Patients treated with combined therapy [median 4695 (IQR 2764-26 491)] had significantly lower median titres of anti-RBD IgG than those receiving only cDMARDs. CONCLUSION Paediatric rheumatic diseases patients receiving immunomodulatory treatments were able to mount an effective humoral response after two dose regimens of BNT162b2 mRNA vaccine safely without interrupting their current treatments.
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Affiliation(s)
- Özlem Akgün
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | - Figen Çakmak
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | - Vafa Guliyeva
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | | | - Ayşe Tanatar
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
| | | | - Dilan Çin
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul Faculty of Medicine
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14
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Syversen SW, Jyssum I, Tveter AT, Sexton J, Christensen IE, Tran TT, Bjørlykke KH, Mjaaland S, Warren DJ, Kvien TK, Chopra A, Kro GB, Jahnsen J, Munthe LA, Haavardsholm EA, Grødeland G, Vaage JT, Provan SA, Jørgensen KK, Goll GL. Immunogenicity and safety of a three-dose SARS-CoV-2 vaccination strategy in patients with immune-mediated inflammatory diseases on immunosuppressive therapy. RMD Open 2022; 8:rmdopen-2022-002417. [PMID: 36328399 PMCID: PMC9638754 DOI: 10.1136/rmdopen-2022-002417] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Humoral vaccine responses to SARS-CoV-2 vaccines are impaired and short lasting in patients with immune-mediated inflammatory diseases (IMID) following two vaccine doses. To protect these vulnerable patients against severe COVID-19 disease, a three-dose primary vaccination strategy has been implemented in many countries. The aim of this study was to evaluate humoral response and safety of primary vaccination with three doses in patients with IMID. Methods Patients with IMID on immunosuppressive therapy and healthy controls receiving three-dose and two-dose primary SARS-CoV-2 vaccination, respectively, were included in this prospective observational cohort study. Anti-Spike antibodies were assessed 2–4 weeks, and 12 weeks following each dose. The main outcome was anti-Spike antibody levels 2–4 weeks following three doses in patients with IMID and two doses in controls. Additional outcomes were the antibody decline rate and adverse events. Results 1100 patients and 303 controls were included. Following three-dose vaccination, patients achieved median (IQR) antibody levels of 5720 BAU/mL (2138–8732) compared with 4495 (1591–6639) in controls receiving two doses, p=0.27. Anti-Spike antibody levels increased with median 1932 BAU/mL (IQR 150–4978) after the third dose. The interval between the vaccine doses and vaccination with mRNA-1273 or a combination of vaccines were associated with antibody levels following the third dose. Antibody levels had a slower decline-rate following the third than the second vaccine dose, p<0.001. Adverse events were reported by 464 (47%) patients and by 196 (78%) controls. Disease flares were reported by 70 (7%) patients. Conclusions This study shows that additional vaccine doses to patients with IMID contribute to strong and sustained immune-responses comparable to healthy persons vaccinated twice, and supports repeated vaccination of patients with IMID. Trial registration number NCT04798625.
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Affiliation(s)
- Silje Watterdal Syversen
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Jyssum
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Therese Tveter
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Joe Sexton
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Egeland Christensen
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trung T Tran
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Kristin Hammersbøen Bjørlykke
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | | | - David J Warren
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Tore K Kvien
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Adity Chopra
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | | | - Jorgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway
| | - Ludvig A Munthe
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
- KG Jebsen Centre for B cell Malignancies, University of Oslo, Oslo, Norway
| | - Espen A Haavardsholm
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gunnveig Grødeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - John Torgils Vaage
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Sella Aarrestad Provan
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | | | - Guro Løvik Goll
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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15
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Li L, Chen X, Li B, Liu D, Liu Y, Mo R, Lai F, Liu R, Peng S, Li Y, Liu M, Xiao H. Effect of Inactivated SARS-CoV-2 Vaccine on Thyroid Function and Autoimmunity Within 28 Days After the Second Dose. Thyroid 2022; 32:1051-1058. [PMID: 35864805 DOI: 10.1089/thy.2022.0101] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: The safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines is widely appreciated. However, there is limited knowledge regarding the potential impact of SARS-CoV-2 vaccines on the thyroid. Methods: We performed two prospective clinical trials between April and June, 2021, enrolling recipients of the inactivated SARS-CoV-2 vaccine (BBIBP-CorV and CoronaVac). Thyroid function, antithyroid antibody levels, and SARS-CoV-2 neutralizing antibody levels were detected for each participant before receiving the first vaccine dose and 28 days after receiving the second vaccine dose. Results: A total of 657 recipients participated in the study. The overall median thyroid function and levels of antithyroid antibodies before and after SARS-CoV-2 vaccination were within the normal range. Among the 564 participants with normal thyroid function at baseline, 36 (6.38% [confidence interval; CI 4.51-8.73]) developed thyroid dysfunction. Of the 545 recipients with negative antithyroid antibodies at baseline, none developed abnormal antibodies after vaccination. Notably, 75.27% (70/93 [CI 65.24-83.63]) of the 93 recipients with thyroid dysfunction returned to normal function after vaccination. The levels of antithyroid peroxidase antibody (96.20% [CI 89.30-99.21]) and antithyroglobulin antibody (TgAb; 88.31% [CI 78.97-94.51]) remained positive after vaccination in most patients with abnormal values at baseline. However, the TgAb levels in more than half of the patients (48/77) decreased. All of 11 abnormal thyrotropin receptor antibody levels at baseline decreased postvaccination. Conclusions: Vaccination with an inactivated SARS-CoV-2 vaccine had no significant adverse impact on thyroid function or antithyroid antibodies within the first 28 days after the second dose. Clinical Trial Registration: ChiCTR2100045109 and ChiCTR2100042222.
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Affiliation(s)
- Liubing Li
- Department of Laboratory Medicine, Guangzhou, People's Republic of China
| | - Xinwen Chen
- Department of Endocrinology, Guangzhou, People's Republic of China
| | - Bin Li
- Department of Clinical Trials Unit; Guangzhou, People's Republic of China
- Department of Institute of Precision Medicine; The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Dayue Liu
- Department of Medical Affairs; Guangzhou, People's Republic of China
| | - Yihao Liu
- Department of Endocrinology, Guangzhou, People's Republic of China
- Department of Clinical Trials Unit; Guangzhou, People's Republic of China
| | - Ruohui Mo
- Department of Clinical Trials Unit; Guangzhou, People's Republic of China
| | - Fenghua Lai
- Department of Endocrinology, Guangzhou, People's Republic of China
| | - Rengyun Liu
- Department of Institute of Precision Medicine; The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Sui Peng
- Department of Clinical Trials Unit; Guangzhou, People's Republic of China
- Department of Institute of Precision Medicine; The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yanbing Li
- Department of Endocrinology, Guangzhou, People's Republic of China
| | - Min Liu
- Department of Laboratory Medicine, Guangzhou, People's Republic of China
| | - Haipeng Xiao
- Department of Endocrinology, Guangzhou, People's Republic of China
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16
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Nevo L, Cahen-Peretz A, Vorontsov O, Frenkel R, Kabessa M, Cohen SM, Hamrani A, Oiknine-Djian E, Lipschuetz M, Goldman-Wohl D, Walfisch A, Kovo M, Neeman M, Yagel S, Wolf DG, Beharier O. Boosting maternal and neonatal humoral immunity following SARS-CoV-2 infection using a single messenger RNA vaccine dose. Am J Obstet Gynecol 2022; 227:486.e1-486.e10. [PMID: 35430228 PMCID: PMC9008977 DOI: 10.1016/j.ajog.2022.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Post-COVID-19 vaccine boosting is a potent tool in the ongoing pandemic. Relevant data regarding this approach during pregnancy are lacking, which affects vaccination policy guidance, public acceptance, and vaccine uptake during pregnancy. We aimed to investigate the dynamics of anti-SARS-CoV-2 antibody levels following SARS-CoV-2 infection during pregnancy and to characterize the effect of a single postinfection vaccine booster dose on the anti-SARS-CoV-2 antibody levels in parturients in comparison with the levels in naïve vaccinated and convalescent, nonboosted parturients. STUDY DESIGN Serum samples prospectively collected from parturients and umbilical cords at delivery at our university-affiliated urban medical center in Jerusalem, Israel, from May to October 2021, were selected and analyzed in a case-control manner. Study groups comprised the following participants: a consecutive sample of parturients with a polymerase chain reaction-confirmed history of COVID-19 during any stage of pregnancy; and comparison groups selected according to time of exposure comprising (1) convalescent, nonboosted parturients with polymerase chain reaction-confirmed COVID-19; (2) convalescent parturients with polymerase chain reaction-confirmed COVID-19 who received a single booster dose of the BNT162b2 messenger RNA vaccine; and (3) infection-naïve, fully vaccinated parturients who received 2 doses of the BNT162b2 messenger RNA vaccine. Outcomes that were determined included maternal and umbilical cord blood anti-SARS-CoV-2 antibody levels detected at delivery, the reported side effects, and pregnancy outcomes. RESULTS A total of 228 parturients aged 18 to 45 years were included. Of those, samples from 64 were studied to characterize the titer dynamics following COVID-19 at all stages of pregnancy. The boosting effect was determined by comparing (1) convalescent (n=54), (2) boosted convalescent (n=60), and (3) naïve, fully vaccinated (n=114) parturients. Anti-SARS-CoV-2 antibody levels detected on delivery showed a gradual and significant decline over time from infection to delivery (r=0.4371; P=.0003). Of the gravidae infected during the first trimester, 34.6% (9/26) tested negative at delivery, compared with 9.1% (3/33) of those infected during the second trimester (P=.023). Significantly higher anti-SARS-CoV-2 antibody levels were observed among boosted convalescent than among nonboosted convalescent (17.6-fold; P<.001) and naïve vaccinated parturients (3.2-fold; P<.001). Similar patterns were observed in umbilical cord blood. Side effects in convalescent gravidae resembled those in previous reports of mild symptoms following COVID-19 vaccination during pregnancy. CONCLUSION Postinfection maternal humoral immunity wanes during pregnancy, leading to low or undetectable protective titers for a marked proportion of patients. A single boosting dose of the BNT162b2 messenger RNA vaccine induced a robust increase in protective titers for both the mother and newborn with moderate reported side effects.
