TY - JOUR
T1 - Zika Vaccines
T2 - Role for Controlled Human Infection
AU - Durbin, Anna P.
AU - Whitehead, Stephen S.
N1 - Funding Information:
Financial support. This work was supported by a contract with the National Institutes of Allergy and Infectious Diseases Intramural Research Program, National Institutes of Health, NIH (contract HHSN272200900010C; to A. P. D.) and by the Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health (S. S. W. is a senior staff scientist).
Publisher Copyright:
© 2017 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Zika virus (ZIKV), a previously little known arbovirus, caused an unprecedented outbreak in Latin America and the Caribbean throughout 2015 and 2016. The virus has been associated with the congenital Zika syndrome (CZS), which can occur with maternal ZIKV infection during any trimester and can result from asymptomatic infection. There is concern that even low levels of viremia can result in CZS, meaning an effective vaccine will need to induce very high levels of protection. Controlled human infection models (CHIMs), in which subjects are infected with a pathogen of interest, have been used to down-select vaccine candidates and have provided efficacy data in support of vaccine licensure. A ZIKV CHIM could be instrumental in determining which of the many ZIKV vaccine candidates provides the highest degree of protection and should be advanced in clinical development. The development of a ZIKV CHIM is not without challenges. The ZIKV, unlike other flaviviruses, is sexually and mosquito-transmitted, and an increase in the incidence of Guillain-Barré syndrome was reported in some countries during the ZIKV outbreak. These obstacles can be overcome with thoughtful study design to ensure maximal risk mitigation. If successful, a ZIKV CHIM could de-risk and accelerate ZIKV vaccine development.
AB - Zika virus (ZIKV), a previously little known arbovirus, caused an unprecedented outbreak in Latin America and the Caribbean throughout 2015 and 2016. The virus has been associated with the congenital Zika syndrome (CZS), which can occur with maternal ZIKV infection during any trimester and can result from asymptomatic infection. There is concern that even low levels of viremia can result in CZS, meaning an effective vaccine will need to induce very high levels of protection. Controlled human infection models (CHIMs), in which subjects are infected with a pathogen of interest, have been used to down-select vaccine candidates and have provided efficacy data in support of vaccine licensure. A ZIKV CHIM could be instrumental in determining which of the many ZIKV vaccine candidates provides the highest degree of protection and should be advanced in clinical development. The development of a ZIKV CHIM is not without challenges. The ZIKV, unlike other flaviviruses, is sexually and mosquito-transmitted, and an increase in the incidence of Guillain-Barré syndrome was reported in some countries during the ZIKV outbreak. These obstacles can be overcome with thoughtful study design to ensure maximal risk mitigation. If successful, a ZIKV CHIM could de-risk and accelerate ZIKV vaccine development.
KW - Zika vaccines
KW - Zika virus
KW - controlled human infection model (CHIM)
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U2 - 10.1093/infdis/jix491
DO - 10.1093/infdis/jix491
M3 - Article
C2 - 29267920
AN - SCOPUS:85040222422
SN - 0022-1899
VL - 216
SP - S971-S975
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
ER -