Postexposure Prophylaxis With rVSV-ZEBOV Following Exposure to a Patient With Ebola Virus Disease Relapse in the United Kingdom: An Operational, Safety, and Immunogenicity Report.
Ebola virus
T cell
rVSV-ZEBOV
vaccine
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
31 12 2020
31 12 2020
Historique:
received:
19
07
2019
accepted:
28
11
2019
pubmed:
1
12
2019
medline:
29
4
2021
entrez:
1
12
2019
Statut:
ppublish
Résumé
In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the United Kingdom. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk. Approval for rapid expanded access to the recombinant vesicular stomatitis virus-Zaire Ebola virus (rVSV-ZEBOV) vaccine as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination. Twenty-six of 45 individuals elected to receive vaccination between 10 and 11 October 2015 following written informed consent. By day 14, 39% had seroconverted, increasing to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralizing antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia, and fever. These were positively associated with glycoprotein-specific T-cell but not immunoglobulin (Ig) M or IgG antibody responses. No severe vaccine-related adverse events were reported. No one exposed to the virus became infected. This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated, but a high percentage developed a fever ≥37.5°C, necessitating urgent screening for Ebola virus, and a small number developed persistent arthralgia.
Sections du résumé
BACKGROUND
In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the United Kingdom. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk.
METHODS
Approval for rapid expanded access to the recombinant vesicular stomatitis virus-Zaire Ebola virus (rVSV-ZEBOV) vaccine as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination.
RESULTS
Twenty-six of 45 individuals elected to receive vaccination between 10 and 11 October 2015 following written informed consent. By day 14, 39% had seroconverted, increasing to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralizing antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia, and fever. These were positively associated with glycoprotein-specific T-cell but not immunoglobulin (Ig) M or IgG antibody responses. No severe vaccine-related adverse events were reported. No one exposed to the virus became infected.
CONCLUSIONS
This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated, but a high percentage developed a fever ≥37.5°C, necessitating urgent screening for Ebola virus, and a small number developed persistent arthralgia.
Identifiants
pubmed: 31784751
pii: 5648103
doi: 10.1093/cid/ciz1165
pmc: PMC7778350
doi:
Substances chimiques
Antibodies, Viral
0
Ebola Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
2872-2879Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Medical Research Council
ID : MC_UU_12014/1
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 102789/Z/13/A
Pays : United Kingdom
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
Clin Infect Dis. 2015 Jun 1;60(11):1725-6
pubmed: 25694650
Vaccine. 2017 Aug 16;35(35 Pt A):4465-4469
pubmed: 28647166
J Infect Dis. 2019 Apr 19;219(10):1634-1641
pubmed: 30561672
Lancet Infect Dis. 2015 Nov;15(11):1300-4
pubmed: 26321189
EBioMedicine. 2017 May;19:107-118
pubmed: 28434944
Cell Rep. 2017 Aug 29;20(9):2251-2261
pubmed: 28854372
J Clin Microbiol. 2016 Jan;54(1):114-9
pubmed: 26537445
N Engl J Med. 2016 Apr 28;374(17):1635-46
pubmed: 25629663
Lancet. 2015 Aug 29;386(9996):857-66
pubmed: 26248676
Clin Infect Dis. 2016 Aug 1;63(3):376-9
pubmed: 27118786
J Infect Dis. 2016 Oct 15;214(suppl 3):S360-S366
pubmed: 27496978
Lancet Infect Dis. 2015 Oct;15(10):1156-1166
pubmed: 26248510
N Engl J Med. 2017 Oct 12;377(15):1438-1447
pubmed: 29020589
JAMA. 2015 Mar 24-31;313(12):1249-55
pubmed: 25742465
Science. 2015 Aug 14;349(6249):739-42
pubmed: 26249231
PLoS Pathog. 2007 Jan;3(1):e2
pubmed: 17238284
Lancet. 2017 Feb 4;389(10068):505-518
pubmed: 28017403
Lancet Infect Dis. 2018 Jul;18(7):738-748
pubmed: 29627147
J Infect Dis. 2011 Nov;204 Suppl 3:S785-90
pubmed: 21987751
N Engl J Med. 2016 Apr 28;374(17):1647-60
pubmed: 25830326
Proc Natl Acad Sci U S A. 2013 Jan 29;110(5):1893-8
pubmed: 23319647
Med Microbiol Immunol. 2016 Apr;205(2):173-83
pubmed: 26475282
J Infect Dis. 2015 Oct 1;212 Suppl 2:S443-51
pubmed: 26109675
Euro Surveill. 2014 Oct 09;19(40):20920
pubmed: 25323076
Lancet Infect Dis. 2018 Jun;18(6):e183-e192
pubmed: 29153266
Lancet. 2016 Jul 30;388(10043):498-503
pubmed: 27209148
Nat Med. 2005 Jul;11(7):786-90
pubmed: 15937495
N Engl J Med. 2017 Jan 26;376(4):330-341
pubmed: 25830322