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Affiliation(s)
- Lea Nevo
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adva Cahen-Peretz
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Olesya Vorontsov
- Clinical Virology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Lautenberg Center for General and Tumor Immunology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rachelli Frenkel
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Maor Kabessa
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sarah M Cohen
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adar Hamrani
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Esther Oiknine-Djian
- Clinical Virology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Lipschuetz
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Debra Goldman-Wohl
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asnat Walfisch
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Kovo
- Department Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - Michal Neeman
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Simcha Yagel
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dana G Wolf
- Clinical Virology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Lautenberg Center for General and Tumor Immunology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ofer Beharier
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
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Beckley M, Olson AK, Portman MA. Tolerability of COVID-19 Infection and Messenger RNA Vaccination Among Patients With a History of Kawasaki Disease. JAMA Netw Open 2022; 5:e2226236. [PMID: 35960521 PMCID: PMC9375169 DOI: 10.1001/jamanetworkopen.2022.26236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Kawasaki disease (KD) symptoms significantly overlap with multisystem inflammatory syndrome in children due to COVID-19. Patients with KD may be at risk for adverse outcomes from exposure to SARS-CoV-2 infection or vaccination. OBJECTIVE To describe the outcomes of patients with KD to SARS-CoV-2 infection or vaccination. DESIGN, SETTING, AND PARTICIPANTS This case series evaluated 2 cohorts using an existing KD database and reviewed individual electronic medical records for the period spanning January 1, 2020, through January 31, 2022, via electronic medical records that include Washington state immunization records. Vaccine cohort inclusion criteria consisted of being 21 years or younger at immunization and receiving 1 or more BNT162b2 (Pfizer-BioNTech) or messenger RNA (mRNA)-1273 (Moderna) vaccine doses. The COVID-19 cohort included patients 21 years or younger with positive polymerase chain reaction or nuclear capsid IgG findings for SARS-CoV-2. Participants included 826 patients from a preexisting KD database. One hundred fifty-three patients received at least 1 BNT162b2 or mRNA-1273 vaccine dose and were included in the mRNA vaccine cohort. Thirty-seven patients had positive test results for SARS-CoV-2 and were included in the COVID-19 cohort. EXPOSURES SARS-CoV-2 vaccination and/or infection. MAIN OUTCOMES AND MEASURES Adverse events after mRNA vaccination and/or COVID-19, including clinician visits, emergency department encounters, or hospitalizations. RESULTS Among the 153 patients included in the mRNA vaccination cohort (mean [SD] age, 13.0 [4.3] years; 94 male [61.4%]), the BNT162b2 vaccine was provided for 143 (93.5%), and the remaining 10 (6.5%) received mRNA-1273 or a combination of both. Among patients in the vaccine cohort, 129 (84.3%) were fully vaccinated or received a third-dose booster. No clinically severe adverse events occurred, and there were no reports of vaccine-related hospitalizations or outpatient visits. The COVID-19 cohort included 37 patients (mean [SD] age, 11.0 [5.5] years; 22 male [59.5%]). No patients required hospitalization due to COVID-19. The most common symptoms included low-grade fever, fatigue, cough, and myalgia with resolution within a few days. Two patients, aged 9 and 19 years, had extended cough and fatigue for 3 to 4 weeks. One patient developed COVID-19 within 6 weeks of receiving intravenous immunoglobulin for KD. CONCLUSIONS AND RELEVANCE These findings suggest that the mRNA vaccines may be safe and COVID-19 may not be severe for patients with a history of KD.
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Affiliation(s)
| | - Aaron K. Olson
- Seattle Children’s Research Institute, Seattle, Washington
- Division of Cardiology, Department of Pediatrics, University of Washington, Seattle
| | - Michael A. Portman
- Seattle Children’s Research Institute, Seattle, Washington
- Division of Cardiology, Department of Pediatrics, University of Washington, Seattle
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18
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Bárczi E, Varga V, Nagy A, Eszes N, Jáky‐Kováts Z, Müller V, Bohács A. Serological findings following the second and third SARS‐CoV‐2 vaccines in lung transplant recipients. Immun Inflamm Dis 2022; 10:e646. [PMID: 35894705 PMCID: PMC9311263 DOI: 10.1002/iid3.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Enikő Bárczi
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
| | - Viktória Varga
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
| | - Alexandra Nagy
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
| | - Noémi Eszes
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
| | | | - Veronika Müller
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
| | - Anikó Bohács
- Department of Pulmonology, Faculty of MedicineSemmelweis UniversityBudapestHungary
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Ronchi GF, Testa L, Iorio M, Pinoni C, Bortone G, Dondona AC, Rossi E, Capista S, Mercante MT, Morelli D, Di Ventura M, Monaco F. Immunogenicity and safety studies of an inactivated vaccine against Rift Valley fever. Acta Trop 2022; 232:106498. [PMID: 35513072 DOI: 10.1016/j.actatropica.2022.106498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/24/2022] [Revised: 04/20/2022] [Accepted: 04/30/2022] [Indexed: 11/29/2022]
Abstract
Rift Valley fever (RVF) is an emerging transboundary, mosquito-borne, zoonotic viral disease caused by a single serotype of a virus belonging to the Phenuiviridae family (genus Phlebovirus). It is considered an important threat to both agriculture and public health in endemic areas, because the virus, transmitted by different mosquito genera, leads to abortions in susceptible animal hosts especially sheep, goat, cattle, and buffaloes, resulting in severe economic losses. Humans can also acquire the infection, and the major sources are represented by the direct contact with infected animal blood, aerosol, consumption of unpasteurized contaminated milk and the bite of infected mosquitoes. Actually, the EU territory does not seem to be exposed to an imminent risk of RVFV introduction, however, the recent outbreaks in a French overseas department and some cases detected in Turkey, Tunisia and Libya, raised the attention of the EU for a possible risk of introduction of infected vectors. Thus, there is an urgent need to develop new therapeutic and/or preventive drugs, such as vaccines. In our work, we studied the immunogenicity of an inactivated and adjuvanted vaccine produced using a Namibian field strain of RVF virus (RVFV). The vaccine object of this study was formulated with Montanide Pet Gel A, a polymer-based adjuvant that has been previously reported for its promising safety profile and for the capacity to elicit a strong immune response. The produced inactivated vaccine was tested on six sheep and the level of IgM and IgG after the immunization of animals was evaluated by a commercial competitive ELISA, in order to assess the immunogenicity profile of our vaccine and to evaluate its potential use, as an alternative to the attenuated vaccines commercially available, in case of Rift Valley fever epidemic disease on EU territory. Following the administration of the second dose, 35 days after the first one, all animals seroconverted.
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Affiliation(s)
| | - Lilia Testa
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Mariangela Iorio
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy.
| | - Chiara Pinoni
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Grazia Bortone
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | | | - Emanuela Rossi
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Sara Capista
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Maria Teresa Mercante
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Daniela Morelli
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Mauro Di Ventura
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
| | - Federica Monaco
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise G. Caporale, Teramo, Italy
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20
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Alirezaei A, Fazeli SA, Shafiei M, Miladipour A. Efficacy of Sinopharm® COVID-19 Vaccine in Hemodialysis Patients: A Preliminary Report. Iran J Kidney Dis 2022; 16:259-265. [PMID: 35962641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION SARS-CoV-2 infection have been reported to have a greater mortality rate in adults receiving dialysis, as compared to general population. Hence, vaccination is very important in this vulnerable population group, in order to achieve an acceptable level of immunity. The aim of this study was to compare the level of anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG neutralizing antibody before and after vaccination with two doses of Sinopharm® vaccine, in patients undergoing hemodialysis. METHODS Ninety patients on maintenance in-center hemodialysis received two doses of Sinopharm® COVID-19 vaccine with an interval of about 28 days. Anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG (Anti-RBD) neutralizing antibody was measured with an ELISA kit. All statistical analyses were performed by SPSS-26 software. RESULTS The absolute mean (± SE) change in antibody titer following full-scheduled vaccination was 8.98 ± 1.49 µg/mL. The rate of seroconversion was 31.1% after two doses of vaccine. In addition, the rate of seroconversion was higher in those with a history of COVID-19 than in those without a history of COVID-19. CONCLUSION The administration of booster doses, doubling of the dose in each episode of vaccination schedule as well as combination of different vaccine platforms are recommended to increase COVID-19 vaccine efficacy in hemodialysis patients. DOI: 10.52547/ijkd.7024.
