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Chikungunya Vaccine Immunogenic and Safe in a Phase I Trial

Summary and Comment |
August 20, 2014

Chikungunya Vaccine Immunogenic and Safe in a Phase I Trial

  1. Mary E. Wilson, MD

In an open-label trial among adults, a viruslike particle–based chikungunya vaccine induced durable neutralizing antibodies and was well tolerated.

  1. Mary E. Wilson, MD

Chikungunya virus, endemic in Africa and Asia and transmitted via the bites of infected mosquitoes, has now spread into the Americas. No vaccine or specific therapy is currently available. A viruslike particle (VLP)-based chikungunya vaccine has been shown to elicit neutralizing antibodies and protect nonhuman primates from infection and illness. To assess immunogenicity and safety in humans, investigators conducted a phase I trial of a VLP chikungunya vaccine in healthy adults.

The vaccine was administered intramuscularly at weeks 0, 4, and 20 in three dosage groups (10 µg, n=5; 20 µg, n=10; and 20 µg, n=10). Twenty-three of the 25 participants received all three doses. Neutralizing antibodies were present in all participants 4 weeks after the second dose and were boosted after the third dose; no significant differences among the group mean titers were noted after the third dose. Antibodies were found against an outbreak strain (OPY1) as well as the vaccine strain (West African strain 37997) and persisted in participants in all groups 6 months after the third dose.

The vaccine was well tolerated. Seven mild-to-moderate adverse events occurred, including transient liver enzyme elevations and transient neutropenia.

Comment

The continued spread of chikungunya infections, which are sometimes followed by disabling polyarthralgia, lends urgency to the search for preventive or treatment options. This candidate vaccine appeared safe and immunogenic in a small phase I trial and produced durable neutralizing antibodies without adjuvants.

Although there are three genotypes of chikungunya virus, the response to the VLP vaccine suggests potential cross-protection against several strains.

The authors and an editorialist note the advantages of a vaccine that can be produced without the high-containment facilities required to manufacture many traditional vaccines. The authors note that the process for making VLPs is a platform technology that might be applicable to the production of other virus vaccines. The results of this small trial warrant larger studies.

  • Disclosures for Mary E. Wilson, MD at time of publication Editorial boards UptoDate; Clinical Infectious Diseases; RSTMH International Health; Infectious Diseases in Clinical Practice; Travel Medicine and Infectious Diseases

Citation(s):

Reader Comments (1)

GEORGE B HOWELL Physician, Family Medicine/General Practice, temporary LOA

Appears very promising and much needed.

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