The Vi Conjugate Typhoid Vaccine Is Safe, Elicits Protective Levels of IgG Anti-Vi, and Is Compatible with Routine Infant Vaccines
Vu Dinh Thiem,Feng-Ying C. Lin,Do Gia Canh,Nguyen Hong Son,Dang Duc Anh,Nguyen Duc Mao,Chiayung Chu,Steven Hunt,John B. Robbins,Rachel Schneerson,Shousun C. Szu +10 more
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Vi-rEPA was safe, induced protective anti-Vi levels, and was compatible with EPI vaccines, and it can be used in infants.Abstract:
Typhoid fever remains a serious problem in developing countries. Current vaccines are licensed for individuals who are 5 years old or older. A conjugate of the capsular polysaccharide (CP) of Salmonella enterica serovar Typhi (Vi) bound to recombinant exoprotein A of Pseudomonas aeruginosa (Vi-rEPA) enhanced Vi immunogenicity and protected 2- to 5-year-olds in Vietnam. In this study, Vi-rEPA was evaluated for use in infants. A total of 301 full-term Vietnamese infants received Expanded Program on Immunization (EPI) vaccines alone or with Vi-rEPA or Haemophilus influenzae type b-tetanus toxoid conjugate (Hib-TT) at 2, 4, and 6 months and Vi-rEPA or Hib-TT alone at 12 months. Infants were visited 6, 24, and 48 h after each injection to monitor adverse reactions. Maternal, cord, and infant sera were assayed for IgG anti-Vi and for IgG antibodies to Hib CP and the diphtheria, tetanus, and pertussis toxins at 7, 12, and 13 months. No vaccine-related serious adverse reactions occurred. In the Vi-rEPA group, the IgG anti-Vi geometric mean (GM) increased from the cord level of 0.66 to 17.4 enzyme-linked immunosorbent assay units (EU) at 7 months, declined to 4.76 EU at 12 months, and increased to 50.1 EU 1 month after the 4th dose (95% of infants had levels of ≥3.5 EU, the estimated protective level). Controls had no increase of the IgG anti-Vi GM. Infants with cord anti-Vi levels of <3.5 EU responded with significantly higher IgG anti-Vi levels than those with levels of ≥3.5 EU. Anti-diphtheria, -tetanus, and -pertussis toxin levels were similar in all groups. Vi-rEPA was safe, induced protective anti-Vi levels, and was compatible with EPI vaccines, and it can be used in infants. High cord IgG anti-Vi levels partially suppressed infant responses to Vi-rEPA.read more
Citations
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Efficacy and immunogenicity of a Vi-tetanus toxoid conjugate vaccine in the prevention of typhoid fever using a controlled human infection model of Salmonella Typhi: a randomised controlled, phase 2b trial.
Celina Jin,Malick M. Gibani,Maria Moore,Helene B Juel,Elizabeth Jones,James E Meiring,Victoria Harris,Jonathan D. Gardner,Anna Nebykova,Simon Kerridge,Jennifer Hill,Helena Thomaides-Brears,Christoph J. Blohmke,Ly-Mee Yu,Brian Angus,Andrew J. Pollard +15 more
TL;DR: Vi-TT is a highly immunogenic vaccine that significantly reduces typhoid fever cases when assessed using a stringent controlled model of typhoid infection.
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Salmonella infections: an update on epidemiology, management, and prevention.
TL;DR: An overview of clinical aspects of typhoid and non-typhoid infections in developing and industrialized countries, respectively, is provided, followed by a description on current treatment concepts and challenges treating multidrug-resistant Salmonella infections.
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Vaccines for preventing typhoid fever
TL;DR: Evaluating the efficacy and adverse effects of vaccines used to prevent typhoid fever found that a new, modified, conjugated Vi vaccine called Vi-rEPA was in development and was more common in the vaccine group.
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Vaccines against invasive Salmonella disease: current status and future directions.
TL;DR: New glycoconjugate vaccines against S. Typhi are becoming available with similar vaccines against other invasive serovars in development, including live-attenuated, protein-based and GMMA vaccines, now is an exciting time for the Salmonella vaccine field.
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Vaccine process technology
TL;DR: The evolution of vaccine process technology has occurred in parallel to the remarkable growth in the development of therapeutic proteins as products; therefore, recent vaccine innovations can leverage the progress made in the broader biotechnology industry.
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TL;DR: The antibody responses and the efficacy suggest that the Vi-rEPA conjugate typhoid vaccine should be at least as protective in persons who are more than five years old.
Journal ArticleDOI
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TL;DR: The findings challenge the common view that typhoid fever is a disorder of school-age children and of adults, and the optimum age of typhoid immunisation and the choice of vaccines needs to be reassessed.
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