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Affiliation(s)
| | | | | | - Amirhossein Miladipour
- Chronic Kidney Disease Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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21
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Monath TP, Nichols R, Tussey L, Scappaticci K, Pullano TG, Whiteman MD, Vasilakis N, Rossi SL, Campos RK, Azar SR, Spratt HM, Seaton BL, Archambault WT, Costecalde YV, Moore EH, Hawks RJ, Fusco J. Recombinant vesicular stomatitis vaccine against Nipah virus has a favorable safety profile: Model for assessment of live vaccines with neurotropic potential. PLoS Pathog 2022; 18:e1010658. [PMID: 35759511 PMCID: PMC9269911 DOI: 10.1371/journal.ppat.1010658] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/08/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
Nipah virus (NiV) disease is a bat-borne zoonosis responsible for outbreaks with high lethality and is a priority for vaccine development. With funding from the Coalition of Epidemic Preparedness Innovations (CEPI), we are developing a chimeric vaccine (PHV02) composed of recombinant vesicular stomatitis virus (VSV) expressing the envelope glycoproteins of both Ebola virus (EBOV) and NiV. The EBOV glycoprotein (GP) mediates fusion and viral entry and the NiV attachment glycoprotein (G) is a ligand for cell receptors, and stimulates neutralizing antibody, the putative mediator of protection against NiV. PHV02 is identical in construction to the registered Ebola vaccine (Ervebo) with the addition of the NiV G gene. NiV ephrin B2 and B3 receptors are expressed on neural cells and the wild-type NiV is neurotropic and causes encephalitis in affected patients. It was therefore important to assess whether the NiV G alters tropism of the rVSV vector and serves as a virulence factor. PHV02 was fully attenuated in adult hamsters inoculated by the intramuscular (IM) route, whereas parental wild-type VSV was 100% lethal. Two rodent models (mice, hamsters) were infected by the intracerebral (IC) route with graded doses of PHV02. Comparator active controls in various experiments included rVSV-EBOV (representative of Ebola vaccine) and yellow fever (YF) 17DD commercial vaccine. These studies showed PHV02 to be more neurovirulent than both rVSV-EBOV and YF 17DD in infant animals. PHV02 was lethal for adult hamsters inoculated IC but not for adult mice. In contrast YF 17DD retained virulence for adult mice inoculated IC but was not virulent for adult hamsters. Because of the inconsistency of neurovirulence patterns in the rodent models, a monkey neurovirulence test (MNVT) was performed, using YF 17DD as the active comparator because it has a well-established profile of quantifiable microscopic changes in brain centers and a known reporting rate of neurotropic adverse events in humans. In the MNVT PHV02 was significantly less neurovirulent than the YF 17DD vaccine reference control, indicating that the vaccine will have an acceptable safety profile for humans. The findings are important because they illustrate the complexities of phenotypic assessment of novel viral vectors with tissue tropisms determined by transgenic proteins, and because it is unprecedented to use a heterologous comparator virus (YF vaccine) in a regulatory-enabling study. This approach may have value in future studies of other novel viral vectors. Nipah virus (NiV) disease is a highly lethal bat-borne virus with epidemic potential causing inflammation of the brain and a severe respiratory syndrome and is a high priority for vaccine development. We developed a novel single-dose vaccine that protects animals against disease and death caused by NiV and have started clinical trials. The vaccine is a live, recombinant vesicular stomatitis virus (VSV) vector identical to the recently approved Ebola vaccine (Ervebo) but also expressing the NiV G protein responsible for attachment of the virus to cell receptors. Vaccination results in antibodies to the G protein that block entry of the virus into cells. Since addition of the NiV receptor-binding G protein to a live virus could potentially target it to receptors on brain cells, extensive safety tests for neurovirulence were required involving direct inoculation of the vaccine virus into brains of different animal models. We showed that the vaccine candidate was significantly less neurovirulent in non-human primates than an unrelated approved live viral vaccine against yellow fever which has a long record of safe use and a known incidence of rare neurological adverse events. The use of an unrelated vaccine as a comparator is unprecedented in regulatory science and provides a novel approach to safety testing that may be applicable to other vaccines.
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Affiliation(s)
- Thomas P. Monath
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
- Crozet BioPharma Inc., Lexington, Massachusetts, United States of America
- * E-mail:
| | - Richard Nichols
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
- Crozet BioPharma Inc., Lexington, Massachusetts, United States of America
| | - Lynda Tussey
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
- Crozet BioPharma Inc., Lexington, Massachusetts, United States of America
| | - Kelly Scappaticci
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
- Crozet BioPharma Inc., Lexington, Massachusetts, United States of America
| | - Thaddeus G. Pullano
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
| | - Mary D. Whiteman
- BioReliance Corporation, Rockville, Maryland, United States of America
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Sealy Center for Vector-Borne and Zoonotic Diseases, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Shannan L. Rossi
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Rafael Kroon Campos
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Sasha R. Azar
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Heidi M. Spratt
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Brent L. Seaton
- Q2 Solutions, San Juan Capistrano, California, United States of America
| | | | - Yanina V. Costecalde
- AmplifyBio, West Jefferson, Ohio, United States of America
- Battelle Memorial Institute, West Jefferson, Ohio, United States of America
| | - Evan H. Moore
- Battelle Memorial Institute, West Jefferson, Ohio, United States of America
| | - Roger J. Hawks
- Battelle Memorial Institute, West Jefferson, Ohio, United States of America
| | - Joan Fusco
- Public Health Vaccines LLC, Cambridge, Massachusetts, United States of America
- Crozet BioPharma Inc., Lexington, Massachusetts, United States of America
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22
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Rangelova V, Raycheva R, Sariyan S, Kevorkyan A. Reporting adverse events of COVID-19 vaccines: The case of Bulgaria. PLoS One 2022; 17:e0269727. [PMID: 35687609 PMCID: PMC9187102 DOI: 10.1371/journal.pone.0269727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/26/2022] [Indexed: 12/19/2022] Open
Abstract
As a member state of the European Union, where vaccines against COVID-19 are available and affordable, Bulgaria reports the lowest immunization coverage and the most pronounced vaccine distrust. The present study aimed to assess the self-reported adverse reactions following COVID-19 vaccination as a possible tool to increase the trust in vaccines. A cross-sectional survey-based study, covering 761 vaccinated respondents, was conducted in Plovdiv (469 with an mRNA vaccine and 292 with an adenoviral vector vaccine). Descriptive statistics parametric and non-parametric methods were applied. Statistical significance was set at p<0.05. The median age of the respondents was 42 years, females (72.5%). At least one adverse reaction was reported in 89.9% of those immunized with mRNA vaccine and 93.8% in the adenoviral vector vaccine group (p>0.05). They were mild to moderate and resolved within several days. The levels of local reactions were comparable: 91.7% in those who received mRNA and 89.7% in those who received an adenoviral vector vaccine (p = 0.366). The most common types of systemic reactions were fatigue, headache, and muscle pains. An association was found between the systemic reactions and the type of vaccine administered: 59.7% in mRNA recipients and 89.4% in adenoviral vector vaccinees (p<0.001). None of the registered systemic reactions required medical attention. There were 3 reports of generalized urticaria after an mRNA and 2 after an adenoviral vector vaccine. The reported reactions are relatively high but expected and no adverse events have been reported that are not listed in the official Summary of Product Characteristics.
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Affiliation(s)
- Vanya Rangelova
- Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Sara Sariyan
- Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ani Kevorkyan
- Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Syversen SW, Jyssum I, Tveter AT, Tran TT, Sexton J, Provan SA, Mjaaland S, Warren DJ, Kvien TK, Grødeland G, Nissen‐Meyer LSH, Ricanek P, Chopra A, Andersson AM, Kro GB, Jahnsen J, Munthe LA, Haavardsholm EA, Vaage JT, Lund‐Johansen F, Jørgensen KK, Goll GL. Immunogenicity and Safety of Standard and Third Dose SARS-CoV-2 Vaccination in Patients on Immunosuppressive Therapy. Arthritis Rheumatol 2022; 74:1321-1332. [PMID: 35507355 PMCID: PMC9347774 DOI: 10.1002/art.42153] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/29/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022]
Abstract
Objective Immunogenicity and safety following receipt of the standard SARS–CoV‐2 vaccination regimen in patients with immune‐mediated inflammatory diseases (IMIDs) are poorly characterized, and data after receipt of the third vaccine dose are lacking. The aim of the study was to evaluate serologic responses and adverse events following the standard 2‐dose regimen and a third dose of SARS–CoV‐2 vaccine in IMID patients receiving immunosuppressive therapy. Methods Adult patients receiving immunosuppressive therapy for rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, Crohn's disease, or ulcerative colitis, as well as healthy adult controls, who received the standard 2‐dose SARS–CoV‐2 vaccination regimen were included in this prospective observational study. Analyses of antibodies to the receptor‐binding domain (RBD) of the SARS–CoV‐2 spike protein were performed prior to and 2–4 weeks after vaccination. Patients with a weak serologic response, defined as an IgG antibody titer of ≤100 arbitrary units per milliliter (AU/ml) against the receptor‐binding domain of the full‐length SARS–Cov‐2 spike protein, were allotted a third vaccine dose. Results A total of 1,505 patients (91%) and 1,096 healthy controls (98%) had a serologic response to the standard regimen (P < 0.001). Anti‐RBD antibody levels were lower in patients (median 619 AU/ml interquartile range [IQR] 192–4,191) than in controls (median 3,355 AU/ml [IQR 896–7,849]) (P < 0.001). The proportion of responders was lowest among patients receiving tumor necrosis factor inhibitor combination therapy, JAK inhibitors, or abatacept. Younger age and receipt of messenger RNA–1273 vaccine were predictors of serologic response. Of 153 patients who had a weak response to the standard regimen and received a third dose, 129 (84%) became responders. The vaccine safety profile among patients and controls was comparable. Conclusion IMID patients had an attenuated response to the standard vaccination regimen as compared to healthy controls. A third vaccine dose was safe and resulted in serologic response in most patients. These data facilitate identification of patient groups at risk of an attenuated vaccine response, and they support administering a third vaccine dose to IMID patients with a weak serologic response to the standard regimen.
