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Vaccine. 2013 Oct 17;31(44):5047-54. doi: 10.1016/j.vaccine.2013.08.088. Epub 2013 Sep 7.

Safety and immunogenicity of three tetravalent dengue vaccine formulations in healthy adults in the USA.

Author information

1
Sanofi Pasteur Inc., Route 611, Discovery Drive, Swiftwater, PA 18370-0187, USA. Electronic address: Gustavo.Dayan@sanofipasteur.com.

Abstract

BACKGROUND:

A candidate recombinant, live-attenuated, CYD tetravalent dengue vaccine (CYD-TDV) has recently demonstrated immunogenicity, efficacy and good tolerability. This study was performed to evaluate three CYD-TDV formulations in adults.

METHODS:

This was a randomized, double-blind, multicenter, phase II trial. The vaccine formulations were: CYD-TDV 5555 (≈5log10 tissue culture infectious dose 50% [TCID50] of serotypes 1-4); CYD-TDV 5553 (≈5log10 TCID50 of serotypes 1-3 and ≈3log10 TCID50 of serotype 4); and CYD-TDV 4444 (≈4log10 TCID50 of serotypes 1-4). Vaccinations were administered at 0, 6 and 12 months. Immunogenicity was assessed using the plaque reduction neutralization test.

RESULTS:

In total, 260 individuals were enrolled. The 5555 formulation elicited a superior serotype 4 response versus the 5553 formulation, with seropositivity rates of 89.7% and 58.3%, respectively, after the second dose (between-group difference 31.4%; 95% confidence interval 18.2-43.2). After each of the three doses, seropositivity rates for serotypes 1-3 were numerically highest with CYD-TDV 5553 and lowest with the 4444 formulation; seropositivity rates for serotype 4 were similar with the 5555 and 4444 formulations, and much lower among recipients of CYD-TDV 5553. Geometric mean titers followed the same pattern as that seen with seropositivity rates. Safety/reactogenicity results were similar for all three vaccine formulations, although the percentage of participants reporting solicited injection site reactions was lower with CYD-TDV 4444 than with the other two formulations. All serious adverse events were unrelated to vaccination.

CONCLUSIONS:

Reducing the dose of serotype 4 antigen (5553 formulation) creates an imbalance in the immune response to CYD-TDV. Immune responses to CYD-TDV 5555 were slightly higher than to the 4444 formulation. Development of CYD-TDV 5555 has subsequently been pursued.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00617344.

KEYWORDS:

CYD-TDV; Clinical trial; Dengue; Formulation; Immunogenicity; PRNT(50); RT-PCR; TCID(50); Vaccine; log(10)tissue culture infectious dose 50%; plaque reduction neutralization test; recombinant live-attenuated tetravalent dengue vaccine; reverse transcriptase-polymerase chain reaction

PMID:
24021313
DOI:
10.1016/j.vaccine.2013.08.088
[Indexed for MEDLINE]

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