Safety and Immunogenicity of a Live Attenuated Tetravalent Dengue Vaccine Candidate in Flavivirus-Naive Adults: A Randomized, Double-Blinded Phase 1 Clinical Trial
Sarah L George, Mimi A Wong, Tina J T Dube, Karen L Boroughs, Janae L Stovall, Betty E Luy, Aurelia A Haller, Jorge E Osorio, Linda M Eggemeyer, Sharon Irby-Moore, Sharon E Frey, Claire Y-H Huang, Dan T Stinchcomb, Sarah L George, Mimi A Wong, Tina J T Dube, Karen L Boroughs, Janae L Stovall, Betty E Luy, Aurelia A Haller, Jorge E Osorio, Linda M Eggemeyer, Sharon Irby-Moore, Sharon E Frey, Claire Y-H Huang, Dan T Stinchcomb
Abstract
Background: Dengue viruses (DENVs) infect >300 million people annually, causing 96 million cases of dengue disease and 22 000 deaths [1]. A safe vaccine that protects against DENV disease is a global health priority [2].
Methods: We enrolled 72 flavivirus-naive healthy adults in a phase 1 double-blinded, randomized, placebo-controlled dose-escalation trial (low and high dose) of a live attenuated recombinant tetravalent dengue vaccine candidate (TDV) given in 2 doses 90 days apart. Volunteers were followed for safety, vaccine component viremia, and development of neutralizing antibodies to the 4 DENV serotypes.
Results: The majority of adverse events were mild, with no vaccine-related serious adverse events. Vaccinees reported injection site pain (52% vs 17%) and erythema (73% vs 25%) more frequently than placebo recipients. Low levels of TDV-serotype 2 (TDV-2), TDV-3, and TDV-4 viremia were observed after the first but not second administration of vaccine. Overall seroconversion rates and geometric mean neutralization titers after 2 doses were 84.2% and 54.1, respectively, for DENV serotype 1 (DENV-1); 92.1% and 292.8, respectively, for DENV-2; 86.8% and 32.3, respectively, for DENV-3; and 71.1% and 15.0, respectively, for DENV-4. More than 90.0% of high-dose recipients had trivalent or broader responses.
Conclusions: TDV was generally well tolerated, induced trivalent or broader neutralizing antibodies to DENV in most flavivirus-naive vaccinees, and is undergoing further development.
Clinical trials registration: NCT01110551.
Keywords: Dengue vaccine; clinical trial; live attenuated tetravalent; neutralizing antibody; viremia.
© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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Source: PubMed