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Affiliation(s)
| | - Ingrid Jyssum
- Diakonhjemmet Hospital and University of OsloOsloNorway
| | | | | | | | | | | | | | - Tore K. Kvien
- Diakonhjemmet Hospital and University of OsloOsloNorway
| | | | | | | | | | | | | | - Jørgen Jahnsen
- University of Oslo, Oslo, and Akershus University HospitalLørenskogNorway
| | | | | | - John T. Vaage
- Oslo University Hospital and University of OsloOsloNorway
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24
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Binh Luong Nguyen L, Lachâtre M, Launay O. [Vaccination contre le SARS-CoV-2, le Graal ?]. Rev Prat 2022; 72:517-522. [PMID: 35899638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ANTI-SARS-COV-2 VACCINATION, THE GRAIL? The Covid-19 pandemic, which caused an unprecedented health crisis, was partially controlled by the rapid development of effective vaccines against SARS-CoV-2. To date, 5 vaccines are approved in Europe, 10 are recognized by the World Health Organization and more than 150 vaccine candidates are in clinical development. This emerging pandemic disease context has shown the value of research and real-life data. The five vaccines used in France have been developed using different technologies with convincing Phase 3 results. Real-life data have provided additional information on the effectiveness and safety of these vaccines: they have shown the importance of a booster dose to protect against severe forms of delta and omicron variants; they have made it possible to characterize and measure the incidence of rare adverse events, such as myocardial toxicity in mRNA vaccines or the risk of thrombocytopenic thrombosis in vectorized vaccines. However, research must continue as many questions remain unanswered.
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Affiliation(s)
- Liem Binh Luong Nguyen
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France
| | - Marie Lachâtre
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, Inserm, centre d'investigation clinique (CIC) 1417, Paris, France - Université Paris Cité, Inserm, F-CRIN, I-REIVAC, COVIREIVAC, Paris, France
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Tran XH, Phuong LTT, Huy NQ, Thuy DT, Nguyen VD, Quang PH, Ngôn QV, Rai A, Gay CG, Gladue DP, Borca MV. Evaluation of the Safety Profile of the ASFV Vaccine Candidate ASFV-G-ΔI177L. Viruses 2022; 14:v14050896. [PMID: 35632638 PMCID: PMC9147362 DOI: 10.3390/v14050896] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 01/09/2023] Open
Abstract
African swine fever (ASF) is the cause of a recent pandemic that is posing a threat to much of the world swine production. The etiological agent, ASF virus (ASFV), infects domestic and wild swine, producing a variety of clinical presentations depending on the virus strain and the genetic background of the pigs infected. No commercial vaccine is currently available, although recombinant live attenuated vaccine candidates have been shown to be efficacious. In addition to determining efficacy, it is paramount to evaluate the safety profile of a live attenuated vaccine. The presence of residual virulence and the possibility of reversion to virulence are two of the concerns that must be evaluated in the development of live attenuated vaccines. Here we evaluate the safety profile of an efficacious live attenuated vaccine candidate, ASFV-G-ΔI177L. Results from safety studies showed that ASFV-G-ΔI177L remains genetically stable and phenotypically attenuated during a five-passage reversion to virulence study in domestic swine. In addition, large-scale experiments to detect virus shedding and transmission confirmed that even under varying conditions, ASFV-G-ΔI177L is a safe live attenuated vaccine.
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Affiliation(s)
- Xuan Hanh Tran
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
- Correspondence: (X.H.T.); (D.P.G.); (M.V.B.)
| | - Le Thi Thu Phuong
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Nguyen Quang Huy
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Do Thanh Thuy
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Van Dung Nguyen
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Pham Hào Quang
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Quách Võ Ngôn
- National Veterinary Joint Stock Company (NAVETCO), Ho Chi Minh City 70000, Vietnam; (L.T.T.P.); (N.Q.H.); (D.T.T.); (N.V.D.); (P.H.Q.); (Q.V.N.)
| | - Ayushi Rai
- Plum Island Animal Disease Center, Agricultural Research Service, U.S. Department of Agriculture, Greenport, NY 11944, USA;
| | - Cyril G. Gay
- Agricultural Research Service, U.S. Department of Agriculture, Beltsville, MD 20705, USA;
| | - Douglas Paul Gladue
- Plum Island Animal Disease Center, Agricultural Research Service, U.S. Department of Agriculture, Greenport, NY 11944, USA;
- Correspondence: (X.H.T.); (D.P.G.); (M.V.B.)
| | - Manuel Victor Borca
- Plum Island Animal Disease Center, Agricultural Research Service, U.S. Department of Agriculture, Greenport, NY 11944, USA;
- Correspondence: (X.H.T.); (D.P.G.); (M.V.B.)
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26
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Melin J, Svensson MK, Albinsson B, Winqvist O, Pauksens K. A third dose SARS‑CoV‑2 BNT162b2 mRNA vaccine results in improved immune response in hemodialysis patients. Ups J Med Sci 2022; 127:8959. [PMID: 36337280 PMCID: PMC9602199 DOI: 10.48101/ujms.v127.8959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The hemodialysis (HD) population has been a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. Advanced chronic kidney disease with uremia is associated with weaker immune response to infections and an attenuated response to vaccines. The aim of this study was to study the humoral and cellular response to the second and third doses of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‑CoV‑2) BNT162b2 mRNA vaccine in HD patients and to follow the response over time. METHODS The patients received their first two vaccine doses from 28 December 2020 within a 4-week interval and the third dose in September 2021 and were followed-up for humoral and cellular immune response at 1) 7-15 weeks and 2) 6-8 months after dose two (no t-cell reactivity measured), and 3) 3 weeks and 4) 3 months after dose three. Fifty patients were initially enrolled, and 40 patients were followed during the entire study. Levels of COVID-19 (SARS-CoV-2) IgG antibody against the Spike antigen (anti-S) and T-cell reactivity testing against the Spike protein using Enzyme-Linked ImmunoSpot (ELISPOT) technology were evaluated. RESULTS IgG antibodies to anti-S were detected in 35 (88%) of the 40 patients 7-15 weeks after vaccine dose two, 31 (78%) were positive, and 4 (10%) borderline. The median anti-S titer was 606 Abbott Units/milliliter (AU/mL) (interquartile range [IQR] 134-1,712). Three months after the third dose, anti-S was detected in 38 (95%) of 40 patients (P < 0.01 compared to after dose two), and the median anti-S titer was 9,910 AU/mL (IQR 2,325-26,975). Cellular reactivity was detected in 22 (55%), 34 (85%), and 28 (71%) of the 40 patients, and the median T-cell response was 9.5 (IQR 3.5-80), 51.5 (14.8-132), and 19.5 (8.8-54.2) units, respectively, for 6-8 months after dose two, 3 weeks, and 3 months after dose three. CONCLUSIONS Our data show that a third dose of SARS‑CoV‑2 BNT162b2 mRNA vaccine gives a robust and improved immunological response in HD patients, but a few patients did not develop any anti-S response during the entire study, indicating the importance to monitor the vaccine response since those who do not respond could now be given monoclonal antibodies if they contract a COVID-19 infection or in the future antivirals.
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Affiliation(s)
- Jan Melin
- Department of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, Sweden
| | - Maria K Svensson
- Department of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, Sweden
| | - Bo Albinsson
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Centre, Uppsala University, Uppsala, Sweden
- Laboratory of Clinical Microbiology, Uppsala, Sweden
| | - Ola Winqvist
- Department of Clinical Immunology, Karolinska University Hospital, Stockholm, Sweden
- ABC Labs, Solna, Sweden
| | - Karlis Pauksens
- Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden
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Affiliation(s)
- Jonathan Hinton
- University Hospital Southampton NHS foundation Trust, Southampton, United Kingdom
| | - Andre Briosa E Gala
- University Hospital Southampton NHS foundation Trust, Southampton, United Kingdom
| | - Simon Corbett
- University Hospital Southampton NHS foundation Trust, Southampton, United Kingdom
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Lockington D, Lee B, Jeng BH, Larkin DFP, Hjortdal J. Survey of Corneal Surgeons' Attitudes Regarding Keratoplasty Rejection Risk Associated With Vaccinations. Cornea 2021; 40:1541-1547. [PMID: 34749379 DOI: 10.1097/ico.0000000000002662] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the attitudes and practice of corneal specialists if patients with keratoplasty sought advice regarding common vaccinations and risk for potential graft rejection. METHODS An online questionnaire was posted on the Kera-net listserv and the EuCornea Web site in early 2020. Attitudes toward vaccinations and keratoplasty were obtained. Decision making for common keratoplasty (endothelial keratoplasty, deep anterior lamellar keratoplasty, and penetrating keratoplasty) scenarios at early and late time points was explored regarding the herpes zoster and influenza vaccines. RESULTS There were 142 respondents: 51.1% (70/137) specifically advise their patients with keratoplasty to get all vaccinations; 19.7% (27/137) stated clinical experience of a vaccine-associated rejection episode; 42.2% (57/135) were unaware of any such cases; and 64% (27/42) of those concerned would recommend delay if within 3 months of transplant surgery, recent corneal infection, or a recent rejection episode. The 2245 total responses to 18 clinical scenarios demonstrated wide variability in management of grafts in the setting of vaccination. Generally, 45.9% would not alter management, 26.2% would increase frequency of topical steroids, and 22.2% would recommend delay to vaccinations. Increased concern was expressed with recent surgery, live zoster vaccine and higher-risk penetrating keratoplasty scenarios. CONCLUSIONS Nearly half of the respondents do not alter management in the setting of keratoplasty and zoster and/or influenza vaccinations. Anecdotal rejection episodes possibly associated with vaccinations were reported by some. Vaccine-related rejection has not been shown in higher-level research, but that has not eliminated clinical concerns. Prospective research into the true vaccine-related risks in keratoplasty is necessary if evidence-based management guidelines are to be developed or definitive reassurance provided.
