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Vaccines for Zaire Ebola Virus Disease

Researchers report that 3 vaccine regimens against Zaire Ebola virus disease were safe and immunogenic, with immune responses evident from day 14 through month 12 in a pair of randomized, placebo-controlled trials. Children as young as 1 year of age were vaccinated without safety concerns, and immune responses in children were higher than in adults.

The trials included 1,400 adults and 1,401 children. The Zaire Ebola virus disease vaccine regimens were Ad26.ZEBOV followed by MVA-BN-Filo 56 days later (the Ad26–MVA group), rVSVΔG-ZEBOV-GP followed by placebo 56 days later (the rVSV group), and rVSVΔG-ZEBOV-GP followed by rVSVΔG-ZEBOV-GP 56 days later (the rVSV–booster group). The primary endpoint was antibody response at 12 months (a 12-month antibody concentration of at least 200 enzyme-linked immunosorbent assay units (EU) per milliliter and an increase from baseline in the antibody concentration by at least a factor of 4).

“Among both adults and children, the incidence of injection-site reactions and symptoms (e.g., feverishness and headache) was higher in the week after receipt of the primary and second or booster vaccinations than after receipt of placebo but not at later time points,” the authors write. “These events were largely low-grade. At month 12, a total of 41% of adults (titer, 401 EU per milliliter) and 78% of children (titer, 828 EU per milliliter) had a response in the Ad26–MVA group; 76% (titer, 992 EU per milliliter) and 87% (titer, 1415 EU per milliliter), respectively, had a response in the rVSV group; 81% (titer, 1037 EU per milliliter) and 93% (titer, 1745 EU per milliliter), respectively, had a response in the rVSV–booster group; and 3% (titer, 93 EU per milliliter) and 4% (titer, 67 EU per milliliter), respectively, had a response in the placebo group (P<0.001 for all comparisons of vaccine with placebo). In both adults and children, antibody responses with vaccine differed from those with placebo beginning on day 14.”

Source: New England Journal of Medicine