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Safety and efficacy of novel malaria vaccine regimens of RTS,S/AS01B alone, or with concomitant ChAd63-MVA-vectored vaccines expressing ME-TRAP.


ABSTRACT: We assessed a combination multi-stage malaria vaccine schedule in which RTS,S/AS01B was given concomitantly with viral vectors expressing multiple-epitope thrombospondin-related adhesion protein (ME-TRAP) in a 0-month, 1-month, and 2-month schedule. RTS,S/AS01B was given as either three full doses or with a fractional (1/5th) third dose. Efficacy was assessed by controlled human malaria infection (CHMI). Safety and immunogenicity of the vaccine regimen was also assessed. Forty-one malaria-naive adults received RTS,S/AS01B at 0, 4 and 8 weeks, either alone (Groups 1 and 2) or with ChAd63 ME-TRAP at week 0, and modified vaccinia Ankara (MVA) ME-TRAP at weeks 4 and 8 (Groups 3 and 4). Groups 2 and 4 received a fractional (1/5th) dose of RTS,S/AS01B at week 8. CHMI was delivered by mosquito bite 11 weeks after first vaccination. Vaccine efficacy was 6/8 (75%), 8/9 (88.9%), 6/10 (60%), and 5/9 (55.6%) of subjects in Groups 1, 2, 3, and 4, respectively. Immunological analysis indicated significant reductions in anti-circumsporozoite protein antibodies and TRAP-specific T cells at CHMI in the combination vaccine groups. This reduced immunogenicity was only observed after concomitant administration of the third dose of RTS,S/AS01B with the second dose of MVA ME-TRAP. The second dose of the MVA vector with a four-week interval caused significantly higher anti-vector immunity than the first and may have been the cause of immunological interference. Co-administration of ChAd63/MVA ME-TRAP with RTS,S/AS01B led to reduced immunogenicity and efficacy, indicating the need for evaluation of alternative schedules or immunization sites in attempts to generate optimal efficacy.

SUBMITTER: Rampling T 

PROVIDER: S-EPMC6177476 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Safety and efficacy of novel malaria vaccine regimens of RTS,S/AS01B alone, or with concomitant ChAd63-MVA-vectored vaccines expressing ME-TRAP.

Rampling Tommy T   Ewer Katie J KJ   Bowyer Georgina G   Edwards Nick J NJ   Wright Danny D   Sridhar Saranya S   Payne Ruth R   Powlson Jonathan J   Bliss Carly C   Venkatraman Navin N   Poulton Ian D ID   de Graaf Hans H   Gbesemete Diane D   Grobbelaar Amy A   Davies Huw H   Roberts Rachel R   Angus Brian B   Ivinson Karen K   Weltzin Rich R   Rajkumar Bebi-Yassin BY   Wille-Reece Ulrike U   Lee Cynthia C   Ockenhouse Chris C   Sinden Robert E RE   Gerry Stephen C SC   Lawrie Alison M AM   Vekemans Johan J   Morelle Danielle D   Lievens Marc M   Ballou Ripley W RW   Lewis David J M DJM   Cooke Graham S GS   Faust Saul N SN   Gilbert Sarah S   Hill Adrian V S AVS  

NPJ vaccines 20181009


We assessed a combination multi-stage malaria vaccine schedule in which RTS,S/AS01B was given concomitantly with viral vectors expressing multiple-epitope thrombospondin-related adhesion protein (ME-TRAP) in a 0-month, 1-month, and 2-month schedule. RTS,S/AS01B was given as either three full doses or with a fractional (1/5th) third dose. Efficacy was assessed by controlled human malaria infection (CHMI). Safety and immunogenicity of the vaccine regimen was also assessed. Forty-one malaria-naive  ...[more]

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