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Affiliation(s)
- David Lockington
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - Barry Lee
- Eye Consultants of Atlanta and Piedmont Hospital, Atlanta, GA
| | - Bennie H Jeng
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - Daniel F P Larkin
- NIHR Moorfields Clinical Research Facility, Moorfields Eye Hospital, London, United Kingdom; and
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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Esposito S, Mariotti Zani E, Torelli L, Scavone S, Petraroli M, Patianna V, Predieri B, Iughetti L, Principi N. Childhood Vaccinations and Type 1 Diabetes. Front Immunol 2021; 12:667889. [PMID: 34512622 PMCID: PMC8427438 DOI: 10.3389/fimmu.2021.667889] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Type 1 diabetes (T1D) is the most common paediatric endocrine disease, and its frequency has been found to increase worldwide. Similar to all conditions associated with poorly regulated glucose metabolism, T1D carries an increased risk of infection. Consequently, careful compliance by T1D children with schedules officially approved for child immunization is strongly recommended. However, because patients with T1D show persistent and profound limitations in immune function, vaccines may evoke a less efficient immune response, with corresponding lower protection. Moreover, T1D is an autoimmune condition that develops in genetically susceptible individuals and some data regarding T1D triggering factors appear to indicate that infections, mainly those due to viruses, play a major role. Accordingly, the use of viral live attenuated vaccines is being debated. In this narrative review, we discussed the most effective and safe use of vaccines in patients at risk of or with overt T1D. Literature analysis showed that several problems related to the use of vaccines in children with T1D have not been completely resolved. There are few studies regarding the immunogenicity and efficacy of vaccines in T1D children, and the need for different immunization schedules has not been precisely established. Fortunately, the previous presumed relationship between vaccine administration and T1D appears to have been debunked, though some doubts regarding rotavirus vaccines remain. Further studies are needed to completely resolve the problems related to vaccine administration in T1D patients. In the meantime, the use of vaccines remains extensively recommended in children with this disease.
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Affiliation(s)
- Susanna Esposito
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Elena Mariotti Zani
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Lisa Torelli
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Sara Scavone
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Maddalena Petraroli
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Viviana Patianna
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Principi
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
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Ganzel C, Ben-Chetrit E. Immune Thrombocytopenia Following the Pfizer-BioNTech BNT162b2 mRNA COVID-19 Vaccine. Isr Med Assoc J 2021; 23:341. [PMID: 34155844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Chezi Ganzel
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah-Hebrew University Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Eli Ben-Chetrit
- Department of Infectious Diseases, Shaare Zedek Medical Center, Jerusalem, Israel
- Hadassah-Hebrew University Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Abstract
SARS-CoV-2 infection and the resulting COVID-19 have afflicted millions of people in an ongoing worldwide pandemic. Safe and effective vaccination is needed urgently to protect not only the general population but also vulnerable subjects such as patients with cancer. Currently approved mRNA-based SARS-CoV-2 vaccines seem suitable for patients with cancer based on their mode of action, efficacy, and favorable safety profile reported in the general population. Here, we provide an overview of mRNA-based vaccines including their safety and efficacy. Extrapolating from insights gained from a different preventable viral infection, we review existing data on immunity against influenza A and B vaccines in patients with cancer. Finally, we discuss COVID-19 vaccination in light of the challenges specific to patients with cancer, such as factors that may hinder protective SARS-CoV-2 immune responses in the context of compromised immunity and the use of immune-suppressive or immune-modulating drugs.
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Affiliation(s)
- Emanuela Romano
- Department of Medical Oncology, Center for Cancer Immunotherapy, Institut Curie, Paris, Île-de-France, France
- INSERM U932, Department of Immunology, PSL Research University, Institut Curie, Paris, Île-de-France, France
| | - Steve Pascolo
- Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - Patrick Ott
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Affiliation(s)
- Mariana C Castells
- From Brigham and Women's Hospital, Boston (M.C.C.); and the Department of Medicine, Vanderbilt University Medical Center, Nashville (E.J.P.)
| | - Elizabeth J Phillips
- From Brigham and Women's Hospital, Boston (M.C.C.); and the Department of Medicine, Vanderbilt University Medical Center, Nashville (E.J.P.)
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Price S. Talk to Patients About: Vaccines and SIDS. Tex Med 2021; 117:43. [PMID: 33641121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Over the years, several vaccines have been blamed for SIDS, including those for pertussis, tetanus, diphtheria, Hemophilus influenzae type B, polio, and hepatitis B. This misconception has triggered a lot of scientific study to find out if vaccines could, in fact, cause SIDS. However, multiple studies and safety reviews have concluded that the answer is no, according to the Centers for Disease Control and Prevention (CDC).
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Lyons-Weiler J, McFarland G, La Joie E. Impact of catch-up vaccination on aluminum exposure due to new laws and post social distancing. J Trace Elem Med Biol 2020; 62:126649. [PMID: 32980768 PMCID: PMC7505097 DOI: 10.1016/j.jtemb.2020.126649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/15/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic has placed significant stressors on the medical community and on the general public. Part of this includes patients skipping well-child visits to reduce risk of exposure to SARS-CoV-2 virus. Published estimates of the duration of whole-body aluminum (Al) toxicity from vaccines in infants from birth to six months indicate that CDC's recommended vaccination schedule leads to unacceptably long periods of time in which infants are in aluminum toxicity (as measured by %AlumTox). METHODS We utilize these established clearance and accumulation models to calculate expected per-body-weight whole-body toxicity of aluminum from vaccines considering for children of all ages under CDC's Catch-Up schedule from birth to ten years, assuming social distancing for 6 months. Our updated Pediatric Dose Limit (PDL) model assumes a linear improvement in renal function from birth to two years. RESULTS Our results indicate that due diligence in considering alternative spacing and use of non-aluminum containing vaccines when possible will reduce whole body toxicity and may reduce risk of morbidity associated with exposure to aluminum. CONCLUSIONS While reduction or elimination of aluminum exposure from all sources is always a good idea, our results indicate that careful consideration of expected aluminum exposures during regular and Catch-Up vaccination is found to be especially important for infants and children below 2 years of age. We urge caution in the mass re-starting of vaccination under CDC's Catch-Up schedule for children under 12 months and offer alternative strategies to minimize per-day/week/month exposure to aluminum hydroxide following the COVID-19 period of isolation.
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Affiliation(s)
- James Lyons-Weiler
- The Institute for Pure and Applied Knowledge, Pittsburgh, PA, United States.
| | - Grant McFarland
- The Institute for Pure and Applied Knowledge, Pittsburgh, PA, United States
| | - Elaine La Joie
- The Institute for Pure and Applied Knowledge, Pittsburgh, PA, United States
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35
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Rubin EJ, Baden LR, Haug CJ, Morrissey S. Audio Interview: Covid-19 in Europe and New Information on Vaccines. N Engl J Med 2020; 383:e134. [PMID: 33207102 DOI: 10.1056/nejme2033666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Jackson LA, Anderson EJ, Rouphael NG, Roberts PC, Makhene M, Coler RN, McCullough MP, Chappell JD, Denison MR, Stevens LJ, Pruijssers AJ, McDermott A, Flach B, Doria-Rose NA, Corbett KS, Morabito KM, O'Dell S, Schmidt SD, Swanson PA, Padilla M, Mascola JR, Neuzil KM, Bennett H, Sun W, Peters E, Makowski M, Albert J, Cross K, Buchanan W, Pikaart-Tautges R, Ledgerwood JE, Graham BS, Beigel JH. An mRNA Vaccine against SARS-CoV-2 - Preliminary Report. N Engl J Med 2020; 383:1920-1931. [PMID: 32663912 PMCID: PMC7377258 DOI: 10.1056/nejmoa2022483] [Citation(s) in RCA: 2238] [Impact Index Per Article: 559.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 and spread globally, prompting an international effort to accelerate development of a vaccine. The candidate vaccine mRNA-1273 encodes the stabilized prefusion SARS-CoV-2 spike protein. METHODS We conducted a phase 1, dose-escalation, open-label trial including 45 healthy adults, 18 to 55 years of age, who received two vaccinations, 28 days apart, with mRNA-1273 in a dose of 25 μg, 100 μg, or 250 μg. There were 15 participants in each dose group. RESULTS After the first vaccination, antibody responses were higher with higher dose (day 29 enzyme-linked immunosorbent assay anti-S-2P antibody geometric mean titer [GMT], 40,227 in the 25-μg group, 109,209 in the 100-μg group, and 213,526 in the 250-μg group). After the second vaccination, the titers increased (day 57 GMT, 299,751, 782,719, and 1,192,154, respectively). After the second vaccination, serum-neutralizing activity was detected by two methods in all participants evaluated, with values generally similar to those in the upper half of the distribution of a panel of control convalescent serum specimens. Solicited adverse events that occurred in more than half the participants included fatigue, chills, headache, myalgia, and pain at the injection site. Systemic adverse events were more common after the second vaccination, particularly with the highest dose, and three participants (21%) in the 250-μg dose group reported one or more severe adverse events. CONCLUSIONS The mRNA-1273 vaccine induced anti-SARS-CoV-2 immune responses in all participants, and no trial-limiting safety concerns were identified. These findings support further development of this vaccine. (Funded by the National Institute of Allergy and Infectious Diseases and others; mRNA-1273 ClinicalTrials.gov number, NCT04283461).
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Affiliation(s)
- Lisa A Jackson
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Evan J Anderson
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Nadine G Rouphael
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Paul C Roberts
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Mamodikoe Makhene
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Rhea N Coler
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Michele P McCullough
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - James D Chappell
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Mark R Denison
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Laura J Stevens
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Andrea J Pruijssers
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Adrian McDermott
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Britta Flach
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Nicole A Doria-Rose
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Kizzmekia S Corbett
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Kaitlyn M Morabito
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Sijy O'Dell
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Stephen D Schmidt
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Phillip A Swanson
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Marcelino Padilla
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - John R Mascola
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Kathleen M Neuzil
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Hamilton Bennett
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Wellington Sun
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Etza Peters
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Mat Makowski
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Jim Albert
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Kaitlyn Cross
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Wendy Buchanan
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Rhonda Pikaart-Tautges
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Julie E Ledgerwood
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - Barney S Graham
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
| | - John H Beigel
- From Kaiser Permanente Washington Health Research Institute (L.A.J.) and the Center for Global Infectious Disease Research (CGIDR), Seattle Children's Research Institute (R.N.C.) - both in Seattle; the Department of Medicine, Center for Childhood Infections and Vaccines (CCIV) of Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta (E.J.A., E.P.), and Hope Clinic, Department of Medicine, Emory University School of Medicine, Decatur (N.G.R., M.P.M.) - both in Georgia; the Division of Microbiology and Infectious Diseases (P.C.R., M. Makhene, W.B., R.P.-T., J.H.B.) and the Vaccine Research Center (A.M., B.F., N.A.D.-R., K.S.C., K.M.M., S.O., S.D.S., P.A.S., M.P., J.R.M., J.E.L., B.S.G.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, the University of Maryland School of Medicine, Baltimore (K.M.N.), and the Emmes Company, Rockville (M. Makowski, J.A., K.C.) - all in Maryland; the Departments of Pediatrics (J.D.C., M.R.D., L.J.S., A.J.P.) and Pathology, Microbiology, and Immunology (M.R.D.), and the Vanderbilt Institute for Infection, Immunology, and Inflammation (J.D.C., M.R.D., A.J.P.), Vanderbilt University Medical Center, Nashville; and Moderna, Cambridge, MA (H.B., W.S.)
