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ABSTRACT: Background
Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based recombinant Newcastle disease virus vaccine expressing the spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It's being developed by public sector manufacturers in Thailand, Vietnam, and Brazil; herein are initial results from Thailand.Methods
This phase 1 stage of a randomised, dose-escalation, observer-blind, placebo-controlled, phase 1/2 trial was conducted at the Vaccine Trial Centre, Mahidol University (Bangkok). Healthy males and non-pregnant females, aged 18-59 years and negative for SARS-CoV-2 antibodies, were eligible. Participants were randomised to receive one of six treatments by intramuscular injection twice, 28 days apart: 1 µg, 1 µg+CpG1018 (a toll-like receptor 9 agonist), 3 µg, 3 µg+CpG1018, 10 µg, or placebo. Participants and personnel assessing outcomes were masked to treatment. The primary outcomes were solicited and spontaneously reported adverse events (AEs) during 7 and 28 days after each vaccination, respectively. Secondary outcomes were immunogenicity measures (anti-S IgG and pseudotyped virus neutralisation). An interim analysis assessed safety at day 57 in treatment-exposed individuals and immunogenicity through day 43 per protocol. ClinicalTrials.gov (NCT04764422).Findings
Between March 20 and April 23, 2021, 377 individuals were screened and 210 were enroled (35 per group); all received dose one; five missed dose two. The most common solicited AEs among vaccinees, all predominantly mild, were injection site pain (<63%), fatigue (<35%), headache (<32%), and myalgia (<32%). The proportion reporting a vaccine-related AE ranged from 5·7% to 17·1% among vaccine groups and was 2·9% in controls; there was no vaccine-related serious adverse event. The 10 µg formulation's immunogenicity ranked best, followed by 3 µg+CpG1018, 3 µg, 1 µg+CpG1018, and 1 µg formulations. On day 43, the geometric mean concentrations of 50% neutralising antibody ranged from 122·23 international units per mL (IU/mL; 1 µg, 95% confidence interval (CI) 86·40-172·91) to 474·35 IU/mL (10 µg, 95% CI 320·90-701·19), with 93·9% to 100% of vaccine groups attaining a ≥ 4-fold increase over baseline.Interpretation
NDV-HXP-S had an acceptable safety profile and potent immunogenicity. The 3 µg and 3 µg+CpG1018 formulations advanced to phase 2.Funding
National Vaccine Institute (Thailand), National Research Council (Thailand), Bill & Melinda Gates Foundation, National Institutes of Health (USA).
SUBMITTER: Pitisuttithum P
PROVIDER: S-EPMC8903824 | biostudies-literature | 2022 Mar
REPOSITORIES: biostudies-literature
Pitisuttithum Punnee P Luvira Viravarn V Lawpoolsri Saranath S Muangnoicharoen Sant S Kamolratanakul Supitcha S Sivakorn Chaisith C Narakorn Piengthong P Surichan Somchaiya S Prangpratanporn Sumalee S Puksuriwong Suttida S Lamola Steven S Mercer Laina D LD Raghunandan Rama R Sun Weina W Liu Yonghong Y Carreño Juan Manuel JM Scharf Rami R Phumratanaprapin Weerapong W Amanat Fatima F Gagnon Luc L Hsieh Ching-Lin CL Kaweepornpoj Ruangchai R Khan Sarwat S Lal Manjari M McCroskery Stephen S McLellan Jason J Mena Ignacio I Meseck Marcia M Phonrat Benjaluck B Sabmee Yupa Y Singchareon Ratsamikorn R Slamanig Stefan S Suthepakul Nava N Tcheou Johnstone J Thantamnu Narumon N Theerasurakarn Sompone S Tran Steven S Vilasmongkolchai Thanakrit T White Jessica A JA Bhardwaj Nina N Garcia-Sastre Adolfo A Palese Peter P Krammer Florian F Poopipatpol Kittisak K Wirachwong Ponthip P Hjorth Richard R Innis Bruce L BL
EClinicalMedicine 20220308
<h4>Background</h4>Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based recombinant Newcastle disease virus vaccine expressing the spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It's being developed by public sector manufacturers in Thailand, Vietnam, and Brazil; herein are initial results from Thailand.<h4>Methods</h4>This phase 1 stage of a randomised, dose- ...[more]