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Lambkin‐Williams R, DeVincenzo JP. A COVID-19 human viral challenge model. Learning from experience. Influenza Other Respir Viruses 2020; 14:747-756. [PMID: 32790065 PMCID: PMC7578316 DOI: 10.1111/irv.12797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 01/15/2023] Open
Abstract
The controlled human infection model and specifically the human viral challenge model are not dissimilar to standard clinical trials while adding another layer of complexity and safety considerations. The models deliberately infect volunteers, with an infectious challenge agent to determine the effect of the infection and the potential benefits of the experimental interventions. The human viral challenge model studies can shorten the time to assess the efficacy of a new vaccine or treatment by combining this with the assessment of safety. The newly emerging SARS-CoV-2 virus is highly contagious, and an urgent race is on to develop a new vaccine against this virus in a timeframe never attempted before. The use of the human viral challenge model has been proposed to accelerate the development of the vaccine. In the early 2000s, the authors successfully developed a pathogenic human viral challenge model for another virus for which there was no effective treatment and established it to evaluate potential therapies and vaccines against respiratory syncytial virus. Experience gained in the development of that model can help with the development of a COVID-19 HVCM and the authors describe it here.
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Zhou X, Jiang X, Qu M, Aninwene G, Jucaud V, Moon JJ, Gu Z, Sun W, Khademhosseini A. Engineering Antiviral Vaccines. ACS Nano 2020; 14:12370-12389. [PMID: 33001626 PMCID: PMC7534801 DOI: 10.1021/acsnano.0c06109] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/18/2020] [Indexed: 05/11/2023]
Abstract
Despite the vital role of vaccines in fighting viral pathogens, effective vaccines are still unavailable for many infectious diseases. The importance of vaccines cannot be overstated during the outbreak of a pandemic, such as the coronavirus disease 2019 (COVID-19) pandemic. The understanding of genomics, structural biology, and innate/adaptive immunity have expanded the toolkits available for current vaccine development. However, sudden outbreaks and the requirement of population-level immunization still pose great challenges in today's vaccine designs. Well-established vaccine development protocols from previous experiences are in place to guide the pipelines of vaccine development for emerging viral diseases. Nevertheless, vaccine development may follow different paradigms during a pandemic. For example, multiple vaccine candidates must be pushed into clinical trials simultaneously, and manufacturing capability must be scaled up in early stages. Factors from essential features of safety, efficacy, manufacturing, and distributions to administration approaches are taken into consideration based on advances in materials science and engineering technologies. In this review, we present recent advances in vaccine development by focusing on vaccine discovery, formulation, and delivery devices enabled by alternative administration approaches. We hope to shed light on developing better solutions for faster and better vaccine development strategies through the use of biomaterials, biomolecular engineering, nanotechnology, and microfabrication techniques.
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Affiliation(s)
- Xingwu Zhou
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA, 90095 USA
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Xing Jiang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Moyuan Qu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine. Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology. Hangzhou, 310006, China
| | - George Aninwene
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA, 90095 USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90064, USA
| | - James J. Moon
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Zhen Gu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA, 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, 90095, USA
| | - Wujin Sun
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA, 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA, 90095, USA
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90064, USA
| | - Ali Khademhosseini
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Center for Minimally Invasive Therapeutics, University of California, Los Angeles, CA, 90095 USA
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, 90095, USA
- Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90064, USA
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Chung YH, Beiss V, Fiering SN, Steinmetz NF. COVID-19 Vaccine Frontrunners and Their Nanotechnology Design. ACS Nano 2020; 14:12522-12537. [PMID: 33034449 PMCID: PMC7553041 DOI: 10.1021/acsnano.0c07197] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/05/2020] [Indexed: 05/18/2023]
Abstract
Humanity is experiencing a catastrophic pandemic. SARS-CoV-2 has spread globally to cause significant morbidity and mortality, and there still remain unknowns about the biology and pathology of the virus. Even with testing, tracing, and social distancing, many countries are struggling to contain SARS-CoV-2. COVID-19 will only be suppressible when herd immunity develops, either because of an effective vaccine or if the population has been infected and is resistant to reinfection. There is virtually no chance of a return to pre-COVID-19 societal behavior until there is an effective vaccine. Concerted efforts by physicians, academic laboratories, and companies around the world have improved detection and treatment and made promising early steps, developing many vaccine candidates at a pace that has been unmatched for prior diseases. As of August 11, 2020, 28 of these companies have advanced into clinical trials with Moderna, CanSino, the University of Oxford, BioNTech, Sinovac, Sinopharm, Anhui Zhifei Longcom, Inovio, Novavax, Vaxine, Zydus Cadila, Institute of Medical Biology, and the Gamaleya Research Institute having moved beyond their initial safety and immunogenicity studies. This review analyzes these frontrunners in the vaccine development space and delves into their posted results while highlighting the role of the nanotechnologies applied by all the vaccine developers.
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Affiliation(s)
- Young Hun Chung
- Department of Bioengineering, University
of California San Diego, La Jolla, California 92093, United
States
| | - Veronique Beiss
- Department of NanoEngineering, University
of California San Diego, La Jolla, California 92093, United
States
| | - Steven N. Fiering
- Geisel School of Medicine, Dartmouth
College, Hanover, New Hampshire 03755, United
States
- Norris Cotton Cancer Center,
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03766,
United States
| | - Nicole F. Steinmetz
- Department of Bioengineering, University
of California San Diego, La Jolla, California 92093, United
States
- Department of NanoEngineering, University
of California San Diego, La Jolla, California 92093, United
States
- Department of Radiology, University of
California San Diego, La Jolla, California 92093, United
States
- Moores Cancer Center, University of California
San Diego, La Jolla, California 92093, United
States
- Center for Nano-ImmunoEngineering,
University of California San Diego, La Jolla, California
92093, United States
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Rubin EJ, Baden LR, Morrissey S. Audio Interview: Vaccinology and Covid-19. N Engl J Med 2020; 383:e109. [PMID: 33053301 DOI: 10.1056/nejme2031646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Antigens, Surface
- Antigens, Viral
- Betacoronavirus
- COVID-19
- COVID-19 Vaccines
- Clinical Trials, Phase I as Topic
- Coronavirus Infections/immunology
- Coronavirus Infections/prevention & control
- Dose-Response Relationship, Immunologic
- Genetic Vectors
- Healthy Volunteers
- History, 18th Century
- Humans
- Pandemics/prevention & control
- Pneumonia, Viral/prevention & control
- RNA, Messenger/immunology
- RNA, Viral/immunology
- SARS-CoV-2
- Spike Glycoprotein, Coronavirus/chemistry
- Vaccines, Attenuated
- Vaccinology/history
- Vaccinology/methods
- Viral Vaccines/adverse effects
- Viral Vaccines/immunology
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41
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Cohen J. A call to test new vaccines head to head, in monkeys. Science 2020; 370:154-155. [PMID: 33033196 DOI: 10.1126/science.370.6513.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Affiliation(s)
| | - Preeti N Malani
- University of Michigan Health System, Division of Infectious Diseases, Ann Arbor
- Associate Editor, JAMA
| | - Joshua Sharfstein
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Kamei K, Miyairi I, Ishikura K, Ogura M, Shoji K, Arai K, Ito R, Kawai T, Ito S. Prospective study of live attenuated vaccines for patients receiving immunosuppressive agents. PLoS One 2020; 15:e0240217. [PMID: 33002085 PMCID: PMC7529194 DOI: 10.1371/journal.pone.0240217] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/21/2020] [Indexed: 11/19/2022] Open
Abstract
Patients receiving immunosuppressive agents are at risk of life-threatening infections. However, live vaccines are generally contraindicated in them. We conducted a prospective study regarding live attenuated vaccines for them. Patients elder than one year of age with immunosuppressive agents who showed negative or borderline antibody titers (virus-specific IgG levels < 4.0) against one or more of measles, rubella, varicella, and mumps and fulfilled the criteria (CD4 cell counts ≥ 500/mm3, stimulation index of lymphocyte blast transformation by PHA ≥ 101.6, serum IgG level ≥ 300 mg/dl, no steroid use or prednisolone < 1 mg/kg/day or < 2 mg/kg/2 days, trough levels of tacrolimus or cyclosporine were < 10 ng/ml or < 100 ng/ml and under good control of primary disease) were enrolled. Sixty-four vaccinations were administered to 32 patients. The seroconversion rates for measles, rubella, varicella, and mumps were 80.0%, 100.0%, 59.1%, and 69.2%, respectively. No life-threatening adverse events were observed, although one patient suffered from vaccine-strain varicella who showed cellular and humoral immunodeficiency (CD4 cell counts = 511/mm3, stimulation index of lymphocyte blast transformation by PHA = 91.1, serum IgG level = 208 mg/dl). This girl was immunized before we established the criteria for vaccination. Immunization with live attenuated vaccines for patients receiving immunosuppressive agents might be effective and safe if their cellular and humoral immunological parameters are within normal levels. However, determining the criteria for vaccination by immunological parameters should be established to guarantee the safety of live vaccines in the future. Clinical Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000007710. The date of registration: 2012/4/13.
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Affiliation(s)
- Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
- * E-mail:
| | - Isao Miyairi
- Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Ishikura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Masao Ogura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Kensuke Shoji
- Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Ito
- Department of General Pediatrics, National Center for Child Health and Development, Tokyo, Japan
| | - Toshinao Kawai
- Division of Immunology, National Center for Child Health and Development, Tokyo, Japan
| | - Shuichi Ito
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Yokohama City University, Kanagawa, Japan
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Mulligan MJ, Lyke KE, Kitchin N, Absalon J, Gurtman A, Lockhart S, Neuzil K, Raabe V, Bailey R, Swanson KA, Li P, Koury K, Kalina W, Cooper D, Fontes-Garfias C, Shi PY, Türeci Ö, Tompkins KR, Walsh EE, Frenck R, Falsey AR, Dormitzer PR, Gruber WC, Şahin U, Jansen KU. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature 2020; 586:589-593. [PMID: 32785213 DOI: 10.1038/s41586-020-2639-4] [Citation(s) in RCA: 961] [Impact Index Per Article: 240.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022]
Abstract
In March 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1, a pandemic. With rapidly accumulating numbers of cases and deaths reported globally2, a vaccine is urgently needed. Here we report the available safety, tolerability and immunogenicity data from an ongoing placebo-controlled, observer-blinded dose-escalation study (ClinicalTrials.gov identifier NCT04368728) among 45 healthy adults (18-55 years of age), who were randomized to receive 2 doses-separated by 21 days-of 10 μg, 30 μg or 100 μg of BNT162b1. BNT162b1 is a lipid-nanoparticle-formulated, nucleoside-modified mRNA vaccine that encodes the trimerized receptor-binding domain (RBD) of the spike glycoprotein of SARS-CoV-2. Local reactions and systemic events were dose-dependent, generally mild to moderate, and transient. A second vaccination with 100 μg was not administered because of the increased reactogenicity and a lack of meaningfully increased immunogenicity after a single dose compared with the 30-μg dose. RBD-binding IgG concentrations and SARS-CoV-2 neutralizing titres in sera increased with dose level and after a second dose. Geometric mean neutralizing titres reached 1.9-4.6-fold that of a panel of COVID-19 convalescent human sera, which were obtained at least 14 days after a positive SARS-CoV-2 PCR. These results support further evaluation of this mRNA vaccine candidate.
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Affiliation(s)
- Mark J Mulligan
- New York University Langone Vaccine Center, New York, NY, USA
- New York University Grossman School of Medicine, New York, NY, USA
| | - Kirsten E Lyke
- University of Maryland School of Medicine, Center for Vaccine Development and Global Health, Baltimore, MD, USA
| | | | - Judith Absalon
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA.
| | | | | | - Kathleen Neuzil
- University of Maryland School of Medicine, Center for Vaccine Development and Global Health, Baltimore, MD, USA
| | - Vanessa Raabe
- New York University Langone Vaccine Center, New York, NY, USA
- New York University Grossman School of Medicine, New York, NY, USA
| | - Ruth Bailey
- Vaccine Research and Development, Pfizer Inc, Hurley, UK
| | - Kena A Swanson
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Ping Li
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Kenneth Koury
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Warren Kalina
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - David Cooper
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | | | - Pei-Yong Shi
- University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Edward E Walsh
- University of Rochester, Rochester, NY, USA
- Rochester General Hospital, Rochester, NY, USA
| | | | - Ann R Falsey
- University of Rochester, Rochester, NY, USA
- Rochester General Hospital, Rochester, NY, USA
| | | | - William C Gruber
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | | | - Kathrin U Jansen
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
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Lee WS, Wheatley AK, Kent SJ, DeKosky BJ. Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies. Nat Microbiol 2020; 5:1185-1191. [PMID: 32908214 DOI: 10.1038/s41564-020-00789-5] [Citation(s) in RCA: 447] [Impact Index Per Article: 111.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
Abstract
Antibody-based drugs and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being expedited through preclinical and clinical development. Data from the study of SARS-CoV and other respiratory viruses suggest that anti-SARS-CoV-2 antibodies could exacerbate COVID-19 through antibody-dependent enhancement (ADE). Previous respiratory syncytial virus and dengue virus vaccine studies revealed human clinical safety risks related to ADE, resulting in failed vaccine trials. Here, we describe key ADE mechanisms and discuss mitigation strategies for SARS-CoV-2 vaccines and therapies in development. We also outline recently published data to evaluate the risks and opportunities for antibody-based protection against SARS-CoV-2.
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Affiliation(s)
- Wen Shi Lee
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- ARC Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
- ARC Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Victoria, Australia.
- Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
| | - Brandon J DeKosky
- Department of Pharmaceutical Chemistry, The University of Kansas, Lawrence, KS, USA.
- Department of Chemical Engineering, The University of Kansas, Lawrence, KS, USA.
- Bioengineering Graduate Program, The University of Kansas, Lawrence, KS, USA.
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46
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Logunov DY, Dolzhikova IV, Zubkova OV, Tukhvatullin AI, Shcheblyakov DV, Dzharullaeva AS, Grousova DM, Erokhova AS, Kovyrshina AV, Botikov AG, Izhaeva FM, Popova O, Ozharovskaya TA, Esmagambetov IB, Favorskaya IA, Zrelkin DI, Voronina DV, Shcherbinin DN, Semikhin AS, Simakova YV, Tokarskaya EA, Lubenets NL, Egorova DA, Shmarov MM, Nikitenko NA, Morozova LF, Smolyarchuk EA, Kryukov EV, Babira VF, Borisevich SV, Naroditsky BS, Gintsburg AL. Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomised phase 1/2 studies from Russia. Lancet 2020; 396:887-897. [PMID: 32896291 PMCID: PMC7471804 DOI: 10.1016/s0140-6736(20)31866-3] [Citation(s) in RCA: 631] [Impact Index Per Article: 157.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND We developed a heterologous COVID-19 vaccine consisting of two components, a recombinant adenovirus type 26 (rAd26) vector and a recombinant adenovirus type 5 (rAd5) vector, both carrying the gene for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein (rAd26-S and rAd5-S). We aimed to assess the safety and immunogenicity of two formulations (frozen and lyophilised) of this vaccine. METHODS We did two open, non-randomised phase 1/2 studies at two hospitals in Russia. We enrolled healthy adult volunteers (men and women) aged 18-60 years to both studies. In phase 1 of each study, we administered intramuscularly on day 0 either one dose of rAd26-S or one dose of rAd5-S and assessed the safety of the two components for 28 days. In phase 2 of the study, which began no earlier than 5 days after phase 1 vaccination, we administered intramuscularly a prime-boost vaccination, with rAd26-S given on day 0 and rAd5-S on day 21. Primary outcome measures were antigen-specific humoral immunity (SARS-CoV-2-specific antibodies measured by ELISA on days 0, 14, 21, 28, and 42) and safety (number of participants with adverse events monitored throughout the study). Secondary outcome measures were antigen-specific cellular immunity (T-cell responses and interferon-γ concentration) and change in neutralising antibodies (detected with a SARS-CoV-2 neutralisation assay). These trials are registered with ClinicalTrials.gov, NCT04436471 and NCT04437875. FINDINGS Between June 18 and Aug 3, 2020, we enrolled 76 participants to the two studies (38 in each study). In each study, nine volunteers received rAd26-S in phase 1, nine received rAd5-S in phase 1, and 20 received rAd26-S and rAd5-S in phase 2. Both vaccine formulations were safe and well tolerated. The most common adverse events were pain at injection site (44 [58%]), hyperthermia (38 [50%]), headache (32 [42%]), asthenia (21 [28%]), and muscle and joint pain (18 [24%]). Most adverse events were mild and no serious adverse events were detected. All participants produced antibodies to SARS-CoV-2 glycoprotein. At day 42, receptor binding domain-specific IgG titres were 14 703 with the frozen formulation and 11 143 with the lyophilised formulation, and neutralising antibodies were 49·25 with the frozen formulation and 45·95 with the lyophilised formulation, with a seroconversion rate of 100%. Cell-mediated responses were detected in all participants at day 28, with median cell proliferation of 2·5% CD4+ and 1·3% CD8+ with the frozen formulation, and a median cell proliferation of 1·3% CD4+ and 1·1% CD8+ with the lyophilised formulation. INTERPRETATION The heterologous rAd26 and rAd5 vector-based COVID-19 vaccine has a good safety profile and induced strong humoral and cellular immune responses in participants. Further investigation is needed of the effectiveness of this vaccine for prevention of COVID-19. FUNDING Ministry of Health of the Russian Federation.
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Affiliation(s)
- Denis Y Logunov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia.
| | - Inna V Dolzhikova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga V Zubkova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Amir I Tukhvatullin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Dmitry V Shcheblyakov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alina S Dzharullaeva
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria M Grousova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alina S Erokhova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Anna V Kovyrshina
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei G Botikov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Fatima M Izhaeva
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga Popova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Tatiana A Ozharovskaya
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Ilias B Esmagambetov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Irina A Favorskaya
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis I Zrelkin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria V Voronina
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Dmitry N Shcherbinin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander S Semikhin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Yana V Simakova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Elizaveta A Tokarskaya
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nadezhda L Lubenets
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria A Egorova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Maksim M Shmarov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Natalia A Nikitenko
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Lola F Morozova
- Federal State Autonomous Educational Institution of Higher Education I M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Elena A Smolyarchuk
- Federal State Autonomous Educational Institution of Higher Education I M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Evgeny V Kryukov
- Federal State Budgetary Institution "The Main Military Clinical Hospital named after N N Burdenko" of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Vladimir F Babira
- Branch No 7 of the Federal State Budgetary Institution "The Main Military Clinical Hospital named after N N Burdenko" of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Sergei V Borisevich
- 48 Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Boris S Naroditsky
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander L Gintsburg
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow, Russia
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Affiliation(s)
- Philip Krause
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Washington, DC, USA
| | - Thomas R Fleming
- Fred Hutchinson Cancer Centre, University of Washington, Seattle, WA, USA
| | - Ira Longini
- Department of Biostatistics, College of Public Health and Health Professions College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Richard Peto
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Abstract
COVID-19 vaccines are the most important tool to stem the pandemic. They are being developed with unprecedented global collaboration and accelerated timelines to achieve WHO Emergency Use Listing, while using regulatory pathways through national regulatory authorities. Alongside preparations to ensure equitable access to the vaccines among people globally, preparations must be made within countries for COVID-19 vaccines safety surveillance on an urgent basis. Safety surveillance must be capable of investigating adverse events of special interest (AESI) and adverse events following immunization to determine a change in the benefit-risk profile of the vaccine, and to be able to anticipate coincidental events that might be attributed to the vaccine. Active surveillance systems should calculate the incidence of background rates of AESI prior to vaccine roll out. These background rates vary tremendously across regions, populations and case ascertainment methods. Active surveillance systems must be established or strengthened now, (including in LMIC), to calculate the background rates. Utilizing standardized case definitions and global standards for AESI will help in harmonization. Vaccine safety communication plans should be developed. Expanding the global vaccine safety system to meet the needs of COVID-19 and other emergency and routine use vaccines is a priority currently.
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Affiliation(s)
- Sonali Kochhar
- Global Healthcare Consulting, India; Department of Global Health, University of Washington, Seattle, United States.
| | - Daniel A Salmon
- Institute for Vaccine Safety, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, United States.
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Xia S, Duan K, Zhang Y, Zhao D, Zhang H, Xie Z, Li X, Peng C, Zhang Y, Zhang W, Yang Y, Chen W, Gao X, You W, Wang X, Wang Z, Shi Z, Wang Y, Yang X, Zhang L, Huang L, Wang Q, Lu J, Yang Y, Guo J, Zhou W, Wan X, Wu C, Wang W, Huang S, Du J, Meng Z, Pan A, Yuan Z, Shen S, Guo W, Yang X. Effect of an Inactivated Vaccine Against SARS-CoV-2 on Safety and Immunogenicity Outcomes: Interim Analysis of 2 Randomized Clinical Trials. JAMA 2020; 324:951-960. [PMID: 32789505 PMCID: PMC7426884 DOI: 10.1001/jama.2020.15543] [Citation(s) in RCA: 552] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE A vaccine against coronavirus disease 2019 (COVID-19) is urgently needed. OBJECTIVE To evaluate the safety and immunogenicity of an investigational inactivated whole-virus COVID-19 vaccine in China. INTERVENTIONS In the phase 1 trial, 96 participants were assigned to 1 of the 3 dose groups (2.5, 5, and 10 μg/dose) and an aluminum hydroxide (alum) adjuvant-only group (n = 24 in each group), and received 3 intramuscular injections at days 0, 28, and 56. In the phase 2 trial, 224 adults were randomized to 5 μg/dose in 2 schedule groups (injections on days 0 and 14 [n = 84] vs alum only [n = 28], and days 0 and 21 [n = 84] vs alum only [n = 28]). DESIGN, SETTING, AND PARTICIPANTS Interim analysis of ongoing randomized, double-blind, placebo-controlled, phase 1 and 2 clinical trials to assess an inactivated COVID-19 vaccine. The trials were conducted in Henan Province, China, among 96 (phase 1) and 224 (phase 2) healthy adults aged between 18 and 59 years. Study enrollment began on April 12, 2020. The interim analysis was conducted on June 16, 2020, and updated on July 27, 2020. MAIN OUTCOMES AND MEASURES The primary safety outcome was the combined adverse reactions 7 days after each injection, and the primary immunogenicity outcome was neutralizing antibody response 14 days after the whole-course vaccination, which was measured by a 50% plaque reduction neutralization test against live severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RESULTS Among 320 patients who were randomized (mean age, 42.8 years; 200 women [62.5%]), all completed the trial up to 28 days after the whole-course vaccination. The 7-day adverse reactions occurred in 3 (12.5%), 5 (20.8%), 4 (16.7%), and 6 (25.0%) patients in the alum only, low-dose, medium-dose, and high-dose groups, respectively, in the phase 1 trial; and in 5 (6.0%) and 4 (14.3%) patients who received injections on days 0 and 14 for vaccine and alum only, and 16 (19.0%) and 5 (17.9%) patients who received injections on days 0 and 21 for vaccine and alum only, respectively, in the phase 2 trial. The most common adverse reaction was injection site pain, followed by fever, which were mild and self-limiting; no serious adverse reactions were noted. The geometric mean titers of neutralizing antibodies in the low-, medium-, and high-dose groups at day 14 after 3 injections were 316 (95% CI, 218-457), 206 (95% CI, 123-343), and 297 (95% CI, 208-424), respectively, in the phase 1 trial, and were 121 (95% CI, 95-154) and 247 (95% CI, 176-345) at day 14 after 2 injections in participants receiving vaccine on days 0 and 14 and on days 0 and 21, respectively, in the phase 2 trial. There were no detectable antibody responses in all alum-only groups. CONCLUSIONS AND RELEVANCE In this interim report of the phase 1 and phase 2 trials of an inactivated COVID-19 vaccine, patients had a low rate of adverse reactions and demonstrated immunogenicity; the study is ongoing. Efficacy and longer-term adverse event assessment will require phase 3 trials. TRIAL REGISTRATION Chinese Clinical Trial Registry Identifier: ChiCTR2000031809.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Adjuvants, Immunologic/adverse effects
- Adolescent
- Adult
- Aluminum Hydroxide/administration & dosage
- Aluminum Hydroxide/adverse effects
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Betacoronavirus/genetics
- Betacoronavirus/immunology
- COVID-19
- COVID-19 Vaccines
- Coronavirus Infections/immunology
- Coronavirus Infections/prevention & control
- Dose-Response Relationship, Immunologic
- Double-Blind Method
- Female
- Humans
- Immunogenicity, Vaccine
- Injections, Intramuscular
- Male
- Pandemics/prevention & control
- Pneumonia, Viral/immunology
- Pneumonia, Viral/prevention & control
- Propiolactone
- SARS-CoV-2
- Vaccines, Inactivated/immunology
- Viral Vaccines/administration & dosage
- Viral Vaccines/adverse effects
- Viral Vaccines/immunology
- Young Adult
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Affiliation(s)
- Shengli Xia
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Kai Duan
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Yuntao Zhang
- China National Biotec Group Company Limited, Beijing, China
| | - Dongyang Zhao
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Huajun Zhang
- Chinese Academy of Sciences Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Zhiqiang Xie
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Xinguo Li
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Cheng Peng
- Chinese Academy of Sciences Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Yanbo Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Yunkai Yang
- China National Biotec Group Company Limited, Beijing, China
| | - Wei Chen
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Xiaoxiao Gao
- Chinese Academy of Sciences Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Wangyang You
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Xuewei Wang
- China National Biotec Group Company Limited, Beijing, China
| | - Zejun Wang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Zhengli Shi
- Chinese Academy of Sciences Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Yanxia Wang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Xuqin Yang
- China National Biotec Group Company Limited, Beijing, China
| | - Lianghao Zhang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Lili Huang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Qian Wang
- China National Biotec Group Company Limited, Beijing, China
| | - Jia Lu
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jing Guo
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Wei Zhou
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Xin Wan
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Cong Wu
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Wenhui Wang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Shihe Huang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Jianhui Du
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Ziyan Meng
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- National Medical Center for Major Public Health Events, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhiming Yuan
- Chinese Academy of Sciences Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Shuo Shen
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
| | - Wanshen Guo
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Xiaoming Yang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co Ltd, Wuhan, Hubei, China
- China National Biotec Group Company Limited, Beijing, China
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Kleen TO, Galdon AA, MacDonald AS, Dalgleish AG. Mitigating Coronavirus Induced Dysfunctional Immunity for At-Risk Populations in COVID-19: Trained Immunity, BCG and "New Old Friends". Front Immunol 2020; 11:2059. [PMID: 33013871 PMCID: PMC7498663 DOI: 10.3389/fimmu.2020.02059] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
The novel, highly contagious coronavirus SARS-CoV-2 spreads rapidly throughout the world, leading to a deadly pandemic of a predominantly respiratory illness called COVID-19. Safe and effective anti-SARS-CoV-2 vaccines are urgently needed. However, emerging immunological observations show hallmarks of significant immunopathological characteristics and dysfunctional immune responses in patients with COVID-19. Combined with existing knowledge about immune responses to other closely related and highly pathogenic coronaviruses, this could forebode significant challenges for vaccine development, including the risk of vaccine failure. Animal data from earlier coronavirus vaccine efforts indicate that elderly people, most at risk from severe COVID-19 disease, could be especially at risk from immunopathologic responses to novel coronavirus vaccines. Bacterial "new old friends" such as Bacille Calmette-Guérin (BCG) or Mycobacterium obuense have the ability to elevate basal systemic levels of type 1 cytokines and immune cells, correlating with increased protection against diverse and unrelated infectious agents, called "trained immunity." Here we describe dysfunctional immune responses induced by coronaviruses, representing potentially difficult to overcome obstacles to safe, effective vaccine development for COVID-19, and outline how trained immunity could help protect high risk populations through immunomodulation with BCG and other "new old friends."
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Affiliation(s)
| | - Alicia A Galdon
- Lydia Becker Institute of Immunology and Inflammation, Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Andrew S MacDonald
- Lydia Becker Institute of Immunology and Inflammation, Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Angus G Dalgleish
- Institute for Infection and Immunity, St George's, University of London, London, United Kingdom
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